An alkylating chemotherapy medicine
Ifosfamide
A chemotherapy medicine given by drip in hospital to treat certain cancers.
What is Ifosfamide?
Ifosfamide is a specialist chemotherapy medicine, an alkylating agent, used to treat certain cancers. It is given by drip into a vein in hospital, under the care of a cancer team. It has several important toxic effects: it can damage and irritate the bladder, causing bleeding (haemorrhagic cystitis), so it is always given with a protective medicine called mesna and plenty of fluids; it can affect the brain, causing confusion and drowsiness (encephalopathy); it lowers the blood cells made in the bone marrow; and it can affect the kidneys. It is only used under specialist cancer care with close monitoring.
Education and reference only. This is a plain-language guide to Ifosfamide — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Ifosfamide is a chemotherapy medicine of a type called alkylating agents, which work by damaging the DNA of cancer cells so they cannot keep growing and dividing. It is used to treat a number of different cancers and is given as a drip into a vein in hospital, as part of cancer treatment overseen by a specialist team. Because it has several significant toxic effects, it is always given with careful precautions, including a protective medicine and extra fluids, and with close monitoring of the blood, kidneys and brain. It is a specialist hospital medicine, not something taken at home.
How it works
Ifosfamide works by damaging the DNA inside cells so they can no longer divide, which is how it kills or slows cancer cells. Because it acts on dividing cells in general, it also affects healthy fast-dividing cells, such as those in the bone marrow and the lining of the bladder, which explains many of its side effects. As the body breaks it down, it produces substances that can irritate and damage the bladder, which is why a protective medicine (mesna) and plenty of fluids are given alongside it. The same broad action on the body underlies its effects on blood counts, the kidneys and, sometimes, the brain.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist chemotherapy medicine given in hospital, by drip, to treat certain cancers, always under cancer-care supervision.
Practical use
How to take Ifosfamide
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as a drip into a vein in hospital by your cancer-care team, not taken at home.
- It is always given with a protective medicine called mesna and plenty of fluids to protect the bladder.
- Drink fluids as advised and pass urine regularly to help protect the bladder during and after treatment.
- Report blood in the urine, confusion, drowsiness, fever or unusual bleeding or bruising to your team straight away.
- Attend all your blood tests and appointments so the team can monitor your blood counts, kidneys and overall health.
Weighing it up
Advantages & disadvantages of Ifosfamide
Advantages
- An established chemotherapy medicine effective against a number of cancers.
- Given as part of carefully planned cancer treatment under specialist supervision.
- The bladder-protecting medicine mesna and extra fluids reduce the risk of bladder damage.
Disadvantages
- Can irritate and damage the bladder and cause bleeding, needing mesna and plenty of fluids.
- Can affect the brain, causing confusion or drowsiness (encephalopathy).
- Lowers blood counts, raising the risk of infection, bleeding and anaemia, and can affect the kidneys.
Practical use
Good to know
Ifosfamide is a powerful chemotherapy medicine with several important toxic effects that the cancer team watches for closely. A key one is bladder toxicity: it can irritate and damage the bladder and cause bleeding (haemorrhagic cystitis), so it is always given together with a protective medicine called mesna and plenty of fluids to flush the bladder. It can also affect the brain, causing confusion, drowsiness or other changes (encephalopathy), which the team monitors for and which usually settles after treatment. Like most chemotherapy, it lowers the blood cells made in the bone marrow, raising the risk of infection, bleeding and anaemia, and it can affect the kidneys. Because of all this, it is given only in hospital with careful monitoring, and any symptoms such as blood in the urine, confusion, fever or unusual bleeding should be reported straight away.
Who should not take it / use with caution
- People who have had a serious allergic reaction to ifosfamide should not receive it.
- It is used with great care, or avoided, in people with poor kidney function or existing bladder problems, guided by the cancer team.
- It is used with care in people with reduced bone-marrow function, and its use in pregnancy is decided by specialists weighing the risks.
Monitoring
- Regular blood tests to check blood counts, kidney and liver function.
- Watching for blood in the urine and signs of bladder irritation.
- Watching for confusion or drowsiness that could signal brain effects.
Side effects
- A drop in blood cells, raising the risk of infection, bleeding and anaemia.
- Bladder irritation and bleeding (haemorrhagic cystitis), which mesna and fluids help prevent.
- Confusion, drowsiness or other brain effects (encephalopathy), and effects on the kidneys.
- Nausea, vomiting and hair loss, as with many chemotherapy medicines.
Key interactions
- Other medicines that affect the kidneys or bone marrow can add to ifosfamide's effects, so the team reviews them.
- Some medicines can affect how ifosfamide is broken down in the body, which the team takes into account.
- Always tell the cancer team about all medicines, including those bought over the counter and herbal products.
Available as: A powder made up into a solution and given as a drip into a vein in hospital.
Answers
Ifosfamide: frequently asked questions
What is ifosfamide used for?
It is a chemotherapy medicine, an alkylating agent, used to treat certain cancers, given as a drip into a vein in hospital under specialist cancer care.
Why is it given with mesna?
Ifosfamide can irritate and damage the bladder and cause bleeding, so mesna and plenty of fluids are given to protect the bladder.
Can it affect my thinking?
Yes, it can sometimes cause confusion or drowsiness (encephalopathy); this is monitored for and usually settles after treatment, but report it straight away.
Why do I need regular blood tests?
Like most chemotherapy, it lowers the blood cells made in the bone marrow, so blood tests check your counts and your kidney function.
What should I report urgently?
Tell your team straight away about blood in the urine, confusion, drowsiness, fever, or unusual bleeding or bruising.
The wider class
About Alkylating chemotherapy
Ifosfamide belongs to the alkylating chemotherapy class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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