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General Information For Ifosfamide

Ifosfamide is used to treat a wide variety of cancers including breast, testicular and lung cancer, as well as some types of lymphoma. It works by sticking the cancer cell's DNA (the cell's genetic code) together so that it can never come apart again. This means that the cell cannot reproduce itself.

Ifosfamide is a clear liquid that you usually have through a drip (infusion) into a fine tube (cannula) put into a vein in your arm. To find out more about the ways of giving chemotherapy click on how chemotherapy is given.

You always have a drug called mesna with ifosfamide. You either have this through your drip in a separate bag, before or after the ifosfamide, or they can be mixed together in one bag. Usually you have a lot of fluid as well, so the drugs will take a long time to go through a drip. You doctor may ask you to stay overnight at the hospital.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for ifosfamide depends on which cancer you are being treated for. To find out more about the way chemotherapy treatment is planned click on Planning Chemotherapy.

Common Side Effects of Ifosfamide

Many people have one or more of the following side effects with ifosfamide

  • Fatigue - patients say this is the most disruptive side effect of all. Tiredness often carries on after treatment has ended. Most people find their energy levels are back to normal from 6 months to a year after their treatment finishes.
  • Temporary effect on the bone marrow. The bone marrow makes blood cells and this can cause 
    -Drop in white blood cell count. This increases the risk of infection. You may have headaches, aching muscles, cough, sore throat, pain when passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should urgently contact your doctor if you think you have an infection. 
    -Drop in red cell count (anaemia), which may make you feel tired and look pale or be short of breath. You may need a blood transfusion or treatment to bring up your red cell count. 
    -Drop in platelet numbers in the blood. This causes bleeding or bruising. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or bleeding gums.

Contact your hospital if you have any of these bone marrow side effects. These effects on your bone marrow can begin about 7 days after each treatment and usually return to normal at about 21-28 days. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

  • Feeling or being sick - this is generally well controlled with anti-sickness injections and tablets. If it does happen, it usually starts a few hours after each treatment and last for about 3 days. Sometimes there is delayed sickness lasting up to 2 weeks. If your sickness is not controlled, tell your doctor.
  • Hair loss - it is very common to get complete head and body hair loss with ifosfamide. This is particularly true if you have it with other chemotherapy drugs. Hair loss usually starts about 3 - 4 weeks after the first treatment. Remember this is only temporary and your hair will grow back.
  • Irritation of the bladder and kidneys - drink as much water as possible to flush out the ifosfamide. You may have fluids into your drip before and after your treatment. You will have a drug called mesna to protect your bladder and kidneys.
  • Your nails may become ridged
  • Loss of fertility - you may not be able to get pregnant or father a child after treatment with this drug. It is important to talk to your doctor about fertility before starting treatment. Women's periods may stop and men may suffer from impotence during the treatment

Occasional Side Effects

Some people have the following side effects

  • Your liver may be temporarily affected. You will have regular blood tests to see how well your liver is working
  • Skin rash which may be itchy
  • Your skin may become darker temporarily
  • About one person in 8 experiences confusion, sleepiness or extreme lack of energy (lethargy) and hallucinations. If you have any of these, it is important to tell your doctor immediately.


  • Not everyone will get these side effects. You may have none or several. A side effect may get worse through your course of treatment, or more side effects may develop as the course goes on. This depends on 
    -How many times you've had the drug before 
    -Your general health 
    -How much of the drug you have (the dose) 
    -The way you take the drug (tablets or drip) 
    -Other drugs you are having
  • Some side effects are upsetting or inconvenient, but not damaging to your health
  • Some side effects are serious medical conditions and need treating. Where we have urged you to contact your doctor, this is because 
    -Your side effect may need treating 
    -Your drug dose may need reducing to try to prevent the side effect
  • Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies - drugs can react together
  • Talk to your doctor or nurse about all your side effects so they can help you manage them

People you can talk to about your side effects

Your chemotherapy nurse, clinic or ward nurse will have given you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call.

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