Ifosfamide, Injection

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KEY POINTS

• This medicine is given by IV to treat testicle cancer and other types of cancer.
• You may get infections more easily when you are taking this medicine.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: ifosfamide, injection; Ifex

What is this medicine used for?

This medicine is given by IV infusion (slow drip through a needle into a large vein) to treat cancer of the testicles. It is usually given with other medicines. This medicine may also be used to treat other types of cancer.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Bone marrow problems
• Chemotherapy
• Heart problems
• Kidney problems
• Radiation therapy to the bladder

Females of childbearing age: This medicine is usually not given during pregnancy because it can harm the baby. Do not become pregnant during treatment. Contact your healthcare provider right away if you become pregnant while you are receiving these injections. Do not breast-feed during this treatment.

How do I use it?

This is a very strong medicine. Only healthcare providers experienced with this drug should prescribe it. It should only be given in a clinic or hospital where you can be monitored closely.

The infusions are usually given daily for 5 days in a row and repeated every 3 weeks. Sometimes they are given less often. Another medicine is usually given when you receive this medicine to help prevent bladder problems. Keep all your appointments for these infusions.

Drink at least 8 full glasses of liquid for 2 to 3 days before your treatment and each day that you receive the medicine.

What should I watch out for?

You need to have blood and urine tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may cause bone marrow problems. Contact your healthcare provider if you develop a fever, chills, sore throat, sores in your mouth or on your lips, bruising, or unusual bleeding. Nausea and vomiting are also common during treatment with this medicine. Contact your healthcare provider if these become severe.

Hair loss is common during treatment. The hair will grow back after treatment stops.

This medicine may make you drowsy, dizzy, confused, and disoriented. Do not drive unless you are fully alert and clearheaded.

This medicine may lower the number of certain types of blood cells in your body. You may get infections or bleed more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Do not have any vaccines without getting your healthcare provider's approval first. If you develop a fever or other signs of infection, or have any unusual bruising or bleeding, contact your healthcare provider right away.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives, itching, rash, tightness in your chest, swelling of your lips, mouth or throat, trouble breathing).

Serious (Report these to your healthcare provider right away.): Severe nausea or vomiting; fast, slow, or irregular heartbeat; fever; chills; sore throat; unusual bruising or bleeding; shortness of breath; stomach pain; sores in your mouth or on your lips; blood in your urine; urinating often; pain or burning when you urinate; ringing in your ears; hallucinations; blurred vision; severe confusion; seizures.

Other: Loss of appetite, nausea, vomiting, diarrhea, constipation, tiredness, dizziness, weakness, drowsiness, hair loss, pain at the injection site.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alcohol
• Antibiotics such as amikacin, erythromycin (E.E.S., Ery-Tab, Erythrocin), gentamicin, telithromycin (Ketek), tobramycin, and vancomycin (Vancocin)
• Antifungal medicines such as amphotericin b (Abelcet, AmBisome, Amphotec), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), fosphenytoin (Cerebyx), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Bosentan (Tracleer)
• Calcitriol (Rocaltrol)
• Clozapine (Clozaril, FazaClo)
• Corticosteroids such as betamethasone, cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisone (Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• Everolimus (Afinitor, Zortress)
• HIV medicines such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), maraviroc (Selzentry), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), saquinavir (Invirase), tipranavir (Aptivus), and zidovudine (Retrovir)
• Immunosuppressants such as azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), mycophenolate (CellCept, Myfortic), sirolimus (Rapamune), tacrolimus (Astagraf, Prograf, Protopic) and temsirolimus (Torisel)
• Medicines to raise white blood cell counts such as filgrastim (Neupogen), pegfilgrastim (Neulasta), and sargramostim (Leukine)
• Medicines to treat or prevent blood clots such as abciximab (ReoPro), apixaban (Eliquis), argatroban, bivalirudin (Angiomax), cilostazol (Pletal), clopidogrel (Plavix), dipyridamole (Persantine), dipyridamole/aspirin (Aggrenox), edoxaban (Savaysa), eptifibatide (Integrilin), lepirudin (Refludan), prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), tirofiban (Aggrastat), and warfarin (Coumadin)
• Nausea medicines such as aprepitant (Emend) and fosaprepitant (Emend)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Other cancer medicines
• St. John's wort
• Stimulants such as armodafinil (Nuvigil) and modafinil (Provigil)
• Tuberculosis medicines such as rifabutin (Mycobutin), rifampin (Rifadin), and rifapentine (Priftin)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.