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Amifostine

(am-uh-foss-teen)

Trade/other name(s): Ethyol

Why would this drug be used?

Amifostine belongs to a general class of drugs known as cytoprotective (cell-protecting) agents. It helps reduce kidney damage caused by chemotherapy drugs that contain platinum, such as cisplatin. Some doctors may also use it to help protect the bone marrow and nervous system from being damaged by chemotherapy. It is also used to protect normal cells in certain areas of the body against radiation therapy damage.

How does this drug work?

Once in the body, amifostine enters normal cells and changes into another drug, which helps protect the cells from damage caused by radiation or platinum-containing chemotherapy drugs. Cancer cells are not as good at changing amifostine into the other drug, and therefore aren’t protected.

Before taking this medicine

Tell your doctor…

  • If you are allergic to any medicines, dyes, additives, or foods.
  • If you have low blood pressure or a history of fainting, or are taking any medicines for high blood pressure. This drug can cause lowered blood pressure during the infusion, which could be made worse if combined with blood pressure medicines.
  • If you have any other medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, heart rhythm problems, congestive heart failure, lung disease, diabetes, gout, infections, stroke, or problems with brain circulation (transient ischemic attack). You may need closer monitoring of these conditions while being treated, or the drug dose, regimen, or timing may need to be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. It is not known if this drug might cause problems if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug should use some kind of birth control during treatment. It is important to check with your doctor about what kinds of birth control can be used with this medicine. This drug should be used during pregnancy only if the potential benefit is thought to justify the potential risk to the fetus.
  • If you are breast-feeding. While no studies are available at this time, this drug may pass into breast milk and affect the baby. Talk with your doctor about the possible risks of breast-feeding while taking this drug.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

This drug can lower blood pressure while it is being given. Other drugs that lower blood pressure could worsen this effect, which could lead to a serious drop in blood pressure.

No other serious interactions are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about all of your medicines, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with Foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether some foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Amifostine is given as infusion into a vein (intravenously, or IV). The infusion is given about 30 minutes before cancer treatment (chemotherapy or radiation), and usually lasts for less than 15 minutes. The dose and schedule will depend on your body size and on the type of cancer treatment you are getting.

You will want to speak with your doctor about stopping any blood pressure medicines 24 hours before the infusion.. You likely will get anti-nausea medicines before and/or during the infusion. Your doctor will want to make sure you are well hydrated and are lying down during the infusion to lower the risk of problems with low blood pressure.

Precautions

This drug can cause low blood pressure during the infusion, which in some cases can be serious. Your health care team will want to make sure you are well hydrated (drinking plenty of fluids) and are lying down during the infusion to lower the risks of problems. They will watch your blood pressure closely at this time. Let them know right away if you feel dizzy, lightheaded, short of breath, or if you notice a fast heart beat.

You may have nausea and vomiting on the day you receive this drug or in the first few days afterward. Your doctor may give you medicine before your treatment to help prevent nausea and vomiting. You will likely also get a prescription for an anti-nausea medicine that you can take at home. It is important to have these medicines on hand and to take them as prescribed by your doctor.

In rare cases, this drug can cause allergic reactions when the drug is given. Mild reactions may consist of fever, chills, skin itching, or feeling flushed. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), chest tightness, shortness of breath, back pain, or swelling of the face, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms during or after being given the drug.

While taking this medicine, and for a few days or even weeks afterward, there is a slight chance of a serious skin reaction. Symptoms often start as a skin rash with redness or blistering in the mouth, nose, or eyes, along with fever and body aches. If this happens, call your doctor right away.

Your doctor will test your blood frequently throughout your treatment, looking for possible effects of the drug on blood counts or on blood chemistry levels. Based on the test results, your doctor may need to reduce or delay your next dose of this drug, or even stop it altogether.

Possible side effects

Most of the following side effects probably will not occur. Your doctor or nurse will want to discuss specific care instructions with you. They can help you understand these side effects and help you deal with them.

Common

  • low blood pressure*
  • nausea/vomiting*

Less common

  • flushing (warmth, redness) in the face or neck
  • fever or chills
  • feeling sleepy
  • hiccups
  • sneezing
  • dizziness, faintness, fast heartbeat, or trouble breathing during or just after this drug*

Rare

  • allergic reaction (may include shortness of breath, wheezing, swelling in the mouth or throat, hives, itching, flushing, or fever)*
  • skin reactions*
  • lowered blood calcium levels (your doctor will explain the importance of this, if any)
  • change in heart rhythm

*See "Precautions" section for more detailed information.

Other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1995

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.

Last Medical Review: 10/22/2009
Last Revised: 10/22/2009