Testicular Cancer, Sarcoma Soft Tissue, Lymphoma Hodgkins, Lymphoma Non-Hodgkins
How does it work?
Ipamide is the combination of Ifosfamide and mesna.
Ifosfamide - Ifosfamide is a type of chemotherapy medicine to treat cancer called an alkylating agent.
Cancers form when some cells within the body multiply uncontrollably and abnormally. These cells spread, destroying nearby tissues. Ifosfamide works by stopping the cancer cells from multiplying. It does this by binding to and damaging the DNA in the cancer cells. This stops the cells from growing and multiplying.
Ifosfamide is used in the treatment of a wide variety of cancers including cancer of the lymph nodes (lymphoma) and blood cells (leukaemias). It may either be used alone or in combination with other anti-cancer medicines, radiotherapy or surgery.
Unfortunately, ifosfamide can also affect normal, healthy cells, particularly those that multiply quickly, such as blood cells and hair cells. The most important side effect is on the bone marrow where blood cells are made. Ifosfamide can decrease the production of blood cells, leaving people susceptible to infection. Regular blood tests are therefore needed to monitor the levels of blood cells.
In most chemotherapy regimens, doses are administered in courses at various intervals to allow normal cells to recover from the adverse effects of the anticancer medicines between doses. However, during this period, cancer cells will also recover and start to replicate again. Successful treatment depends on the administration of the next course of therapy before the cancer has regrown to its previous size and the net effect is to decrease the amount of cancer with each successive course.
Ifosfamide is usually given as a slow infusion (drip) into a vein (intravenously) over several hours or sometimes several days.
Mesna - Mesna is not an anticancer medicine. It is given for protecting the bladder and kidneys during chemotherapy with ifosfamide.
When given in high doses, ifosfamide can produce a toxic by-product called acrolein. This by-product can irritate and damage the lining of the bladder and kidneys. This can show up as blood in the urine (haemorrhagic cystitis). Mesna binds to acrolein in the urinary tract and prevents this damage from occuring.
Treatment with mesna is given at the same time as the chemotherapy treatment with cyclophosphamide or ifosfamide. Mesna is then continued after treatment with the chemotherapy medicine has finished, until the level of the toxic by-product of the medicine in the urine has fallen to an acceptable level. You will need to have regular tests on your urine during this time to check the amount of chemotherapy medicine in the urine, as well as to check for any blood or protein in the urine.
You should avoid drinking grapefruit juice and eating grapefruit while having treatment with this medicine. This is because grapefruit juice can affect the metabolism of this medicine and could decrease the amount of the medicine in your blood, thus making it less effective.
Chemotherapy medicines can decrease the number of blood cells in your blood. A low white blood cell count can increase your susceptibility to infections; a low red blood cell count causes anaemia and a low platelet count can cause problems with blood clotting. For this reason, you will need regular blood tests to monitor your blood cells during treatment with this medicine. Tell your doctor immediately if you experience any of the following symptoms during your treatment, as they may indicate problems with your blood cells: unexplained bruising or bleeding, purple spots, sore mouth or throat, mouth ulcers, high temperature (fever) or other signs of infection, or suddenly feeling tired, breathless, or generally unwell.
Ifosfamide can cause damage to your bladder and kidneys. It is important to try to drink plenty of fluid during your treatment to minimise any problems, but you will also usually be given intravenous fluids before and after the ifosfamide. Mesna is also given to reduce the irritant effects of ifosfamide on the bladder . While having the chemotherapy you will be encouraged to pass urine every three to four hours during the day and last thing at night. Your urine may be measured and tested for the presence of blood. This is to check your kidney function, your ability to pass urine and to check for any irritation to your bladder that might mean your treatment needs interrupting. If you notice any blood in your urine during treatment it is important to tell your doctor straight away.
This medicine may be harmful to an unborn baby, and for this reason you should use effective contraception to avoid becoming pregnant or fathering a child during treatment. You should continue to use contraception to prevent pregnancy for at least six months after stopping this medicine, but discuss this with your doctor. Women should consult their doctor immediately if they get pregnant during treatment.
Your ability to become pregnant or father a child may be affected by this medicine. It is important to discuss fertility with your doctor before starting treatment.
Use with caution in
People with diabetes.
People with only one kidney.
Hereditary blood disorders called porphyrias.
Not to be used in
People with acute infections.
People with a severe reduction in blood cell production in the bone marrow, resulting in low levels of white blood cells or platelets in the blood (for example due to radiotherapy or previous courses of chemotherapy).
People with inflammation of the bladder (cystitis).
People with any obstruction to passing urine.
Decreased kidney function.
Decreased liver function.
This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
This medicine should not be used in pregnancy, unless considered essential by your doctor due to life-threatening disease, because it may be harmful to a developing baby.
Women who could get pregnant should use effective contraception to prevent pregnancy, and men should use effective contraception to prevent fathering a child, both during treatment, and for at least six months after treatment is finished. Seek further medical advice from your doctor.
It is not known if this medicine passes into breast milk. Mothers who need treatment with this medicine should not breastfeed. Seek medical advice from your doctor.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Decrease in the number of white blood cells in the blood (leukopenia and neutropenia).
Decreased production of blood cells by the bone marrow (bone marrow suppression).
Hair loss (alopecia).
Nausea and vomiting.
Blood in the urine (tell your doctor straight away if you notice this).
Feeling weak or tired.
Decrease in the number of platelets in the blood (thrombocytopenia).
Increased acid levels in the blood (metabolic acidosis).
Inflammation of the bladder.
Infection of the blood or body tissues with pus-forming or other pathogenic organisms (sepsis).
Diarrhoea or constipation.
Loss of appetite.
Irregular heart beat (arrthymias).
Cancer of the urinary tract.
Low red blood cell count (anaemia).
Disturbances in the levels of chemical components (electrolytes) in the blood.
Problems controlling your bowel movements (faecal incontinence).
Skin reactions such as rash, dermatitis.
Inflammation of the lining of the mouth (stomatitis).
Reaction at site of injection.
Inflammation of the pancreas (pancreatitis).
Interstitial lung disease.
Low potassium levels (hypokalaemia).
Formation of blood clots in the blood vessels (thromboembolism).
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
Disclaimer: The information provided above is general. It does not include all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for your doctor’s advice. Please consult your doctor before taking any action towards your medical condition.