The total daily dose of mesnex is 100% of the ifosfamide dose. Bar codes included on the vial and carton for ease of scanning. Ha3001425 ifex ifosfamide for injection, usp package insert. Mesnex tablets are given orally in a dosage equal to 40% of the ifosfamide dose 2 and 6 hours after each dose of ifosfamide.
Prescriber restriction the medication must be recommended by an oncologist d. Makei 2005 cisplatin etoposide ifosfamide pei skion. Stable if stored in accordance with information listed on the product insert. Each 20 ml vial contains 200 mg of dacarbazine, usp active ingredient. Mesnex injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage weight by weight ww at the time of ifosfamide administration and 4 and 8 hours after each dose of ifosfamide. This case report describes the use of ifosfamide in a patient with synovial sarcoma, a common type of soft tissue sarcoma. Ifosfamide is embryotoxic to rabbits receiving 88 mgm2day doses from the 6th through the 18th day. Etopophos etoposide phosphate for injection is an antineoplastic agent which is available for intravenous infusion as a sterile lyophile in singledose vials containing etoposide phosphate equivalent to 100 mg etoposide, 32. The number of anomalies was also significantly increased over the. To the best of our knowledge, this report is the first to describe serious liver toxicity associated with ifosfamide used in combination with doxorubicin that caused acute but fully reversible liver failure and encephalopathy. The total daily dose of mesna is 100% of the ifosfamide dose. Careful monitoring is required, in particular for patients with cerebral metastases and others at. Injections are prepared for parenteral use by adding sterile water for.
You will receive a drug called mesna to prevent this side. Ifosfamide 3778732 1 gram or 3 gram vials ifosfamide for injection, usp fresenius. Highlights of prescribing information these highlights do not include all the information needed to use tecentriq safely and effectively. Evaluation of thiamine for the prevention of ifosfamide. Mesnex injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage. The incidence of ifosfamideinduced encephalopathy was measured using the common terminology criteria for adverse events and documentation in the patient chart. Ifosfamide is a chemotherapeutic agent chemically related to the nitrogen mustards and a synthetic analog of cyclophosphamide. Drug information uptodate kuwait cancer control center. Dacarbazine for injection usp is reconstituted and administered intravenously ph 3. Some patients, especially those 65 years and older, have had serious infections caused by viruses, fungi or bacteria that have spread throughout the body, including tuberculosis tb and histoplasmosis.
It has been proposed that ifos metabolites may interfere with the. This is a multidose vial which contains a total of 22. Recommended intravenous and oral dosing schedule 0 hours 2 hours 6 hours ifosfamide 1. Idamycin idarubicin hydrochloride for injection, usp. In patients taking lysodren, adrenal crisis occurs in the setting of shock or severe trauma and response to shock is impaired. Dailymed dacarbazine injection, powder, for solution. Holoxan sterile ifosfamide is supplied as singledose vials of 500mg, mg. Procytox cyclophosphamide and ifex ifosfamide product monographs. Camptosar injection must be diluted prior to infusion. Idamycin idarubicin hydrochloride for injection, usp is intended for administration under the supervision of a physician who is experienced in leukemia chemotherapy. Ifosfamide plus mesna have been used recently in a highdose regimen that allows this.
These highlights do not include all the information needed to use halaven safely and effectively. For intravenous infusion the drug can be diluted by adding the. Camptosar should be diluted in 5% dextrose injection, usp, preferred or 0. Highlights of prescribing information these highlights do not include all the information needed to use gleevec safely and effectively. Mesnex may be given on a fractionated dosing schedule of three bolus intravenous injections as outlined below. The majority of these reports have occurred in patients who received concomitant immunosuppressants. Mesnex is indicated as a prophylactic agent in reducing. Mesnex injection contains the preservative benzyl alcohol. Ifosfamide may cause significant neurologic toxicities which may prove fatal despite careful monitoring prior to and during therapy. Ifosfamide injection 1g summary of product characteristics smpc. Ifosfamide is a white crystalline powder soluble in water. Plaquenil hydroxychloroquine sulfate tablets is indicated for the treatment of rheumatoid arthritis, and discoid and systemic lupus erythematosus, in patients who have not responded satisfactorily to drugs with less potential for serious side effects. Your blood counts will be monitored closely while on therapy and your chemotherapy may need to be delayed due to low red blood cells, white blood cells, and platelets.
Vinp03 vinblastine sulfate for injection usp warning caution this preparation should be administered by individuals experienced in the administration of vinblastine sulfate. Easytoread drug name and dosage strength to aid in identifying the right product. Siop cns gct ii highdose cisplatin etoposide ifosfamide hdpei. Ifosfamide should only be administered when there are facilities for regular monitoring of clinical, biochemical and haematological parameters before, during and after administration and under the direction of a specialist oncology service by physicians experienced with this drug.
