Ifosfamide intravenous - IFEX

Formal renal-impairment studies are lacking. Ifosfamide and metabolites may accumulate; monitor toxicity closely and consider dose reduction. Assess glomerular and tubular function before, during and after treatment, including serum/urine chemistries and urinary sediment as appropriate. Tubular dysfunction can appear after treatment ends. The source describes dialyzability but does not provide a complete dialysis dosing schedule. No renal percentage reduction is inferred from this qualitative warning.

For this protocol, ifosfamide is full dose at eGFR at least 60 and at 45-59, with increased adverse-event risk in the latter band. At 30-44, reduce by 20% or select an alternative protocol. At 15-29, use an alternative protocol; the page notes possible use in other circumstances but not this regimen. Below 15 without KRT, avoid and use an alternative. KRT requires multidisciplinary oncology/nephrology/pharmacology input. Reductions apply to each starting dose, not automatically to cycle duration.

For this lymphoma protocol, use full-dose ifosfamide at eGFR at least 60 and 45-59, with increased adverse-event risk at 45-59. At both 30-44 and 15-29, reduce by 20% or use an alternative protocol, accounting for increased adverse-event risk. Below 15 without KRT, obtain multidisciplinary guidance; KRT also requires specialist collaboration. These are modifiers of the specified regimen, not stand-alone doses or permission to override another protocol.