amifostine
Ethyol (amifostine) is used to prevent kidney damage or dry mouth from certain anticancer treatments. This medication is injected into a vein typically at an infusion center, so your provider will help you set up your appointments.
What is Ethyol (amifostine)?
What is Ethyol (amifostine) used for?
- Reduce kidney damage from repeated treatment with cisplatin in people with ovarian cancer that has spread outside of the ovary
- Lower the risk of moderate-to-severe dry mouth from radiation therapy in people with head and neck cancer
How Ethyol (amifostine) works
Ethyol (amifostine) is a cytoprotective agent (medication that protects your cells). It's used with certain anticancer treatments to prevent harmful side effects.
After you receive Ethyol (amifostine), your body breaks down this medication into different chemicals, one of which is called thiol. The normal cells in your body absorb thiol. This chemical is able to neutralize the toxic effects of certain other anticancer treatments on your normal cells and protect them from damage.
Ethyol (amifostine) can help protect your kidney cells from damage caused by cisplatin treatment. In addition, radiation therapy used for head and neck cancer can cause damage to your salivary gland (an organ that makes saliva in your mouth), leading to dry mouth. By protecting your salivary gland tissues, Ethyol (amifostine) can help prevent dry mouth.
Drug facts
Side effects of Ethyol (amifostine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
The following side effects happened when people received Ethyol (amifostine) with anticancer medications or radiation treatment.
- Nausea or vomiting (up to 96%)
- Low blood pressure (up to 62%)
Less Common Side Effects
- Infusion reactions (e.g., chills, fever, dizziness, blurry vision)
- Injection site reactions (e.g., rash, itching, hives, skin pain, bruising)
Ethyol (amifostine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: fever, chills, chest discomfort, shortness of breath, tightness in throat, hives, swelling
- Serious skin reactions: rash with blisters, fever, itchy skin, hives, skin pain, skin peeling, skin or mouth sores
- Serious heart problems: irregular heartbeat, feeling weak, pain in the jaw or back, chest pain
The following Ethyol (amifostine) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Blurred vision
confusion
dizziness, faintness, or lightheadedness when suddenly getting up from a lying or sitting position
fainting or loss of consciousness
fast or irregular breathing
nausea, vomiting
red, scaly, swollen, or peeling areas of the skin
skin rash
sweating
swelling of the eyes or eyelids
tightness in the chest
trouble with breathing
unusual tiredness or weakness
Rare
Blistering, peeling, or loosening of the skin
burning or tingling sensation
chills
cracks in the skin
fast, slow, or irregular heartbeat or pulse
joint or muscle pain
loss of bladder control
loss of heat from the body
muscle cramps in the hands, arms, feet, legs, or face
muscle spasm or jerking of all extremities
no blood pressure or pulse
numbness and tingling around the mouth, fingertips, or feet
red, irritated eyes
red skin lesions, often with a purple center
seizures
sores, ulcers, or white spots in the mouth or on the lips
stomach cramps
stopping of the heart
sudden loss of consciousness
Incidence not known
Bloody urine
decreased frequency or amount of urine
difficulty with swallowing
hives or welts
hoarseness
increased blood pressure
increased thirst
lower back or side pain
loss of appetite
pain or discomfort in the arms, jaw, back, or neck
slow or irregular breathing
swelling of the face, fingers, or lower legs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common or rare
Feeling unusually warm or cold
flushing or redness of the face or neck
headache
hiccups
nervousness
pounding in the ears
sleepiness (severe)
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Ethyol (amifostine)
Pros
- The first FDA-approved medication to lower side effects from radiation
- Given right before anticancer treatment, so it's convenient for people with a busy schedule
Cons
- Likely to cause nausea and vomiting
- Requires blood pressure monitoring
- Only available as a brand medication, so it might be expensive
Pharmacist tips for Ethyol (amifostine)
- Be sure to plan for some extra time for your appointment. Your provider will need to check your blood pressure before and after you've received Ethyol (amifostine). If you're receiving higher doses of this medication before your cisplatin treatment, your provider will also check your blood pressure every 5 minutes during the Ethyol (amifostine) infusion. This is because Ethyol (amifostine) can lower your blood pressure to dangerous levels.
- Make sure you're lying down in a reclining chair while receiving Ethyol (amifostine) since it can cause dizziness. Let your provider know right away if you experience fainting, dizziness, or nausea after you've received Ethyol (amifostine).
- Before you receive Ethyol (amifostine), drink plenty of water and stay hydrated. Doing so can help prevent low blood pressure as well as relieve nausea from the infusion. Your provider might also give you IV fluids before your infusion as extra precaution.
- To help prevent nausea and vomiting from the infusion, your provider will give you some medication before you receive Ethyol (amifostine).
- Taking certain medications that can lower your blood pressure while receiving Ethyol (amifostine) therapy can be dangerous. This combination can make your blood pressure drop too much. Let your provider know what medications you're taking, including over-the-counter products and supplements, before you start Ethyol (amifostine). Talk with your provider if you have any questions about interactions with this medication.
- Tell your provider if you experience any changes in weight while receiving Ethyol (amifostine). Since the dose is based on your weight, your provider might need to adjust how much Ethyol (amifostine) you need.
Common questions about Ethyol (amifostine)
Currently, Ethyol (amifostine) is only FDA-approved to prevent kidney damage in certain people receiving cisplatin for ovarian cancer and to prevent dry mouth in people receiving radiation for head and neck cancer. But, some studies suggest that when given into the rectum, Ethyol (amifostine) might work well and be safe to use in preventing proctitis (inflamed rectum) in people receiving radiation for prostate cancer. There are many treatments available to prevent or manage proctitis from radiation, each with its own safety risks. Discuss with your provider to see what the best option is for you.
