Ifosfamida
Ifosfamide
También conocido como: Ifex · Holoxan · Holaxane · Mitoxana · Asoifos · Cuantil · Duvaxan · Fentul · IFO-cell · IFX · Ifocris · Ifolem · Ifomida · Ifosmixan · Ifoxan · Seromida · Troxanol · MJF-9325 · NSC-109724 · Z-4942
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Es una dosis de infusión continua (CRI) basada en la velocidad. Calcule la velocidad de infusión; no aplique un simple ajuste por peso.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Lymphomas and soft tissue sarcomas | Give IV saline at 18.3 mL/kg/hr for 6 hours. Give ifosfamide at 350 mg/m2 (if patient weighs less than 10 kg), 375 mg/m2 (if greater than 10 kg) IV during the second 30 minutes of the 6-hour infusion. Mesna at a dose of 20% of the ifosfamide dose is given as an IV bolus at the start of the IV infusion and again 2 and 5 hours after the ifosfamide infusion. Repeat every 3 weeks. | IV | Every 3 weeks | — | 🌎 NA |
| Lymphomas and soft tissue sarcomas | 375 mg/m2 | IV | Every 21 days | — | 🌎 NA |
- Lymphomas and soft tissue sarcomas: Requires saline diuresis and mesna
- Lymphomas and soft tissue sarcomas: Follow cat dose 'b' protocol for diuresis and mesna administration
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Vaccine-related sarcomas | 900 mg/m2 every 3 weeks. Mesna bolus and saline diuresis (30 minutes at 18.3 mL/kg/hr) were first given, then ifosfamide and saline diuresis continued for 5 hours after ifosfamide administration completed. | IV | Every 3 weeks | — | 🌎 NA |
| Neoplasia | Normal (0.9%) saline IV diuresis at a fluid rate of 6 times maintenance over 30 minutes. Ifosfamide 900 mg/m2 diluted to 20 mg/mL or less, IV over 20 minutes. Normal saline IV diuresis at 6 times maintenance over 5 hours. Mesna urothelial protectant at 1/5 the patient's calculated mg dose at time zero (immediately before ifosfamide administration), and repeated 2 and 5 hours after ifosfamide. This therapy may be repeated on a 21 day basis. | IV | Every 21 days | — | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La ifosfamida es un potente agente antineoplásico alquilante estructuralmente relacionado con la ciclofosfamida.
- Profármaco: Requiere activación hepática para volverse farmacológicamente activo.
- Uso veterinario: Se utiliza principalmente en protocolos de investigación para linfomas y sarcomas de tejidos blandos (p. ej., sarcomas asociados a vacunas en felinos).
- Advertencia de toxicidad: Altamente tóxico; requiere la administración concomitante de mesna (un protector urotelial) y una diuresis salina agresiva para prevenir cistitis hemorrágica grave y nefrotoxicidad.
Mecanismo de acción
Ifosfamide is a cell-cycle phase nonspecific alkylating agent.
- Activation: As a prodrug, it is metabolized primarily by hepatic cytochrome P450 enzymes (and to a lesser extent in the lungs) → ifosfamide mustard (the primary active alkylating metabolite).
- Mechanism: The active mustard metabolite forms covalent bonds with DNA → cross-linking of DNA strands → interferes with DNA replication and RNA transcription → disrupts nucleic acid function and induces cell death.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to ifosfamide
- Severely depressed bone marrow function
- Active hemorrhagic cystitis
Efectos adversos
- Myelosuppression (neutropenia at 5-7 days, potentially delayed to 14-21 days; thrombocytopenia)
- Hemorrhagic cystitis (bladder epithelial damage)
- Nephrotoxicity (proximal and distal tubular damage, electrolyte abnormalities)
- Volume overload and pulmonary edema (secondary to required saline diuresis)
- Neurotoxicity (somnolence, confusion, coma, encephalopathy)
- Gastrointestinal effects (nausea, vomiting, anorexia)
- Hypersensitivity reactions
- Alopecia
- Abnormal liver function tests
Precauciones
Because of its toxicity, ifosfamide should only be used by clinicians experienced with cytotoxic agents. Must be used in conjunction with mesna and saline diuresis to reduce the risk of hemorrhagic cystitis and nephrotoxicity. Use with extreme caution in patients with impaired renal function or preexisting cardiac disease (due to volume overload risk). Handle and dispose of as a hazardous cytotoxic drug. FDA Category D for pregnancy (teratogenic and fetotoxic).
Interacciones farmacológicas
May increase concentrations of active ifosfamide and increase toxicity (demonstrated in mice; clinical significance in veterinary patients undetermined)
Ifosfamide may enhance cisplatin-induced ototoxicity and nephrotoxicity
Additive myelosuppression
Monitorización
- CBC with platelets (baseline and before re-dosing)
- Renal function with electrolytes (baseline and before re-dosing)
- Urinalysis (baseline and periodic)
- Liver function (baseline and periodic)
- Other adverse effects (volume overload/pulmonary edema, neurotoxicity, GI toxicity)
- Efficacy
Farmacocinética
Absorción
Well absorbed after SC injection or oral administration (bioavailability >90%), though normally administered IV.
Distribución
Ifosfamide and its metabolites are widely distributed and enter into both bone and the CNS.
Metabolismo
Prodrug requiring biotransformation. Converted primarily via oxidative pathways in the liver (and to a smaller extent in the lungs) into active metabolites, primarily ifosfamide mustard.
Eliminación
Ifosfamide and its metabolites are primarily excreted via the kidney into urine.
Sobredosis
There is limited information available on acute overdoses. Toxicity is expected to be an exacerbation of adverse effects seen at usual doses. No specific antidote (including mesna) is known; treatment is supportive. Methylene blue (50 mg in a ~2% aqueous solution IV over 5 minutes) has been suggested to treat ifosfamide-induced encephalopathy in humans.
Productos disponibles
Formulaciones
- Powder for IV infusion
Etiquetado para humanos
- Ifosfamide Powder for IV infusion: 1 gram with 200 mg amps of Mesnex (mesna) in single dose vials
- Ifosfamide Powder for IV infusion: 3 grams with 400 mg amps of Mesnex (mesna) in single dose vials
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store powder at 20-25°C (68-77°F). Protect from temperatures >30°C (86°F) as the drug may liquefy at >35°C (95°F). Reconstituted solution is stable for 24 hours when refrigerated. Compatible with D5W, normal saline, or lactated Ringer's. Compatible and stable when mixed with mesna in D5W or lactated Ringer's.
Información para el cliente
Advertencia de seguridad importante: La ifosfamida es un fármaco de quimioterapia potente con un alto riesgo de efectos secundarios graves. A menudo se utiliza como tratamiento de investigación en medicina veterinaria.
- Precauciones de manejo: Este fármaco se excreta en los fluidos corporales de su mascota. Evite el contacto directo con la saliva o la orina de su mascota durante al menos 24 horas después del tratamiento. Use guantes al limpiar los desechos.
- Efectos secundarios: Observe de cerca si hay signos de infección, sangrado, vómitos o cambios neurológicos (confusión, somnolencia extrema o comportamiento anormal).
- Hospitalización: El tratamiento requiere infusiones intravenosas prolongadas con líquidos adicionales y medicamentos protectores (mesna) para salvaguardar la vejiga y los riñones.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.