ইঙ্গিত ও ব্যবহার
Fosfa এর জন্য নির্দেশিত:
ডোজ নির্দেশিকা
শুধুমাত্র নির্দেশিকা তথ্য
প্রদর্শিত ডোজগুলি সরকারি উৎসের সাধারণ নির্দেশিকা। ব্যক্তিগতকৃত ডোজের জন্য সর্বদা আপনার ডাক্তার বা ফার্মাসিস্টের পরামর্শ নিন।
Adults:
Ifosfamide should be given intravenously at a dose of 1.2 g/m2 per day for 5 consecutive days. Treatment is repeated every 3 weeks or after recovery from blood-related toxicity (platelets at least 100,000/mL, white blood cell count, WBC, at least 4,000/mL). To help prevent bladder toxicity, ifosfamide should be given along with generous hydration, consisting of at least 2 liters of oral or intravenous fluid per day. A protective agent such as Mesna (Mes-D) should also be used to prevent hemorrhagic cystitis. Ifosfamide should be given as a slow intravenous infusion lasting at least 30 minutes. Although ifosfamide has been given to a small number of patients with compromised liver or kidney function, studies establishing optimal dosing schedules for such patients have not been carried out.
পার্শ্বপ্রতিক্রিয়া
Adverse Reactions from Clinical Trials: Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. The adverse reactions and frequencies below are based on 30 publications describing clinical experience with fractionated administration of Ifodex as monotherapy, with a total dose of 4 to 12 g/m2 per course.
সতর্কতা ও নিষেধাজ্ঞা
Warnings & Precautions
Myelosuppression, Immunosuppression, and Infections Treatment with Ifodex may cause myelosuppression and significant suppression of immune responses, which can lead to severe infections. Fatal outcomes of Ifodex-associated myelosuppression have been reported. Ifodex-induced myelosuppression can cause leukopenia, neutropenia, thrombocytopenia (associated with a higher risk of bleeding events), and anemia. The nadir of the leukocyte count tends to be reached approximately during the second week after administration. When Ifodex is given in combination with other chemotherapeutic/hematotoxic agents and/or radiation therapy, severe myelosuppression is frequently observed. The risk of myelosuppression is dose-dependent and is increased with administration of a single high dose compared with fractionated administration. The risk of myelosuppression is also increased in patients with reduced renal function. Severe immunosuppression has led to serious, sometimes fatal, infections. Sepsis and septic shock also have been reported. Infections reported with Ifodex include pneumonias, as well as other bacterial, fungal, viral, and parasitic infections. Latent infections can be reactivated. In patients treated with Ifodex, reactivation has been reported for various viral infections. Infections must be treated appropriately. Antimicrobial prophylaxis may be indicated in certain cases of neutropenia at the discretion of the managing physician. In case of neutropenic fever, antibiotics and/or antimycotics must be given. Close hematologic monitoring is recommended. White blood cell (WBC) count, platelet count and hemoglobin should be obtained prior to each administration and at appropriate intervals after administration. Unless clinically essential, Ifodex should not be given to patients with a WBC count below 2000/microliter and/or a platelet count below 50,000/microliter. Ifodex should be given cautiously, if at all, to patients with presence of an infection, severe immunosuppression or compromised bone marrow reserve, as indicated by leukopenia, granulocytopenia, extensive bone marrow metastases, prior radiation therapy, or prior therapy with other cytotoxic agents.Central Nervous System Toxicity, Neurotoxicity Administration of Ifodex can cause CNS toxicity and other neurotoxic effects. The risk of CNS oxicity and other neurotoxic effects necessitates careful monitoring of the patient. Neurologic manifestations consisting of somnolence, confusion, hallucinations, blurred vision, psychotic ehavior, extrapyramidal symptoms, urinary incontinence, seizures, and in some instances, coma, ave been reported following Ifodex therapy. There have also been reports of peripheral europathy associated with Ifodex use. fosfamide neurotoxicity may become manifest within a few hours to a few days after first dministration and in most cases resolves within 48 to 72 hours of Ifodex discontinuation. Symptoms may persist for longer periods of time. Supportive therapy should be maintained until heir complete resolution. Occasionally, recovery has been incomplete. Fatal outcomes of CNS oxicity have been reported. Recurrence of CNS toxicity after several uneventful treatment courses as been reported. If encephalopathy develops, administration of Ifodex should be discontinued. Due to the potential for additive effects, drugs acting on the CNS (such as antiemetics, sedatives, arcotics, or antihistamines) must be used with particular caution or, if necessary, be discontinued n case of Ifodex-induced encephalopathy. Manifestations of CNS toxicity may impair a patient’s ability to operate an automobile or other eavy machinery. Renal and Urothelial Toxicity and Effects fosfamide is both nephrotoxic and urotoxic. Women should not become pregnant and men should not father a child during therapy with osfamide. Further, men should not father a child for up to 6 months after the end of therapy. If his drug is used during pregnancy, or if the patient becomes pregnant while taking Ifodex or fter treatment, the patient should be apprised of the potential hazard to a fetus. Effects on Fertility fosfamide interferes with oogenesis and spermatogenesis. Amenorrhea, azoospermia, and sterility both sexes have been reported.
নিষেধাজ্ঞা
Ifosfamide should not be used in people who are hypersensitive to it or who have a blockage affecting the outflow of urine.