Dosing & Uses
Dosage Forms & Strengths
powder for injection
Indicated to reduce cumulative renal toxicity associated with repeated administration of cisplatin in patients with advanced ovarian cancer
Blood pressure should be followed following its administration and interrupted if systolic blood pressure decreases signficantly from baseline as described below
Interrupt Therapy If Systolic Blood Pressure Baseline Decreased
- Decreased by 20 mm Hg if baseline <100
- Decreased by 25 mm Hg if baseline <100-119
- Decreased by 30 mm Hg if baseline <120-139
- Decreased by 40 mm Hg if baseline <140-179
- Decreases by 50 mm Hg if baseline ≥180
Indicated to reduce incidence of moderate-to-severe xerostomia in patients undergoing postoperative radiation treatment for head and neck cancer, where the radiation port includes a substantial portion of the parotid glands
500 mg SC qDay prior to radiation therapy
Chemoprotective Agent (Orphan)
- Chemoprotection for cisplatin in the treatment of metastatic melanoma
- Reduction of incidence and severity of toxicities associated with cisplatin administration
- Chemoprotection for cyclophosphamide in the treatment of advanced ovarian carcinoma
- Treatment of myelodysplastic syndromes
Orphan indications sponsor
- Medimmune Oncology, Inc; One MedImmune Way; Gaithersburg, MD 20878
Ensure adequate hydration and premedicate with antiemetic treatment
Safety and efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Hypotension (61%) - discontinue infusion if significant BP drop
Stevens-Johnson syndrome (1%)
Frequency Not Defined
Chills/feeling of coldness
Flushing/feeling of warmth
Hypersensitivity to aminothiol, monitor closely during and after IV
Cardiovascular disease, hypocalcemia, hypotension, cutaneous reactions, or nausea/vomiting may occur
Ensure adequate hydration
Do not give to patients receiving definitive radiotherapy except in the context of a clinical trial, since there are at present insufficient data to exclude a tumor-protective effect in this setting; amifostine was studied only with standard fractionated radiotherapy and only when ≥75% of both parotid glands were exposed to radiation
Use caution in hypotension and cerebrovascular disease
Interrupt antihypertensive therapy 24 hr before treatment; patients unable to safely interupt antihypertensive therapy should not recieve amifostine
Pregnancy & Lactation
Pregnancy Category: C
Lactation: excretion in milk unknown/not recommended
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Thiol metabolite binds to reactive metabolites of cisplatin and scavenges free radicals
Half-Life: 8 min
Metabolite: Free thiol
Vd: 3.5 L
Half-life: 8-9 min
Y-site: acyclovir, amphotericin B, cefoperazone, chlorpromazine, cisplatin, ganciclovir, hydroxyzine, minocycline, prochlorperazine
Y-site (partial list): amikacin, ampicillin, carboplatin, cefazolin, ceftriaxone, cefoxitin, clindamycin, dopamine, furosemide, heparin, lorazepam, MgSO4, metoclopramide, morphine, ondansetron, NaHCO3, trimethoprim/sulfamethoxazole, vancomycin
Reconstitute with 9.5 mL 0.9% NaCl
Amifostine should be further diluted in 0.9% NaCl to a concentration of 5-40 mcg/mL
Infuse over 15 min before chemotherapy
Infuse over 3 min before radiation treatment
Administration as a longer infusion is associated with a higher incidence of adverse effects
Refrigerate lyophilized powder
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.