Article Contents ::

Details About Generic Salt ::  Amifosti

Main Medicine Class::    

(am-ih-FOSS-teen)
Ethyol
Sterile lyophilized powder for injection
500 mg in 10 mL single-use vials
Class: Selective tissue chemoprotectant and radioprotectant

 Indications Prevent or reduce renal damage in patients receiving repeated cisplatin doses for advanced ovarian or non-small cell lung cancer; reduce incidence of moderate to severe xerostomia in patients undergoing radiation of the parotid gland for head and neck cancer.

Prevent or reduce cisplatin-induced neurotoxicity and cyclophosphamide-induced granulocytopenia; prevent or reduce toxicity of radiation therapy to other areas; reduce toxicity of paclitaxel.

 Contraindications Sensitivity to aminothiol compounds.

 Route/Dosage

Reduction of Cumulative Renal Toxicity with Chemotherapy

ADULTS: IV Amifostine 910 mg/m2 qd as a 15 min IV infusion, 30 min before chemotherapy.

Reduction of Moderate to Severe Xerostomia from Radiation of the Head and Heck

ADULTS: IV Amifostine 200 mg/m2 qd as a 3 min IV infusion, 15 to 30 min prior to standard fraction radiation therapy (1.8 to 2 Gy).

Interactions

Antihypertensives

Coadministration of drugs with similar pharmacologic effects may cause additive side effects, including toxicity.

Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Transient hypotension (up to 62%). CNS: Dizziness; somnolence; drowsiness. DERMATOLOGIC: Flushing. ENDOCRINE: Hypocalcemia; hypomagnesemia; drug fever. GI: Moderate to moderately low potential for nausea and vomiting. RESPIRATORY: Hiccoughs; sneezing. OTHER: Feelings of warmth or coldness.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Effectiveness of the cytotoxic regimen: Do not use in patients receiving chemotherapy for malignancies in which chemotherapy can produce a significant survival benefit or cure. Effectiveness of radiotherapy: Do not administer in patients receiving definitive radiotherapy. Hypotension: Do not give to patients who are hypotensive or dehydrated. Elderly: Safety and efficacy not established. Special populations: Avoid use in patients with hypersensitivity to amifostine, aminothiol compounds. Use cautiously in patients with cerebrovascular or cardiovascular disease, hypocalcemia, or in patients who are pregnant or breastfeeding.

PATIENT CARE CONSIDERATIONS


 Administration/Storage

  • Administer by IV route only. Not for IM or SC administration.
  • Reconstitute powder with 9.7 mL of 0.9% NaCl for a final amifostine concentration of 50 mg/mL.
  • Prior to infusion further dilute amifostine in 0.9% NaCl to a final concentration of 5 to 40 mg/mL.
  • Do not mix with other IV medications or IV fluids.
  • To reduce nephrotoxicity with chemotherapy administer as a 15 min infusion, starting 30 min prior to chemotherapy.
  • To reduce xerostomia from radiation therapy administer as a 3 min infusion, starting 15 to 30 min before radiation treatment.
  • Do not administer if cloudiness or particulate matter is noted.
  • Store vials at controlled room temperature. Reconstituted and diluted solutions are stable for up to 5 hr at controlled room temperature, or for up to 24 hr if refrigerated.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note if patient is hypotensive, dehydrated, or taking antihypertensive medications. Note history of preexisting cardiovascular or cerebrovascular conditions.
  • Ensure that patient is well hydrated prior to infusion.
  • Ensure that patient remains supine while receiving the infusion and for at least several minutes after completion of the infusion.
  • Monitor BP every 5 min during the 15 min infusion and thereafter as clinically indicated. Stop the infusion for significant decreases in systolic BP. If systolic BP returns to normal and the patient is asymptomatic within 5 min, restart the infusion and continue to monitor BP. If systolic BP remains low, do not administer remainder of dose but administer reduced dose for subsequent cycles.
  • Monitor BP before and immediately after the 3 min infusion and thereafter as clinically indicated.
  • If symptomatic hypotension develops, discontinue the infusion, place the patient in the Trendelenburg position and administer normal saline via a separate IV line.
  • Ensure that appropriate antiemetic medication is administered prior to and in conjunction with amifostine.
  • Monitor fluid balance when highly emetogenic chemotherapy is being used.
  • Ensure that serum calcium is monitored in patients at risk of hypocalcemia. Administer calcium supplements if necessary.
  • Monitor patient for signs of allergic reaction during and shortly after infusion. Be prepared to respond if a serious reaction occurs.
OVERDOSAGE: SIGNS & SYMPTOMS
  Anxiety and reversible urinary retention; hypotension

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug.
  • Advise patient that medication will be prepared and administered by health care provider in a health care setting just before chemotherapy or radiation therapy.
  • Advise patient to remain supine for 15 min after completion of infusion and to use caution when standing up.
  • Instruct patient to inform health care provider if they note any of the following during the administration of drug: anxiety, sweating, rapid heart beat, shortness of breath or difficulty breathing, swelling of the throat, rash, or itching.
  • Instruct patient not to take any prescription or OTC medications or dietary supplements unless advised to do so by health care provider.
  • Instruct women of child bearing potential to notify health care providers if pregnant, planning to become pregnant, or breastfeeding.
  • Advise patient that follow-up visits and laboratory tests will be required to monitor therapy and to keep appointments.

