Amifostine
1531588
207848571
2008-04-24T13:10:36Z
134.151.33.86
{{drugbox
| IUPAC_name = 2-(3-aminopropylamino)ethylsulfanyl<br>phosphonic acid
| image = Amifostine.svg
| CAS_number = 20537-88-6
| ATC_prefix = V03
| ATC_suffix = AF05
| PubChem = 2141
| DrugBank = APRD00021
| C = 5 |H = 15 |N = 2 |O = 3 |P = 1 |S = 1
| molecular_weight = 214.224 [[Gram|g]]/[[Mole (unit)|mol]]
| bioavailability =
| protein_bound =
| metabolism =
| elimination_half-life = 8 minutes
| pregnancy_US = C
| legal_US = Rx-only
| routes_of_administration = [[Intravenous therapy|Intravenous]]
}}
'''Amifostine''' is a cytoprotective adjuvant used in cancer [[chemotherapy]] involving [[DNA]]-binding chemotherapeutic agents. Also commonly known as WR-1065 in its active form. It is marketed by [[MedImmune]] under the trade name '''Ethyol'''.
Amifostine is used therapeutically to reduce the incidence of [[neutropenia]]-related fever and infection induced by DNA-binding chemotherapeutic agents including [[alkylating antineoplastic agent|alkylating agent]]s (e.g. [[cyclophosphamide]]) and platinum-containing agents (e.g. [[cisplatin]]). It is also used to decrease the cumulative nephrotoxicity associated with platinum-containing agents. Amifostine is also indicated to reduce the incidence of [[xerostomia]] in patients undergoing radiotherapy for head and neck cancer.
Of note, amifostine was originally indicated to reduce the cumulative renal toxicity from cisplatin in non-small cell [[lung cancer]]. However, while nephroprotection was observed, the fact that amifostine could protect tumors could not be excluded. Given better treatment options for non-small cell lung cancer, this indication for non-small cell lung cancer was withdrawn in 2005.
Amifostine is an organic thiophosphate [[prodrug]] which is hydrolysed ''[[in vivo]]'' by [[alkaline phosphatase]] to the active cytoprotective [[thiol]] metabolite. The selective protection of non-malignant tissues is believed to be due to higher alkaline phosphatase activity, higher [[pH]], and vascular permeation of normal tissues.
Amifostine can only be administered intravenously, after reconstitution with [[saline (medicine)|normal saline]]. Infusions lasting less than 15 minutes decrease the risk of adverse effects. The patient should be well-hydrated before administration.
==Adverse effects==
Common [[adverse drug reaction|side effect]]s of amifostine include [[hypocalcemia]], [[diarrhea]], [[nausea]], [[vomiting]], sneezing, somnolence, and [[hiccoughs]].
Serious side effects include: hypotension (found in 62% of patients), [[erythema multiforme]], [[Stevens-Johnson syndrome]] and [[toxic epidermal necrolysis]], [[immune hypersensitivity syndrome]], [[erythroderma]], [[anaphylaxis]], and loss of consciousness (rare).
==Contraindications==
Contraindications to receiving amifostine include hypersensitivity to amifostine, aminothiol compounds, and [[mannitol]].
[[Category:Chemotherapeutic adjuvants]]
[[Category:Prodrugs]]
{{pharma-stub}}
{{Detoxifying agents for antineoplastic treatment}}
[[fr:Amifostine]]