Ifosfamide (Mitoxana)
Find out what ifosfamide is, how you have it and other important information about having ifosfamide for bone cancer.
Ifosphamide is a chemotherapy drug used to treat different types of cancer.
How does ifosfamide work?
Ifosfamide works by sticking the cancer cell’s 
(the cell’s genetic code) together so that it can't come apart again. This means that the cell can't divide and grow.
How do you have ifosfamide?
You have ifosfamide into your bloodstream as a drip into a vein (intravenously).
Into your bloodstream
You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
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 too, so the drugs take a long time to go through the drip. You may need to stay overnight at the hospital.
How often do you have ifosfamide?
You usually have ifosfamide as a course of several . Each cycle varies depending on what type of cancer you have. Your doctor or nurse will tell you more about this.
Tests
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Side effects
Important information
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This treatment might harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you're having treatment and for a few months afterwards.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.
Breastfeeding
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Blood clots
You are more at risk of developing a blood clot during treatment. Drink plenty of fluids and keep moving to help prevent clots.
Treatment for other conditions
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Immunisations
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.
You can usually have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
Contact with others who have had immunisations
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
Slow wound healing
Ifosfamide can slow wound healing. If you need to have an operation your doctor will normally stop the ifosfamide for a while beforehand. They will let you know when you can start having it again.
More information about this treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
