Amifostine

It is an organic thiophosphate and protects cells against damage induced by radio and chemotherapy. It is a prodrug and require activation in the body by alkaline phosphotase to the active metabolite with a thiol group. It shows a much greater protective action in the higher activity of alkaline phosphatase in their cell membrances thus allowing greater conversion of amifostine into the active metaboline.

Indications

It provide protection from haematological, acute and cumulative nonhaematological side-effects associated with cancer chemo-therapeutic agents.

Dosage

910mg/m2 administered once daily as an IV infusion over 15minutes starting within 30 miutes prior to chemotherapy infusions.

Contra-Indications

hypersensitivity to aminothiol compounds, patients with low blood pressure or in dehydration, patients with renal or hepatic impairment..

Special Precautions

Patients should be well hydrated and kept supine during amifostine infusion. The dose of amifostine should be administered in 15 minutes. Antiemetics should be administered before and during the infusion of amifostine. Antihypertensive drug should be stopped 24 h before the infusion of amifostine. Paediatrics: Contraindicated. Pregnancy & Lactation : Contraindicated. Elderly: Contraindicated.

Side Effects

Hypertension, transient & rapidly reversible loss of consciousness. Nausea, vomiting, flushing or feeling of warmth, chills, dizziness, somnolence, sneezing and hiccups.

Drug Interactions

Concurrent use of antihypertensive drugs may potentiate hypotensive effects.