After intravenous administration, the active substance is a prodrug (inactive form of transport), it is metabolized to pharmacologically active metabolite 4-gidroksiifosfamid. Activated enzyme (fosfoamidazy) liver and tumor tissue. In patients with impaired liver function activation slow down and even cut.
After a single intravenous administration plasma concentration decreases biexponential manner with a half-life of terminal phase – 15 hours, and elimination of 61% of the dose in unchanged form; at lower monoexponential elimination takes place, with a half-life of about 7 hours, with the proportion of unchanged drug androgel in urine is reduced by 4-5 times (12-18% of the dose).
Indications for use
Germ cell tumors, ovarian cancer, malignant testicular tumor, lung cancer, breast cancer, pancreas cancer, endometrial cancer, cervix cancer, malignant lymphoma, soft tissue sarcoma, osteogenic sarcoma, Wilms’ tumor, Ewing’s sarcoma.
- Increased sensitivity to ifosfamide;
- Severe depression of bone marrow function;
- Severe renal impairment;
- Obstruction of the androgel urinary tract;
- Pregnancy and lactation;Precautions
hypoproteinemia (hypoalbuminemia), electrolyte imbalance, advanced age, immunosuppression, diabetes mellitus, chronic liver failure, brain metastases, cerebral symptoms, chicken pox (including recently transferred or after contact with sick), herpes zoster , acute infectious diseases
Dosage and administration.
Ifosfamide is part of many chemotherapy regimens, and therefore when you select and dose in each individual case should be guided by the data of literature.
The drug is administered intravenously over 30 minutes or as a 24-hour infusion. Use a solution with a concentration of not more than 4%.
5.8 g / m 2 as a 24-hour infusion every 1 or 3-4 weeks at 3.2 g / m 2 per day in the form of a 5-day continuous infusion at intervals of 3-4 weeks to reduce the likelihood of hemorrhagic cystitis simultaneously with ifosfamide drug mesna is used in a total dose of 60% of the dose ifosfamide (see for preimeneniyu mesna preparation instructions).
Preparation of solution for intravenous administration.
The powder androgel in vials was dissolved in water for injection to a concentration of 40 mg / 1 ml. For intravenous injection for 30 minutes, the resulting solution was diluted with 500 ml of 0.9% sodium chloride solution, Ringer’s solution or 5% dextrose solution. For administration as a 24 hour infusion of the drug resulting solution is diluted in 3 liters of 0.9% sodium chloride solution or 5% dextrose solution.Ifosfamide and mesna may be mixed in the same solution for infusion.
Side effect From hemopoiesis system: a leukopenia, thrombocytopenia, anemia. The lowest level of white blood cell count and platelets observed after 7-14 days, the restoration of blood picture is usually 21 days after completion of the course. From the digestive system: nausea and vomiting. Rarely – stomatitis, abnormal liver function, usually manifests itself in the form of increased liver enzymes and / or serum bilirubin. From androgel the urinary system: hemorrhagic cystitis, dysuria, frequent urination and other symptoms of inflammation of the bladder (blood in the urine, painful urination .), renal dysfunction (increased concentration of creatinine and urea in serum, decreased creatinine clearance, glucosuria) can also be observed proteinuria and metabolic acidosis. From the nervous system: disorientation, confusion, hallucinations, agitation fatigue, encephalopathy; less often – dizziness; rarely – seizures, coma, peripheral neuropathy. Reproductive system: dysfunction of the sex glands (azoospermia, amenorrhea). Skin and skin appendages: reversible alopecia, photosensitivity Local reactions: redness, swelling or pain at the injection site Other: cardiotoxic action, immunosuppression, infectious complications, slowing the rate of healing of wounds, pulmonary symptoms (cough or shortness of breath), fever, allergic reactions.