Medicscientist Drug Facts

 

Drugs Class ::

(am-ih-FOSS-teen)
Ethyol
Sterile lyophilized powder for injection
500 mg in 10 mL single-use vials
Class: Selective tissue chemoprotectant and radioprotectant

Indications for Drugs ::

 Indications Prevent or reduce renal damage in patients receiving repeated cisplatin doses for advanced ovarian or non-small cell lung cancer; reduce incidence of moderate to severe xerostomia in patients undergoing radiation of the parotid gland for head and neck cancer.

Prevent or reduce cisplatin-induced neurotoxicity and cyclophosphamide-induced granulocytopenia; prevent or reduce toxicity of radiation therapy to other areas; reduce toxicity of paclitaxel.

Drug Dose ::

 Route/Dosage

Reduction of Cumulative Renal Toxicity with Chemotherapy

ADULTS: IV Amifostine 910 mg/m2 qd as a 15 min IV infusion, 30 min before chemotherapy.

Reduction of Moderate to Severe Xerostomia from Radiation of the Head and Heck

ADULTS: IV Amifostine 200 mg/m2 qd as a 3 min IV infusion, 15 to 30 min prior to standard fraction radiation therapy (1.8 to 2 Gy).

Contraindication ::

 Contraindications Sensitivity to aminothiol compounds.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Effectiveness of the cytotoxic regimen: Do not use in patients receiving chemotherapy for malignancies in which chemotherapy can produce a significant survival benefit or cure. Effectiveness of radiotherapy: Do not administer in patients receiving definitive radiotherapy. Hypotension: Do not give to patients who are hypotensive or dehydrated. Elderly: Safety and efficacy not established. Special populations: Avoid use in patients with hypersensitivity to amifostine, aminothiol compounds. Use cautiously in patients with cerebrovascular or cardiovascular disease, hypocalcemia, or in patients who are pregnant or breastfeeding.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CARDIOVASCULAR: Transient hypotension (up to 62%). CNS: Dizziness; somnolence; drowsiness. DERMATOLOGIC: Flushing. ENDOCRINE: Hypocalcemia; hypomagnesemia; drug fever. GI: Moderate to moderately low potential for nausea and vomiting. RESPIRATORY: Hiccoughs; sneezing. OTHER: Feelings of warmth or coldness.

Drug Mode of Action ::  

(am-ih-FOSS-teen)
Ethyol
Sterile lyophilized powder for injection
500 mg in 10 mL single-use vials
Class: Selective tissue chemoprotectant and radioprotectant

Drug Interactions ::

Interactions

Antihypertensives

Coadministration of drugs with similar pharmacologic effects may cause additive side effects, including toxicity.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note if patient is hypotensive, dehydrated, or taking antihypertensive medications. Note history of preexisting cardiovascular or cerebrovascular conditions.
  • Ensure that patient is well hydrated prior to infusion.
  • Ensure that patient remains supine while receiving the infusion and for at least several minutes after completion of the infusion.
  • Monitor BP every 5 min during the 15 min infusion and thereafter as clinically indicated. Stop the infusion for significant decreases in systolic BP. If systolic BP returns to normal and the patient is asymptomatic within 5 min, restart the infusion and continue to monitor BP. If systolic BP remains low, do not administer remainder of dose but administer reduced dose for subsequent cycles.
  • Monitor BP before and immediately after the 3 min infusion and thereafter as clinically indicated.
  • If symptomatic hypotension develops, discontinue the infusion, place the patient in the Trendelenburg position and administer normal saline via a separate IV line.
  • Ensure that appropriate antiemetic medication is administered prior to and in conjunction with amifostine.
  • Monitor fluid balance when highly emetogenic chemotherapy is being used.
  • Ensure that serum calcium is monitored in patients at risk of hypocalcemia. Administer calcium supplements if necessary.
  • Monitor patient for signs of allergic reaction during and shortly after infusion. Be prepared to respond if a serious reaction occurs.
OVERDOSAGE: SIGNS & SYMPTOMS
  Anxiety and reversible urinary retention; hypotension

Drug Storage/Management ::

 Administration/Storage

  • Administer by IV route only. Not for IM or SC administration.
  • Reconstitute powder with 9.7 mL of 0.9% NaCl for a final amifostine concentration of 50 mg/mL.
  • Prior to infusion further dilute amifostine in 0.9% NaCl to a final concentration of 5 to 40 mg/mL.
  • Do not mix with other IV medications or IV fluids.
  • To reduce nephrotoxicity with chemotherapy administer as a 15 min infusion, starting 30 min prior to chemotherapy.
  • To reduce xerostomia from radiation therapy administer as a 3 min infusion, starting 15 to 30 min before radiation treatment.
  • Do not administer if cloudiness or particulate matter is noted.
  • Store vials at controlled room temperature. Reconstituted and diluted solutions are stable for up to 5 hr at controlled room temperature, or for up to 24 hr if refrigerated.

Drug Notes ::

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug.
  • Advise patient that medication will be prepared and administered by health care provider in a health care setting just before chemotherapy or radiation therapy.
  • Advise patient to remain supine for 15 min after completion of infusion and to use caution when standing up.
  • Instruct patient to inform health care provider if they note any of the following during the administration of drug: anxiety, sweating, rapid heart beat, shortness of breath or difficulty breathing, swelling of the throat, rash, or itching.
  • Instruct patient not to take any prescription or OTC medications or dietary supplements unless advised to do so by health care provider.
  • Instruct women of child bearing potential to notify health care providers if pregnant, planning to become pregnant, or breastfeeding.
  • Advise patient that follow-up visits and laboratory tests will be required to monitor therapy and to keep appointments.

Medicscientist Drug Facts

Disclaimer ::

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