Select therapeutic use:
Indications for IFEX:
Third-line adjunctive treatment of germ cell testicular cancer.
Give by slow IV infusion over at least 30 mins. 1.2g/m2 per day for 5 consecutive days; repeat every 3 weeks or after hematological recovery (platelets ≥100000/µL, WBC ≥4000/µL).
Urinary outflow obstruction.
Risk of myelosuppression, immunosuppression, and infections. Do hematologic profile before each dose; discontinue if WBCs <2000/µL or platelets <50000/µL. Risk of CNS toxicity and other neurotoxic effects. Discontinue if encephalopathy develops. Do urinalysis before each dose, postpone dose if hematuria occurs. Give mesna and at least 2L fluids daily. Active urinary tract infections. Impaired hepatic, renal, or hematopoetic function. Preexisting cardiac disease. May interfere with wound healing. Prior radiation therapy or other cytotoxic agents. Ensure adequate hydration. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.
Increased risk of myelosuppression with other chemotherapy agents. Caution with drugs acting on the CNS (eg, antiemetics, sedatives, narcotics, antihistamines).
Alopecia, nausea, vomiting, leukopenia, anemia, CNS toxicity, hematuria, infection, renal or liver dysfunction, phlebitis, fever, urotoxicity (eg, hemorrhagic cystitis), thrombocytopenia, pulmonary toxicity, secondary malignancies.