Ifosfamide is a clear fluid which can be given:

● as a drip (infusion) or injection into a vein in your arm, through a fine tube (cannula)
● through a central, PICC or hickman line

Are there any side effects?

Some people only get a few side effects while others have more. It’s hard to know how it will be for you. Most side effects are short term and will gradually disappear once the treatment has finished.

The doctors and nurses on the ward will keep a close eye on you while you have your treatment. But it’s important to let them know if you feel unwell or have any problems.

Common side effects

• Lowered resistance to infection: Your immune system doesn’t work so well when you’re having chemo, so you might pick up more colds and infections. This begins around 7 days after treatment is started and reaches its lowest point around 10–14 days after chemo. Your blood cells then gradually go back to normal.

Keep an eye on your temperature and if it goes above 38°C (or you feel unwell) it’s important to let your doctor know. If necessary, you’ll be given antibiotics to keep any infection under control.

• Bruising and bleeding: The number of platelets in your blood can fall because of the chemo. This can cause bleeding or bruising (for example, gums, nose bleeds, heavy periods or pin prick dots on the skin). Let your doctor know if you have any problems with this. If your platelets are really low, they might suggest a platelet transfusion.
• Anaemia: The number of red cells (haemoglobin) in your blood can be low because of the chemo. This can make you feel tired and sometimes breathless. If necessary (to help with the symptoms) your doctor might suggest a blood transfusion to increase the amount of red cells in your blood.
• Nausea and vomiting: Ifosfamide can make you feel sick (nausea) or actually be sick (vomit). You will be given anti-sickness drugs to try to stop any sickness. You can feel sick from a few minutes to a few hours after you have the chemo. It might last for a couple of hours or (very rarely) for several days. Your doctor will prescribe anti-sickness drugs that will be given intravenously with your chemo. You’ll also have tablets to take home just in case.
• Hair loss:Hair loss usually happens 3-4 weeks after the first dose of Ifosfamide. Very rarely it can start to fall out within a few days. You may also lose your eyelashes, eyebrows, underarm, pubic and other body hair. This can be really upsetting and tough to cope with. It’s important to remember that your hair will grow back once you’ve finished the treatment. You might want to look at our section on wigs and scarves and read some tips from other teenagers.
• Irritation of the bladder: Ifosfamide can irritate your bladder so it’s important to drink plenty of fluids to prevent this. You will usually be given lots of fluid into your vein before and after the chemo. While you are having the chemo your urine may be measured and tested to make sure that your bladder and kidneys are ok.
• Nail changes:Your nails might get ridges on them. These ridges will grow ouover a few months once the treatment has finished.
• Tiredness:The chemo can make you feel tired and weak, so it’s important to rest and take things easy whenever you can.

less common side effects

•  Skin changes – Ifosfamide can cause a rash that can be itchy. Let your doctor know if this happens. It can also make your skin darken, which should return to normal once the treatment has finished.
• Confusion, sleepiness and loss of balance – this is a very rare side effect and only happens with high dose treatment. If you feel any of these symptoms you must let your doctor know.

It can feel really scary reading about all these side effects. It’s important to remember that most of them can be controlled and once the treatment stops, the side effects will get better.

If you’re feeling nervous or worried, chat to your doctor and parents about things. They are there to help you. Also have a look at our forum, where you can talk to other young people who have been through a similar experience.

Anything else I should know?

How will I feel? 

 Chemo affects everyone differently, but you’ll probably feel a bit rough sometimes when you’re having your treatment. You might also feel emotional, depressed or irritable at times. All of these feelings are normal for people having chemo. Some people find it really helps to talk things over with someone close or a counsellor. If you want to find out more, there’s lots of information in our deal with it section.