Ifosfamide Dosage

Usual Adult Dose for Testicular Cancer

For third line chemotherapy of germ cell testicular cancer:

1.2 g/m2, diluted to 50 mg/mL IV over 30 minutes once a day with mesna (intravenous, oral, or continuous intravenous infusion) just before and 4 and 8 hours after each dose and aggressive (usually IV) hydration (2 to 4 L/day).

Ifosfamide is usually given for 5 days, with 5 day regimens repeated every 3 to 4 weeks, and after recovery from hematologic toxicity.

Usual Adult Dose for Cervical Cancer

(In combination with other chemotherapeutic agents as a part of the BIP regimen)
5,000 mg/m2 IV over 24 hours on day 2
Cycle repeated every 21 days

(In combination with other chemotherapeutic agents as a part of the BIC regimen)
2,000 mg/m2 IV on days 1 through 3
Cycle repeated every 21 days

Usual Pediatric Dose for Malignant Disease

1200 to 1800 mg/m2/day for 3 to 5 days every 21 to 28 days

or

5000 mg/m2 as a single 24 hour infusion

or

3 g/m2/day for 2 days

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

The recommended dose of ifosfamide may depend on whether other cytotoxic agents are coadministered. For adults, many experts recommend total daily doses as high as 5 g/m2 or total doses over 4 days of 8 to 18 g/m2. Reference to specific protocols is recommended.

Precautions

Use with caution in patients with renal or hepatic impairment. Unless clinically essential, initial or repeat doses should not be given to patients with a white blood cell count less than 1500 to 2000/mm3 and/or a platelet count less than 50,000/mm3. Because of the common occurrence of hemorrhagic cystitis associated with the use of ifosfamide, checking the urine for blood (dipstick) or urinalysis prior to each dose, vigorous hydration and monitoring for adequate urine output, frequent bladder voiding, concomitant use of a prophylactic agent (such as mesna, 2-mercaptoetjene sulfonate), and close monitoring of serum and urine chemistries (including phosphorus, potassium, and alkaline phosphatase) are strongly recommended. Ifosfamide should be discontinued if neurologic symptoms of somnolence, irritability, anxiety, confusion, hallucinations, or coma are observed.

Dialysis

Data not available