title: Physical and chemical stability of high-dose ifosfamide and mesna for prolonged 14-day continuous infusion.
abstract: OBJECTIVE
  Ifosfamide plus mesna have been used recently in a high-dose regimen that allows this chemotherapy to be given to outpatients with less toxicity over 14 days using a portable pump. However, there is a need for published stability information. The aim of this study was to investigate the physicochemical stability of ifosfamide with mesna in normal saline at room temperature over a prolonged period of 14 days.
  
  
  METHODS
  Infusion solutions of 1:1 ifosfamide and mesna at final concentrations of 10, 20 and 30 mg/mL were prepared with 0.9% sodium chloride in PVC bags. Solutions were stored at room temperature. Concentrations of ifosfamide and mesna were measured at 0 and 1, 3, 7 and 14 days using a stability-indicating reversed phase high-performance liquid chromatography (HPLC) assay with ultraviolet detection.
  
  
  RESULTS
  Ifosfamide and mesna were both physicochemically stable (>94%) for 14 days in all tested infusion solutions (10, 20 and 30 mg/mL).
  
  
  CONCLUSIONS
  Our stability data indicate that ifosfamide and mesna (1:1) combination can be administered as a prolonged continuous infusion with portable pump in an outpatient setting without replacement of the infusion bag. We suggest 20 mg/mL as a reasonable concentration for infusion rates of about 2-4 cc/hr over prolonged periods of time.
authors.affiliation: Department of Pharmacy Research, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: YanPing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jitesh D
authors.initials: JD
authors.lastname: Kawedia
authors.forename: Alan L
authors.initials: AL
authors.lastname: Myers
authors.forename: Chelsey M
authors.initials: CM
authors.lastname: McIntyre
authors.forename: Peter M
authors.initials: PM
authors.lastname: Anderson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kramer
authors.forename: Kirk S
authors.initials: KS
authors.lastname: Culotta
mesh_terms: D055598:Chemical Phenomena; D004338:Drug Combinations; D004355:Drug Stability; D004356:Drug Storage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000737:chemistry*; D007262:Infusions, Intravenous; D015080:Mesna / Q000008:administration & dosage / Q000737:chemistry*; D010045:Outpatients; D019999:Pharmaceutical Solutions / Q000008:administration & dosage / Q000737:chemistry*
chemical_list: D004338:Drug Combinations; D019999:Pharmaceutical Solutions; D015080:Mesna; D007069:Ifosfamide
keywords: Ifosfamide; improved therapeutic index; infusion solutions; mesna; outpatient chemotherapy; physicochemical stability; prolonged stability