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Alkylating agent

Ifosfamide (Specialist drug)

Brand names: Mitoxana

Ifosfamide is an oxazaphosphorine alkylating cytotoxic agent used to treat a range of solid tumours including sarcomas and certain germ-cell and lymphoid malignancies.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a prodrug activated in the liver to a metabolite that cross-links DNA, inhibiting replication and transcription and causing cell death.

Prescribing in practice

  • It causes haemorrhagic cystitis from the urotoxic metabolite acrolein, so mesna uroprotection and adequate hydration are essential during administration.
  • It is given by specialists experienced in cytotoxic chemotherapy, with significant myelosuppression and nephrotoxicity expected.
  • Encephalopathy can occur and may be severe, requiring prompt recognition and discontinuation if it develops.

Monitoring

Monitor full blood count, renal function, urine for blood and neurological status throughout treatment.

Counselling the patient

  • Maintain a good fluid intake and report blood in the urine or painful urination promptly.
  • Report confusion, drowsiness or hallucinations to the team without delay.
  • Effective contraception is advised during and after treatment as directed.

Evidence & guidelines

Its role in sarcoma and germ-cell tumours is supported by established oncology treatment regimens and trial evidence.

Reference: SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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