Ifosfamide Side Effects

Medically reviewed by Drugs.com. Last updated on Jan 14, 2023.

Summary

Commonly reported side effects of ifosfamide include: central nervous system toxicity, confusion, drowsiness, and hallucination. Continue reading for a comprehensive list of adverse effects.

Applies to ifosfamide: intravenous powder for solution, intravenous solution.

Warning

Intravenous route (Powder for Solution)

Myelosuppression can be severe and lead to fatal infections. Monitor blood counts prior to and at intervals after each treatment cycle. CNS toxicities can be severe and result in encephalopathy and death. Monitor for CNS toxicity and discontinue treatment for encephalopathy. Nephrotoxicity can be severe and result in renal failure. Hemorrhagic cystitis can be severe and can be reduced by the prophylactic use of mesna.

Serious side effects of Ifosfamide

Along with its needed effects, ifosfamide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking ifosfamide:

More common

Agitation
black, tarry stools
blood in the urine
chest pain
confusion
cough or hoarseness
fever or chills
frequent urination
hallucinations (seeing, hearing, or feeling things that are not there)
lower back or side pain
painful or difficult urination
pale skin
shortness of breath
sore throat
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness

Less common

Abdominal or stomach pain or tenderness
bleeding gums
bluish color
changes in skin color
clay colored stools
dark urine
decreased appetite
dizziness
headache
itching
loss of appetite
nausea and vomiting
pain
pinpoint red spots on the skin
skin rash
swelling of the feet or lower legs
yellow eyes or skin

Rare

Blurred vision
burning, numbness, tingling, or painful sensations
confusion
convulsions (seizures)
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast or irregular heartbeat
sweating
troubled breathing
unsteadiness or awkwardness
weakness in the arms, hands, legs, or feet

Other side effects of Ifosfamide

Some side effects of ifosfamide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea
hair loss or thinning of the hair
swelling or inflammation of the mouth

Less common

Redness, swelling, or pain at place of injection
weight loss

For Healthcare Professionals

Applies to ifosfamide: intravenous powder for injection, intravenous solution.

Genitourinary

Very common (10% or more): Hemorrhagic cystitis, hematuria, dysuria, urinary frequency, urinary incontinence, urinary retention

Frequency not reported: Infertility, ovarian failure, premature menopause, amenorrhea, ovulation disorder, azoospermia, oligospermia^[Ref]

Renal

Very common (10% or more): Renal dysfunction, acute renal failure

Frequency not reported: Acute renal failure, chronic renal failure, aminoaciduria, phosphaturia, Fanconi syndrome, tubulointerstitial nephritis, renal structural damage, nephrogenic diabetes insipidus, polyuria, enuresis, feeling of residual urine^[Ref]

Hematologic

Very common (10% or more): Leukopenia (44%), anemia (38%)

Common (1% to 10%): Thrombocytopenia

Frequency not reported: Agranulocytosis, hemolytic anemia, methemoglobinemia, febrile bone marrow aplasia, disseminated intravascular coagulation, hemolytic uremic syndrome, neonatal anemia^[Ref]

Gastrointestinal

Very common (10% or more): Nausea/vomiting (47%)

Uncommon (0.1% to 1%): Diarrhea, stomatitis

Frequency not reported: Enterocolitis, pancreatitis, ileus, GI hemorrhage, mucosal ulceration, constipation, abdominal pain, salivary hypersecretion^[Ref]

Nervous system

Very common (10% or more): CNS toxicity (e.g., abnormal behavior, affect lability aggression, agitation, anxiety, aphasia, asthenia, ataxia, cerebellar syndrome, cerebral function deficiency, cognitive disorder, coma, confusional state, convulsions, cranial nerve dysfunction, depressed state of consciousness, depression, disorientation, dizziness, electroencephalogram abnormal, encephalopathy, flat affect. hallucinations, headache, ideation, lethargy, memory impairment, mood change, motor dysfunction, muscle spasms, myoclonus, progressive loss of brainstem reflexes, psychotic reaction, restlessness, somnolence, tremor, urinary incontinence) (15%)

Uncommon (0.1% to 1%): Peripheral neuropathy^[Ref]

Dermatologic

Very common (10% or more): Alopecia

Rare (0.01% to 0.1%): Dermatitis, papular rash

Frequency not reported: Angioedema, urticaria, toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, palmar-plantar erythrodysesthesia syndrome, radiation recall dermatitis, skin necrosis, facial swelling, rash, pruritus, erythema, skin hyperpigmentation, hyperhidrosis, nail disorder^[Ref]

Hepatic

Common (1% to 10%): Hepatotoxicity (increases in liver enzymes, i.e., serum alanine aminotransferase, serum aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltransferase and lactate dehydrogenase), increased bilirubin, jaundice, hepatorenal syndrome

Frequency not reported: Hepatic failure, veno-occlusive liver disease, portal vein thrombosis, cytolytic hepatitis^[Ref]

Respiratory

Frequency not reported: Respiratory failure, acute respiratory distress syndrome, pulmonary hypertension, interstitial lung disease (as manifested by pulmonary fibrosis), pneumonitis, pulmonary edema, pleural effusion, dyspnea, hypoxia, cough^[Ref]

Hypersensitivity

Frequency not reported: Hypersensitivity, anaphylactic reaction^[Ref]

Cardiovascular

Uncommon (0.1% to 1%): Cardiotoxicity (e.g., congestive heart failure, tachycardia, pulmonary edema), hypotension

Frequency not reported: Arrythmia (including supraventricular and ventricular arrhythmia), atrial fibrillation, premature atrial contractions, bradycardia, cardiac arrest, myocardial infarction, cardiac failure, myocardial hemorrhage, angina pectoris, cardiomyopathy (including congestive cardiomyopathy), electrocardiogram ST-segment abnormal, electrocardiogram T-wave inversion, electrocardiogram QRS complex abnormal^[Ref]

Endocrine

Frequency not reported: Syndrome of inappropriate antidiuretic hormone secretion (SIADH)^[Ref]

Immunologic

Very common (10% or more): Infection (10%)

Frequency not reported: Sepsis, septic shock, immunosuppression^[Ref]

Local

Frequency not reported: Injection/infusion site reactions^[Ref]

Musculoskeletal

Frequency not reported: Rhabdomyolysis, osteomalacia, rickets, growth retardation, myalgia, arthralgia, muscle twitching^[Ref]

Ocular

Frequency not reported: Visual impairment, conjunctivitis, eye irritation^[Ref]

Metabolic

Common (1% to 10%): Anorexia

Frequency not reported: Tumor lysis syndrome, metabolic acidosis, hypokalemia, hypocalcemia, hypophosphatemia, hyperglycemia, polydipsia^[Ref]

Psychiatric

Frequency not reported: Mutism, mental status change (e.g., mania, paranoia, delusion, delirium, catatonia, amnesia, panic attack), echolalia, perseveration^[Ref]

Oncologic

Frequency not reported: Secondary malignancies, myelodysplastic alterations, acute leukemia, lymphoma, thyroid cancer, sarcomas^[Ref]

Other

Frequency not reported: Secondary tumors (e.g., urinary tract carcinoma, myelodysplastic syndrome, acute leukemia, acute lymphocytic leukemia, lymphoma [Non-Hodgkin's lymphoma], sarcomas, renal cell carcinoma, thyroid cancer), progressions of underlying malignancies, deafness tinnitus, vertigo, fetal growth retardation, phlebitis, fatigue, malaise, multiorgan failure, general physical deterioration, edema, pain, pyrexia, chills^[Ref]