Ifosfamid

When ATH:
L01AA06

Characteristic.

The white crystalline powder, water-soluble.

Pharmacological action.
Antitumor, cytostatic, alkylating.

Application.

Inoperable malignancy: lung cancer, ovarian cancer, testicular cancer, mammary cancer, cervical cancer, pancreatic cancer, soft tissue sarcoma, kidney cancer, bladder cancer, endometrial cancer, malignant lymphoma, sarkoma Juinga; опухоли у детей — саркома, Wilms' tumor, sympathicoblastoma, germ cell tumors, malignant lymphoma.

Contraindications.

Hypersensitivity, severe bone marrow hypoplasia, expressed by the human kidney.

Restrictions apply.

Inhibition of bone marrow function (especially in patients, previously treated with radiation or chemotherapy), impairment of renal function, cystitis, urinary tract obstruction, only kidney tumor, acute infectious diseases (incl. enable vetryanaya, shingles), hypoproteinemia, abnormal liver function, advanced age (more likely to age renal dysfunction), debilitated patients.

Pregnancy and breast-feeding.

When pregnancy is possible only for health reasons (possible mutagenic, teratogenic and carcinogenic effects). In the I trimester is absolutely necessary counseling on abortion. After I trimester of pregnancy, if therapy can not be delayed and the patient does not want an abortion, chemotherapy can be used, warning the patient about the potential hazard to the fetus.

Category actions result in FDA - D. (There is evidence of the risk of adverse effects of drugs on the human fetus, obtained in research or practice, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk, if the drug is needed in life-threatening situations or severe disease, when safer agents should not be used or are ineffective.)

At the time of treatment should stop breastfeeding (It passes into breast milk, the possibility of severe side effects in a child).

Side effects.

From the nervous system and sensory organs: encephalopathy, disorientation, confusion, hallucinations, unusual tiredness, dizziness, seizures, coma, polyneuropathy.

Cardio-vascular system and blood (hematopoiesis, hemostasis): inhibition of bone marrow hematopoiesis to change the cells of peripheral blood (leukopenia, thrombocytopenia, anemia).

From the digestive tract: nausea, vomiting, abnormal liver function (increase in liver enzymes and / or bilirubin levels in the blood serum), stomatitis.

With the genitourinary system: hemorrhagic cystitis (частое и/или болезненное мочеиспускание, blood in urine), dizurija, nephropathy, impairment of renal function (increased levels of creatinine and urea in the blood plasma, a decrease in creatinine clearance, proteinuria), increased release of glucose, phosphate excretion, metabolic acidosis.

For the skin: obratimaya alopecia.

Other: violation of oogenesis and spermatogenesis, pulmonary symptoms (cough, breathlessness), fever, allergic reactions, cardiotoxicity, decreased immunity, Local reactions (redness, puffiness, pain at the injection site).

Cooperation.

Local snizhaet nefrotoksichnostь ifosfamide. Compatible with other anti-cancer agents. Cisplatin (a preliminary or simultaneous reception) may increase the toxic effects of ifosfamide. In an application with drugs, causing myelosuppression and nephrotoxicity, may increase the side effects. When combined with the previous application or inducers of microsomal liver enzymes (phenobarbital, phenytoin, khloralgidrat) may increase the formation of alkylating metabolites. Increases hypoglycemic effect of antidiabetic agents. Allopurinol increases myelosuppression. The introduction of the vaccine with the simultaneous use of immunosuppressive drugs ifosfamide and reduces the effectiveness of a vaccine. Simultaneous treatment with warfarin can lead to a significant deterioration of blood clotting and increase the risk of bleeding. Ifosfamide may enhance skin reactions to radiation.

Overdose.

Symptoms: rapid development and pronounced main side effects.

Treatment: symptomatic, with mandatory use of mesna (Uromiteksana).

Dosing and Administration.

B / drip during 30 мин или 24-часовой инфузии. Selecting doses and in each case is determined individually, depending on the regimen (ifosfamide is part of many chemotherapy regimens).

Precautions.

Ifosfamide therapy should be combined with taking mesna (Uromiteksan) to prevent the effects urotoksicheskih.

During treatment and for 3 months after the end of men and women of childbearing age should use reliable methods of contraception. Required control cells of peripheral blood, liver and kidney function. There should be no prior chemotherapy 3 months after nephrectomy, Special care is required when treating only kidney tumors. Before treatment is necessary to restore the flow of urine, sanitize the centers of a chronic infection, correct water and electrolyte metabolism. In the case of cystitis with macro- or the use of ifosfamide microhematuria must stop before the normalization of.

Patients with a weakened immune system, diabetes, chronic liver disease require special attention. Special kontol required in patients with brain metastases, cerebral symptoms and / or compromised renal function.

Unrecognized and / or time Untreated renal dysfunction may (especially in children) develop into a picture of Fanconi syndrome.

Cooperation