Ifosfamide is used with other medicines to treat testicular cancer in men.

Ifosfamide is usually given after other treatments have failed.

Ifosfamide may also be used for purposes not listed in this medication guide.

You should not be treated with ifosfamide if you are allergic to it, or if you have a medical condition that causes urination problems (such as an enlarged prostate).

Tell your doctor if you have ever had:

• kidney disease;
• heart disease;
• a bladder infection;
• treatment with busulfan; or
• radiation treatment of your bladder.

Using ifosfamide may increase your risk of developing other cancers, such as leukemia. Ask your doctor about this risk.

Ifosfamide can cause birth defects if a woman is exposed to it during pregnancy.

Use effective birth control to prevent pregnancy, whether you are a man or a woman. Ifosfamide use by either parent may cause birth defects. Keep using birth control for at least 6 months after treatment.

This medication may affect fertility (your ability to have children), whether you are a man or a woman. Some women using ifosfamide have stopped having periods, or started having symptoms of early menopause.

A woman receiving ifosfamide should not breast-feed.

Use Ifosfamide (Ifex) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

You may get infections more easily, even serious or fatal infections. Call your doctor right away if you have signs of infection such as:

• fever, chills, flu symptoms;
• mouth and throat ulcers;
• skin sores, pale skin, cold hands and feet;
• easy bruising, unusual bleeding;
• rapid heart rate, shallow breathing; or
• feeling light-headed or short of breath.

Call your doctor at once if you have any of these side effects:

• confusion, unusual thoughts or behavior, hallucinations, seizure (convulsions);
• little or no urination, painful or difficult urination, blood in your urine;
• loss of bladder control;
• a seizure;
• muscle movements you cannot control;
• problems with your hearing or vision, ringing in your ears;
• sudden chest pain, wheezing, dry cough;
• dark urine, jaundice (yellowing of the skin or eyes); or
• a wound that will not heal.

Common side effects may include:

• nausea and vomiting;
• confusion, vision problems, thinking problems;
• numbness, tingling, burning pain;
• infections;
• urination problems; or
• hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Drinking alcohol can increase certain side effects of ifosfamide, especially nausea and vomiting.

Grapefruit may interact with ifosfamide and lead to unwanted side effects. Avoid the use of grapefruit products.

Do not receive a "live" vaccine while using ifosfamide, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.