Ifosfamide Side Effects

Medically reviewed by Drugs.com. Last updated on Sep 8, 2024.

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

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. Women should not become pregnant during therapy and men should not father a child while receiving this medicine and for 6 months after stopping it. If you think you have become pregnant while using the medicine, tell your doctor right away.

While you are being treated with ifosfamide, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Ifosfamide may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your house should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the past several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Ifosfamide can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. This may also cause delay in wound healing. If this occurs, there are certain precautions you can take to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or have painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

This medicine may cause a brain disease called encephalopathy. Tell your doctor right away if you have the following symptoms while taking this medicine: agitation, back pain, blurred vision, coma, confusion, dizziness, drowsiness, fever, hallucinations, headache, irritability, mood or mental changes, seizures, stiff neck, or unusual tiredness or weakness.

This medicine may cause drowsiness, trouble in thinking, trouble in controlling movements, or trouble in seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are using this medicine.

This medicine may cause children to grow more slowly than usual. Talk to your child's doctor if you have any concerns.

Using this medicine may increase your risk of getting lymphoma (cancer of the lymph nodes) and other types of cancers (such as leukemia, sarcoma, thyroid cancer). Talk to your doctor if you have concerns about this risk.

If you plan to have children, talk with your doctor before using this medicine. Some men and women using this medicine have become infertile (unable to have children).

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine without asking your doctor first.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (e.g., St. John's wort) or vitamin supplements.

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:

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:

For healthcare professionals

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

Genitourinary adverse events

• 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]

See also:

Further information

Ifosfamide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer