Classifications: cytoprotective agent; Therapeutic: cytoprotective agent
Pregnancy Category: C
500 mg vial
Amifostine reduces cytotoxic damage induced by radiation or antineoplastic agents in well-oxygenated cells. Protective effects
appear to be mediated by the formation of a metabolite of amifostine that removes free radicals from normal cells exposed
Amifostine is cytoprotective in the kidney, bone marrow, and GI mucosa, but not in the brain or spinal cord. The cytoprotection
results in decreased myelosuppression and peripheral neuropathy.
Reduction of the cumulative renal toxicity associated with cisplatin, xerostomia.
Reduction of paclitaxel toxicity.
Sensitivity to aminothiol compounds or mannitol, patients with potentially curable malignancies, hypotensive patients or
those who are dehydrated, lactation; exfoliated dermatitis; pregnancy (category C).
Patients at risk for hypocalcemia, cardiovascular disease (i.e., arrhythmias, CHF, TIA, CVA); radiation therapy; renal disease.
Route & Dosage
Adult: IV 910 mg/m2 once daily prior to chemotherapy
Reduction of Xerostomia
Adult: IV 200 mg/m2 prior to radiation therapy
PREPARE: IV Infusion: Reconstitute by adding 9.7 mL of NS injection to a single-dose vial to yield 50 mg/mL. May be further diluted with NS to
a concentration as low as 5 mg/mL.
ADMINISTER: IV Infusion: Infuse over no more than 15 min, beginning 30 min before chemotherapy; place patient in supine position prior to and during
infusion. For xerostomia, infuse over 3 min; begin 1530 min before radiation.
INCOMPATIBILITIES Solution/additive: Do not mix with any solutions other than NS. Y-site: Acyclovir, amphotericin B, chlorpromazine, cisplatin, ganciclovir, hydroxyzine, prochlorperazine.
- Store reconstituted solution at 15°30° C (59°86° F) for 5 h or refrigerate up to 24 h.
Adverse Effects (≥1%)CV: Transient reduction in blood pressure. GI: Nausea, vomiting. Other:
Infusion reactions (flushing, feeling of warmth or coldness, chills, dizziness, somnolence, hiccups, sneezing), hypocalcemia,
could cause or potentiate hypotension.
58 min. Metabolism:
In liver to active free thiol metabolite
Renally excreted. Half-Life:
Assessment & Drug Effects
- Monitor for S&S of hypocalcemia and fluid balance if vomiting is significant.
- Monitor BP every 5 min during infusion. Stop infusion if systolic BP drops significantly from baseline (e.g., baseline[drop]:
<100, 100119, 120139, 140179, >180) and place patient flat with legs raised. Restart
infusion if BP returns to normal in 5 min.
Patient & Family Education
- Know and understand adverse effects.