Yes, Ethyol (amifostine) can lower the levels of calcium in your body. This is because Ethyol (amifostine) can prevent the body from releasing a hormone called parathyroid hormone (PTH). PTH helps regulate how much calcium you have in your blood through signals to your bones, kidneys, and intestines. Having less PTH in the body can lead to low calcium in the blood, which can affect bone and muscle strength. You're at higher risk if you have a history of kidney problems or if you're receiving Ethyol (amifostine) regularly. Your provider might recommend you to take calcium supplements after receiving Ethyol (amifostine). Tell your provider right away if you have symptoms of low calcium including dry skin, brittle nails, muscle cramps, and confusion.
There isn't enough information to know if Ethyol (amifostine) is safe in pregnancy. Animal studies showed that it can cause harm to unborn babies. If you’re pregnant or planning on becoming pregnant, talk to your provider so you can discuss the risks of using this medication.
It's not clear whether Ethyol (amifostine) is safe to use while breastfeeding. But it's recommended that you don't breastfeed your baby while receiving it due to the risk of serious side effects to babies. Speak to your provider before using Ethyol (amifostine) if you're breastfeeding. They can help you come up with the safest option for you and your baby.
The effect of Ethyol (amifostine) on human fertility (the ability to have children) hasn't been studied. But, animal studies showed that this medication lowered the ability of male rats to have babies. While animal studies don’t always represent what happens in humans, it’s possible that Ethyol (amifostine) can affect lower your ability to have children if you're male. If you plan to have children, please talk with your provider about the benefits and risks of taking this medication.
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Risks and warnings for Ethyol (amifostine)
Ethyol (amifostine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Lower effectiveness of chemotherapy or radiotherapy
Ethyol (amifostine) can interfere with certain anticancer treatments and make them less effective against tumor cells. While this medication can protect normal cells from damage caused by anticancer therapy, it's unclear if it might also be able to protect tumor cells from being destroyed. Ethyol (amifostine) shouldn't be used in people with cancer that can be successfully treated with either chemotherapy or radiotherapy. Talk with your provider so you can discuss the benefits and risks of receiving Ethyol (amifostine).
Low blood pressure
- Risk factor: Dehydration | Taking medications that lower your blood pressure
Ethyol (amifostine) can sometimes cause severely low blood pressure during or after the infusion. If blood pressure drops too much, it can lead to serious heart problems, such as irregular heartbeat, heart attack, or cardiac arrest (heart stops beating). Blood pressure typically drops within 15 minutes of starting the Ethyol (amifostine) infusion.
To prevent your blood pressure from dropping too much, your provider might ask you to stop any blood pressure medications you're taking 24 hours before each Ethyol (amifostine) infusion. On the day of your infusion, your provider will make sure you're hydrated enough before you receive Ethyol (amifostine) to prevent your blood pressure from dropping. Your provider might check your blood pressure multiple times during the infusion to make sure this medication is safe for you. If you experience symptoms of low blood pressure, like fainting, dizziness, chest pain, or shortness of breath during or after your infusion, get medical attention right away.
Serious skin reactions
- Risk factor: Receiving radiation therapy
Ethyol (amifostine) can sometimes cause rash and other severe skin reactions that can be life-threatening. These reactions can happen during the infusion or several weeks after you've received this medication. Your risk is higher if you're receiving Ethyol (amifostine) to lower the risk of dry mouth from radiation. If you have a rash with blisters, raw skin, itchy skin, hives, skin pain, skin peeling, skin sores on the palms or soles, mouth sores, or swollen face, stop using Ethyol (amifostine) and get medical help right away.
Serious allergic reaction
In some rare cases, Ethyol (amifostine) can cause allergic reactions, which can be life-threatening. Watch out for signs and symptoms, such as fever, chills, hives, swelling, chest discomfort, shortness of breath, or tightness in the throat. Get emergency medical help if you experience any symptoms of an allergic reaction.
Nausea and vomiting
- Risk factor: Higher dose of Ethyol (amifostine)
People who receive Ethyol (amifostine) commonly experience nausea and vomiting. If these episodes are serious, they can cause dehydration and a drop in blood pressure, which can be life-threatening. Nausea and vomiting are more common in people who receive higher doses of this medication. Your provider will prescribe antinausea medication for you to take before starting Ethyol (amifostine). Let your provider know if you feel sick to your stomach or have vomiting during or after your infusion.
Ethyol (amifostine) dosage
Typical dosage for Ethyol (amifostine)
The dose is based on your body surface area (BSA, or body size; in units of m2), which takes account your weight and height. Your provider will calculate the right dose for you and determine the number of infusions you need. In general:
- To reduce kidney damage from cisplatin: The typical starting dose is 910 mg/m2 injected into a vein (intravenous, or IV) over 15 minutes. Your provider will give you Ethyol (amifostine) 30 minutes before chemotherapy.
- To prevent dry mouth from head and neck radiation: The typical dose is 200 mg/m2 injected into a vein (IV) over 3 minutes. Your provider will give you Ethyol (amifostine) 15 to 30 minutes before radiation.
Interactions between Ethyol (amifostine) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Ethyol (amifostine) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Ethyol (amifostine) will not be safe for you to take.
- History of allergy to aminothiol substances (i.e., amifostine)
