이포스파미드

Ifosfamide

다른 이름: Ifex · Holoxan · Holaxane · Mitoxana · Asoifos · Cuantil · Duvaxan · Fentul · IFO-cell · IFX · Ifocris · Ifolem · Ifomida · Ifosmixan · Ifoxan · Seromida · Troxanol · MJF-9325 · NSC-109724 · Z-4942

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

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

지속 정주(CRI) 속도 기반 용량입니다. 단순 체중 환산이 아니라 주입 속도를 계산해야 합니다.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
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

고양이

적응증	용량	경로	빈도	기간	지역
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

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

이포스파미드는 시클로포스파미드와 구조적으로 유사한 강력한 항종양 알킬화제입니다.

전구약물: 약리학적 활성을 나타내려면 간에서 활성화되어야 합니다。
수의학적 용도: 주로 개와 고양이의 림프종 및 연조직 육종(예: 고양이 백신 관련 육종)의 시험적 치료 프로토콜에 사용됩니다。
독성 경고: 독성이 매우 강하며, 심각한 출혈성 방광염과 신독성을 예방하기 위해 메스나(mesna) 병용 투여와 적극적인 생리식염수 이뇨가 필수적입니다。

작용 기전

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.

안전성·주의사항

금기사항

Hypersensitivity to ifosfamide
Severely depressed bone marrow function
Active hemorrhagic cystitis

부작용

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

주의

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).

약물 상호작용

Benzodiazepines (diazepam, chlordiazepoxide, oxazepam)

May increase concentrations of active ifosfamide and increase toxicity (demonstrated in mice; clinical significance in veterinary patients undetermined)

Cisplatin

Ifosfamide may enhance cisplatin-induced ototoxicity and nephrotoxicity

Myelosuppressive drugs (chloramphenicol, flucytosine, amphotericin B, colchicine, other antineoplastics)

Additive myelosuppression

모니터링

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

약동학

흡수

Well absorbed after SC injection or oral administration (bioavailability >90%), though normally administered IV.

분포

Ifosfamide and its metabolites are widely distributed and enter into both bone and the CNS.

대사

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.

배설

Ifosfamide and its metabolites are primarily excreted via the kidney into urine.

과다투여

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.

제품

제형

Powder for IV infusion

인용의약품

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

규제 현황

규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

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.

보호자 정보

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