Ifosfamide is available as a powder in vials containing 1 or 3 g of ifosfamide.4005 Reconstitute the 1- or 3-g vial with 20 or 60 mL, respectively, of sterile water for injection or bacteriostatic water for injection (parabens or benzyl alcohol) to yield a 50-mg/mL solution.4005 Shake to dissolve.4005 The manufacturer states the reconstituted solution may be further diluted in a compatible infusion solution to a concentration of 0.6 to 20 mg/mL.4005
pH
Approximately 6.72
Trade Name(s)
Ifex
Ifosfamide is administered by slow intravenous infusion over a minimum of 30 minutes.4005 Ifosfamide also has been administered by continuous intravenous infusion.4
Intact vials should be stored at controlled room temperature and protected from temperatures above 30°C.4005 Ifosfamide may liquify at temperatures above 35°C.72
Reconstituted solutions should be refrigerated and used within 24 hours.4005 The manufacturer states reconstituted solutions that have been further diluted in a compatible infusion solution are stable in glass, PVC, or polyolefin (polyethylene and polypropylene) containers for up to 24 hours when kept refrigerated.4005
Ifosfamide (Boehringer-Ingelheim) 80 mg/mL in sodium chloride 0.9% exhibited about 7% loss in 9 days at 37°C in the dark.1494
The manufacturer states benzyl alcohol-containing solutions can reduce the stability of ifosfamide.4005 Reconstitution to an ifosfamide concentration of 100 mg/mL with benzyl alcohol-preserved bacteriostatic water for injection resulted in a turbid mixture, separating into 2 distinct liquid phases. The separate phases dissolved completely, with no loss of drug or preservative, when diluted to about 60 mg/mL or less.1289
pH Effects
Ifosfamide exhibits maximum solution stability in the pH range of 4 to 10; the rate of decomposition is essentially the same over this pH range. At pH values less than 4 and above 10, increased rates of decomposition have been observed.2002; 2401
Syringes
Ifosfamide 0.6 and 20 mg/mL in dextrose 5%, lactated Ringer’s injection, sodium chloride 0.9%, and sterile water for injection in polypropylene syringes (Becton Dickinson) is physically and chemically stable for at least 24 hours at 30°C.1496
Ambulatory Pumps
Ifosfamide (Asta Medica) 20 mg/mL and mesna (Asta Medica) 20 mg/mL in water for injection were evaluated for stability and compatibility in polyvinyl chloride (PVC) reservoirs for Graseby 9000 ambulatory pumps. The solutions were physically compatible and analysis found about 3% ifosfamide and 9% mesna loss in 7 days at 37°C. About 2% or less loss of both drugs was found after 14 days at 4°C. Furthermore, weight losses due to moisture loss were minimal.2288
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