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Doxorubicin and ifosfamide (Doxifos)

Find out what doxorubicin and ifosfamide is, how you have it and other important information about having this drug combination.

Doxorubicin and ifosfamide is a combination of chemotherapy drugs used to treat soft tissue sarcoma. 

This combination is sometimes called dox-ifos or Doxifos. It is made up of the drugs:

  • doxorubicin (also known as Adriamycin)
  • ifosfamide

How it works

These cancer drugs destroy quickly dividing cells, such as cancer cells.

How you have Doxifos chemotherpay

You have doxorubicin and ifosfamide into your bloodstream, usually through a long line: a central line, a PICC line or a portacath.

These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of your treatment.

When you have treatment

There are different ways (schedules) of having doxorubicin and ifosfamide chemotherapy. Your doctor or nurse will discuss with you which one you have and why. Some of the commonly used ones are described below.

Schedule A
  • You stay in hospital when having this schedule
  • On the first day of the treatment cycle you start an ifosfamide and mesna drip which continues for 3 days or 5 days
  • On the first, second and third day you have doxorubicin as an injection through your cannula or central line
  • After this you have no treatment for 16 to 18 days and then start the treatment cycle again
Schedule B
  • You can go home between treatments in this schedule
  • On the first day of the treatment cycle you have an injection of doxorubicin plus a four hour drip (infusion) of ifosfamide. You take mesna as tablets
  • This treatment is repeated on day 2 and day 3
  • After the third day of treatment you have no treatment for 18 days. Then you start the next cycle
Schedule C
  • You might need to stay in hospital for the 2 days of treatment in this schedule
  • On the first day you have an injection of doxorubicin into your cannula or central line plus a four hour drip (infusion) of ifosfamide. You have a mesna injection before you start the ifosfamide infusion and another two doses four and eight hours later
  • On the second day you have the same treatment
  • After this you have no treatment for 19 days. then you start the next cycle
Schedule D
  • You have treatment overnight in hospital with this schedule
  • You have an injection of doxorubicin plus a 24 hour drip (infusion) of ifosfamide
  • You have a mesna injection before you begin your ifosfamide drip and also a 24 hour mesna drip alongside the ifosfamide
  • You go home and have no treatment for 20 days. Then you start the next cycle

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Find out about possible side effects of doxifos and what to do if you have them.

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Fertility

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue, but this is rare.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Having immunisations 

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)

Contact with others who have had immunisations 

You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help