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Ifosfamide and mesna
1Department of Pharmacy Practice, University of Houston College of Pharmacy, TX.
Clinical Pharmacy
|March 1, 1990
Summary
Ifosfamide, an alkylating agent requiring liver activation, and mesna, a uroprotective detoxificant, are used together. Concurrent use of ifosfamide and mesna offers a therapeutic option for testicular cancer and other malignancies.
Area of Science:
- Oncology
- Pharmacology
- Clinical Chemistry
Background:
- Ifosfamide is an alkylating agent requiring hepatic biotransformation for activity.
- Mesna acts as a regional detoxificant for urotoxic oxazaphosphorines like ifosfamide.
- Concurrent administration of ifosfamide and mesna is utilized in cancer therapy.
Purpose of the Study:
- To describe the chemistry, pharmacology, pharmacokinetics, and adverse effects of ifosfamide and mesna.
- To discuss the adverse effects of concurrent ifosfamide and mesna administration.
- To review the clinical spectrum, dosage, and administration of ifosfamide and mesna.
Main Methods:
- Separate descriptions of ifosfamide and mesna properties.
- Discussion of combined drug adverse effects and clinical applications.
- Review of pharmacokinetic data and toxicity profiles.
Main Results:
- Ifosfamide exhibits high oral bioavailability (>95%) and causes hematologic, urinary, GI, and CNS toxicity.
- Mesna (76% oral availability) can cause GI and allergic reactions.
- Concurrent use may lead to urinary tract and renal toxicity.
Conclusions:
- Ifosfamide, with mesna for uroprotection, is a valuable treatment for testicular cancer, sarcomas, and lymphomas.
- Optimal ifosfamide dosage and scheduling require further determination.
- Fractionated dosing may enhance antineoplastic activity while managing toxicity.