amifostine (Ethyol, ethiofos, gammaphos, amifostinum)
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Introduction
Tradename: Ethyol.
Indications
- chemoprotectant used to prevent cumulative cisplatin-induced (chemotherapy-related) nephrotoxicity in
- protection during radiation therapy
- may be protective against neurotoxicity
- mucositis[2]
Dosage
- 910 mg/m2 IV QD infused over 15 minutes starting 30 minutes prior to cisplatin chemotherapy
- 15 minute infusion is better tolerated than longer infusions
- patient should be in the supine position during infusion
- concurrent administration of antiemetics:
- dexamethasone 20 mg IV
- serotonin 5HT3 receptor antagonist
Injection: vials: 500 mg.
Monitor
- 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
- serum Ca+2 levels in patients at risk for hypocalcemia, especially those with nephrotic syndrome
Adverse effects
- common (> 10%)
- flushing
- hypotension (62%)
- chills
- dizziness
- somnolence
- nausea/vomiting (may be severe)
- sneezing
- feeling of warmth/coldness
- hiccups
- uncommon (< 1%)
- mild rash, hypocalcemia, rigors
Drug interactions
Notes
- 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