Chloroacetaldehyde
from ifosfamide
What it isA reactive metabolite of ifosfamide.
Why it mattersIt is the leading explanation for ifosfamide’s neurotoxicity (encephalopathy) and contributes to nephrotoxicity — toxicities cyclophosphamide largely lacks.
What it changesMethylene blue and supportive care address the encephalopathy; the metabolite is why ifosfamide, not cyclophosphamide, causes it.
NO BOXED WARNINGS