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amifostine (Ethyol, ethiofos, gammaphos, amifostinum)
Tradename: Ethyol.
Indications:
- chemoprotectant used to prevent cumulative cisplatin-induced (chemotherapy-related) nephrotoxicity in
- advanced ovarian cancer
- small cell cancer of the lung
- myelodysplastic syndrome [2]
- protection during radiation therapy
- may be protective against neurotoxicity
- mucositis [2]
Dosage:
1) 910 mg/m2 IV QD infused over 15 minutes starting 30 minutes prior to cisplatin chemotherapy
2) 15 minute infusion is better tolerated than longer infusions
3) patient should be in the supine position during infusion
4) concurrent administration of antiemetics:
a) dexamethasone 20 mg IV
b) serotonin 5HT3 receptor antagonist
Injection: vials: 500 mg.
Monitor:
1) blood pressure every 5 min during the infusion mean onset of hypotension is 14 minutes into infusion mean duration of hypotension is 6 minutes interrupt infusion for significant hypotension
2) serum Ca+2 levels in patients at risk for hypocalcemia, especially those with nephrotic syndrome
Adverse effects:
1) common (> 10%)
- flushing
- hypotension (62%)
- chills
- dizziness
- somnolence
- nausea/vomiting (may be severe)
- sneezing
- feeling of warmth/coldness
- hiccups
2) uncommon (< 1%)
- mild rash, hypocalcemia, rigors
Drug interactions:
-> antihypertensive agents
Note:
- data regarding the preservation of cisplatin antitumor activity when amifostine is administered in combination is not established except for ovarian cancer & small cell cancer of the lung
Related
cisplatin (Platinol)
ovarian cancer
small cell carcinoma of the lung (SCLC, oat cell carcinoma)
General
amine
antidote
thiol; sulhydryl compound; mercaptan
Properties
MISC-INFO: pregnancy-category C
Database Correlations
PUBCHEM correlations
References
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Deprecated Reference