Ifosfamide

Ifosfamide is a chemotherapy medicine used to treat certain types of cancer. This page from Great Ormond Street Hospital (GOSH) explains what ifosfamide is, how it is given and some of the possible side effects. Ifosfamide is given into a vein (intravenously or IV) through a cannula, central venous catheter or implantable port with extra IV fluids.

Anti-sickness drugs can be given to reduce or prevent these symptoms. Please tell your doctor or nurse if your child’s sickness is very bad or continues for more than a few days.

Your child may lose some or all of their hair, or it may become thinner. This is temporary and the hair will grow back once the treatment is finished.

There will be a temporary reduction in how well your child’s bone marrow works. This means they may become anaemic (reduced red blood cells), bruise or bleed more easily than usual, and have a higher risk of infection.

Your child’s blood counts will be checked regularly to see how the bone marrow is working. Please tell your doctor if your child seems unusually tired, has bruising, bleeding, or any signs of infection, especially a high temperature.

Depending on the combination of medicines and the dose that your child is given, his or her fertility may be affected. If you feel you would like more information, please discuss this with your doctor.

Ifosfamide can cause irritation of the bladder wall. Your child will be given a drug called mesna and intravenous fluids to reduce or stop this irritation. They will also be encouraged to drink lots of fluids. Your child’s urine will be tested for blood while they are receiving ifosfamide.

Ifosfamide may change how well your child’s kidneys work, over a period of time. Your child may have a blood and urine test (TRP) or a GFR (Glomerular Filtration Rate) before treatment is started and then at stages during and after treatment to monitor kidney function.

There have been rare reports of children becoming disorientated while receiving ifosfamide. Your child will be closely observed. Subsequent drug therapy may be changed if your child experiences this side effect. If you feel you would like more information, please discuss this with your doctor.

If your child is given ifosfamide for a long time, there is a very small risk of them developing a second cancer after many years. If you feel you would like more information, please discuss this with your doctor.

Ifosfamide may cause the kidneys to retain water leading to the dilution of the salts in the body. This is known as SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone). Rarely, this may lead to drowsiness, weakness or fits. If you feel you would like more information, please discuss this with your doctor.

Some medicines can react with ifosfamide, altering how well it works. Always check with your doctor or pharmacist before giving your child any other medicine, including medicines on prescription from your family doctor (GP), medicines bought from a pharmacy (chemist) or any herbal or complementary medicines.

If ifosfamide leaks into the tissues underneath your child’s skin, it can damage the tissue in this area. This is called extravasation.

• If given through a cannula and your child complains of stinging and burning around the cannula, please tell your doctor or nurse immediately.
• If given through a central venous catheter or implantable port and your child complains of pain around their chest or neck, please tell your doctor or nurse immediately.