Doselimiting bone marrow suppression is the most significant toxicity associated with etoposide therapy. The recommended dosing schedule is outlined below in table 1. Ifex ifosfamide should be given cautiously to patients with any of the following. The recommended dosing schedule is outlined in table 2. Guidelines for the administration of mesna with ifosfamide. Each vial also contains anhydrous citric acid and mannitol. The molecular formula is c 7 h 15 cl 2 n 2 o 2 p and its molecular weight is 261. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Extravasation of etopophos may result in swelling, pain, cellulitis, and necrosis including skin necrosis.
Ifosfamide is a cytotoxic drug for the treatment of. Camptosar injection 20 mgml is intended for single use only and any unused portion should be discarded. The total daily dose of mesnex is 60% of the ifosfamide dose. Animal studies indicate that the drug is capable of causing gene mutations. Acute liver toxicity with ifosfamide in the treatment of. Criteria for approval pancreatic cancer authorization of 6 months may be. Lactated ringers irrigation in arthromatic plastic container prescribing information. Tablets containing sorafenib tosylate 274 mg equivalent to 200 mg of sorafenib. Supportive therapy should be maintained until their complete resolution. Summary of product characteristics last updated on the emc.
Keep accurate 68 hourly fluid balance, inserting a urinary catheter if. Myelosuppression, neurotoxicity, and urotoxicity see full prescribing information for complete boxed warning. Ifosfamide can cause fetal harm when administered to a pregnant woman. Pdf ifosfamide is a chemotherapy agent infrequently associated with liver toxicity. Follow applicable special handling and disposal procedures. Patients undergoing treatment with mesna may experience syncope, lightheadedness, lethargydrowsiness, dizziness, and blurred vision which could affect the ability to drive or use. Ifosfamide neurotoxicity may become manifest within a few hours to a few days after first administration and in most cases resolves within 48 to 72 hours of ifosfamide discontinuation. Mesna equivalent of 40% total daily ifosfamide dose given as iv bolus postifosfamide mesna equivalent of 40% total daily ifosfamide dose given orally 2 and 6 hours after the end of the ifosfamide infusion. Has been linked to the development of other cancers in a small number of people. Ifex ifosfamide for injection, intravenous use warning. Refer to the ifosfamide prescribing information for more information on use during pregnancy. Nexavar tablets are round, biconvex, red filmcoated tablets, debossed with the bayer cross on one side and 200 on the other side. Acute liver toxicity with ifosfamide in the treatment of sarcoma.
Ifosfamide induced encephalopathy overview ifosfamide induced encephalopathy is an acute neurological disturbance occurring during or shortly after ifosfamide infusion. Ifosfamide is 32chloroethyl22chloroethylaminotetrahydro2h1,3,2oxazaphosphorine 2oxide. Ifosfamide, like cyclophosphamide, is an oxazophosphorine alkylating agent. Myelosuppression can be severe and lead to fatal infections 5. Etopophos solutions may be administered at infusion rates up to 3. In some instances, hbv reactivation occurring in conjunction with tnfblocker therapy has been fatal. Treatment of ifosfamide encephalopathy with intravenous. Following activation in the liver, ifosfamide interferes with dna. Data sources include ibm watson micromedex updated 28 feb 2020, cerner multum updated 2 mar 2020. Dacarbazine for injection usp is a white to an ivory colored solid which is light sensitive.
This leaflet is offered as a guide to you and your family. Cns toxicity has been reported very commonly and appears to be dosedependent. Ifosfamide and mesna given together via iv infusion over 5 hours. Pdf physical and chemical stability of highdose ifosfamide and. Mesnex injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage ww at the time of ifosfamide administration.
Ifosfamide ifosfamide injection, powder, for solution. Remicade infliximab can cause serious side effects such as lowering your ability to fight infections. This leaflet is part iii of a threepart product monograph. Ketorolac tromethamine injection, usp prescribing information ketorolac tromethamine injection, usp medication guide l. Although it is usually reversible, it is a serious and potentially fatal complication and should always be discussed with the consultant on call. Administer hydrocortisone, monitor for escalating signs of shock and discontinue. Ifex ifosfamide for injection singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Ifex ifosfamide for injection, usp singledose vials for constitution and administration by. Ifex ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Toposar is contraindicated in patients who have demonstrated a previous hypersensitivity to it. Regarding the primary endpoint of ifosfamideinduced encephalopathy, eight patients 18.
Table 1 shows a list of adverse drug reactions listed on the product package insert. Mesnex is used in combination with ifosfamide or other cytotoxic agents. Ifosfamide fda prescribing information, side effects and. Ifosfamide is a chemotherapy agent infrequently associated with liver toxicity.
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