Adult Dosing

Prophylaxis in patients receiving cisplatin

• 910 mg/m² IV given 30 mins before chemotherapy
• If significant hypotension occurs, reduce subsequent doses to 740 mg/m²
• Stop hypertension medicines 24 hrs before dose

Prophylaxis for xerostomia in patients undergoing radiation therapy for head and neck cancer

• 200 mg/m² IV qd over 3 min initiated 15-30 min prior to fractioned radiation therapy

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

• Reduction of cumulative renal toxicity associated with cisplatin in patients with advanced ovarian cancer
• Reduction of incidence of moderate to severe xerostomia from postoperative radiation for head and neck cancer in which the radiation port includes a large portion of the parotid glands

• Hypersensitivity to aminothiol compounds
• Hypotension
• Dehydration
• Definitive XRT
• Curable malignancy

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Perform Cutaneous evaluation prior to each dose
• Monitor Ca if hypocalcemia risk including nephrotic syndrome or multiple dose therapy
• Monitor BP q5 min during infusion (or before/after if <5min infusion), then periodically
• Pretreat with antiemetics and hydration

Cautions: Use cautiously in

• Cardiovascular disease
• Cerebrovascular disease
• Hypocalcemia

Pregnancy Category:C

Breastfeeding: Safety unknown. Because many drugs are excreted in human milk and because of the potential for adverse reactions in nursing infants, breastfeeding must be discontinued.

• CNS: Dizziness, somnolence, seizures,
• CV: Hypotension, chest pain, cardiac arrest, atrial fibrillation, bradycardia, tachycardia
• EENT: Sneezing
• RESP: Apnea, dyspnea, hypoxia
• GI: Nausea, vomiting (severe)
• DERM: Flushing, pruritus, rash, urticaria
• METABOLIC: Hypocalcemia
• MISC: Fever, chills, Angioedema, allergic reactions including anaphylaxis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, erythema multiforme, exfoliative dermatitis

• Oncologic Toxicities: Binds and detoxifies damaging metabolites of cisplatin and reactive oxygen species generated by radiation, prevents nucleic acid alkylation; scavenges reactive oxygen species generated by exposure to either cisplatin or radiation
• Amifostine is a prodrug that is converted to active free thiol metabolite
• Metabolized by tissue dephosphorylation
• Renally excreted
• Half-life: 8 mins (elimination phase)

US Trade Name(s)

• Ethyol

US Availability

amifostine (generic)

• PWDR for INJ: 500 mg/vial

Ethyol

• PWDR for INJ: 500 mg/vial

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• Ethyol

Australian Availability

Ethyol

• PWDR for INJ: 500 mg/vial

Hematology/Oncology

Antineoplastic Detoxifying Agents