Uses of Xifox 2: - Pancreatic cancer - Ovarian cancer - Breast cancer - Non-small cell lung cancer - Testicular cancer - Blood cancer Breast cancer, Lung cancer, Ovarian cancer, Lymphoma, Testicular cancer, Soft tissue sarcoma, Osteogenic sarcoma, Cervical cancer Hypersensitivity; severe bone-marrow depression. Pregnancy, lactation.

Cytotoxic Chemotherapy

Ifosfamide is converted to its active metabolites via hepatic microsomal enzymes. These active metabolites act as alkylating agents, disrupting DNA and protein synthesis of the target cells. It is routinely given with mesna to reduce urothelial toxicity.

How to use Ifosfamide: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: IV Administration Slow IV infusion over 30 min, or continuous infusion over 5 d Mesna should be administered concomitantly (20% of the ifosfamide dose 15 min before, 4 hr after, & 8 hr after ifosfamide administration) Adequate hydration (at least 2 L/day) before & for 72 hr after therapy is recommended to minimize risk of hemorrhagic cystitis Reconstitution: Add 20 ml of sterile water for inj or sterile bacteriostatic water for inj containing benzyl alcohol or parabens for each 1 g of the drug to produce solutions of 50 mg/ml. Adult Dose: Intravenous Germ cell testicular carcinoma Adult: 1.2 g/m2/day for 5 days via slow infusion over at least 30 minutes, repeat treatment every 3 wk or after recovery from haematological toxicity. To be given with mesna and adequate hydration of at least 2 L of oral or IV fluid per day. Lymphoma; Sarcoma; Solid tumours Adult: Different licensed dosage regimens are available. Regimen 1: 8-12 g/m2 divided over 3-5 days, repeat course every 2-4 wk. Regimen 2: 6 g/m2 divided over 5 days, repeat course every 3 wk. Regimen 3: 5-6 g/m2 (max: 10 g), give as a single 24-hr infusion, repeat course every 3-4 wkly. Child Dose: Safety and efficacy not established Renal Dose: Renal impairment: CrCl (ml/min) <10 Administer 75% of dose.

Causes enhanced toxicity with allopurinol, cisplatin. Ifosfamide enhances the anticoagulant effect of warfarin. CYP2A6 inducers (e.g. amobarbital, pentobarbital, phenobarbital, rifampin and secobarbital) may reduce serum levels of ifosfamide while the inhibitors (e.g. isoniazid, methoxsalen and miconazole) may increase its serum levels. CYP3A4 inducers (e.g. aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins) may reduce serum levels of ifosfamide while the inhibitors (e.g. azole antifungals, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid) may increase its serum levels.

Hypersensitivity; severe bone-marrow depression. Pregnancy, lactation.

Common - Nausea - Vomiting - Anemia (low number of red blood cells) - Hair loss - Decreased white blood cell count - Infection - Blood in urine - CNS toxicity >10% Alopecia (83%),Nausea (58%),Vomiting (58%),Leukopenia (50%),Hematuria (46%),Metabolic acidosis (31%),Thrombocytopenia (20%),CNS toxicity (12%),Neurotoxicity (10-20%) 1-10% Infection (8%),Nephrotoxicity (6%) Potentially Fatal: Severe myelosuppression, haemorrhagic cystitis, nephrotoxicity, cardiotoxicity, coma.

Category D: There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Precaution: Hepatic or renal dysfunction, compromised bone marrow reserve. Use with mesna and ensure high oral/IV fluid intake to reduce urotoxic effects. Lactation: excreted in breast milk, do not nurse

Store at 20-25° C.

Cytotoxic Chemotherapy

Ifosfamide is converted to its active metabolites via hepatic microsomal enzymes. These active metabolites act as alkylating agents, disrupting DNA and protein synthesis of the target cells. It is routinely given with mesna to reduce urothelial toxicity.

Category D: There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).