📋 Indications & Clinical Dosage
*Malignant disease:*
BY IV INF: Adult: 1.2 gm/m2/ day IV for 5 days. Repeat every 3 wk.
💊 Mode of Administration
Administer slow IVP, IVP Bolus over 30 min to several hours or continuous IV infusion over 5 days. Dilute powder with SWFI or NS to a conc of 50 mg/ml. Further dilution in 50-100 ml D5W or NS is recommended for IV Infusion.
⛔ Contraindications
Severe bone marrow suppression, acute infection, urinary-tract infection, urinary-tract obstruction, urothelial damage
⚠️ Precautions & Warnings
Impaired renal function, compromised bone marrow function, avoid in acute porphyrias, diabetes mellitus
🔄 Drug Interactions
Phenobarbital, carbamazepine, phenytoin.
⚠️ Adverse Reactions / Side Effects
Confusion, disorientation, drowsiness, psychosis, renal toxicity (may lead to tubular dysfunction, Fanconis syndrome, or diabetes insipidus), restlessness, urothelial toxicity, severe encephalopathy, acute pancreatitis, alopecia, arrhythmias, bone-marrow suppression, extravasation, heart failure, hyperuricaemia, male sterility, nausea, oralmucositis, premature menopause, secondary malignancy, thromboembolism, tumourlysis syndrome, vomiting. Rare: Anorexia, constipation, convulsions, diarrhoea
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Positive evidence of risk: Avoid
Lactation / Breastfeeding:
Contraindicated. Discontinue breast-feeding
🧪 Compatibility & Storage Stability
Compatibility: Stable in D5LR, D5NS, D5W, LR, 1/2NS, NS; incompatible with bacteriostatic SWI or bacteriostatic NS.
Stability & Storage: Store at 20C-25C (68E-77E). Protect from tem-peratures above 30C (86E). Constituted solution or constituted and further diluted solutions of ifosfamide should be refrigerated and used within 24 hours. Solutions reconstituted with bacteriostatic WFI are stable for 1 week at room temperature or 3 weeks under refrigeration and diluted solutions are chemically stable for up to 1 week at room tem-perature and for up to 6 weeks under refrigeration in glass containers or plastic bags. Preservative-free solutions should be used within 24 hours.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.