Amifostine, Injection

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KEY POINTS

• This medicine is given by IV to reduce the risk of kidney problems caused by cisplatin or to reduce dry mouth caused by radiation treatments of the head and neck.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause severe skin reactions or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: cytoprotective agent

Generic and brand names: amifostine, injection; Ethyol

What is this medicine used for?

This medicine is given by IV infusion (slow drip through a needle into a large vein) before cancer treatment. It is used to reduce the risk of kidney problems caused by cisplatin or to reduce dry mouth caused by radiation treatments of the head and neck.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A stroke or transient ischemic attack (TIA)
• Heart disease, irregular heartbeat, or heart failure
• Low levels of calcium in the blood
• Low blood pressure, or if you take medicine for high blood pressure

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine is given within 30 minutes of chemotherapy or radiation. The infusions are given by a healthcare provider.

You may be given other medicines to decrease the risk of certain side effects. Take all other medicines as prescribed.

What should I watch out for?

This medicine may cause your blood pressure to fall. Your blood pressure will be checked often while you are being treated. Make sure your provider knows if you take diuretics (water pills) or other medicines for high blood pressure. Talk with your healthcare provider about how much liquid you should drink while you are receiving this medicine. Tell your healthcare provider if you become lightheaded or dizzy or feel faint.

Severe skin reactions such as blisters, peeling skin, or redness of the palms of your hands or soles of your feet can develop weeks after you start treatment with this medicine. Report any skin reactions to your provider right away.

You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reactions (hives, itching, rash, tightness in your chest, swelling of your lips, tongue or throat, trouble breathing); blisters or peeling of the skin; red or irritated eyes; sores in your mouth, throat, nose, or eyes; redness or irritation of the palms of hands or soles of feet.

Serious (Report these to your healthcare provider right away.): Severe nausea and vomiting; severe lightheadedness or dizziness; shortness of breath; slow or shallow breathing; chest pain; seizures; fever; fainting; irregular, fast, or slow heartbeat; severe weakness; muscle cramps or twitching; numbness or tingling; trouble urinating; decreased urination.

Other: Flushing, chills, mild dizziness, tiredness, drowsiness, hiccups, sneezing, mild skin rash, diarrhea, mild nausea and vomiting, injection site pain or irritation.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Aliskiren (Tekturna) and aliskiren/hydrochlorothiazide (Tekturna HCT)
• Alpha blockers such as doxazosin (Cardura), prazosin (Minipress), and terazosin
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antipsychotic medicines such as chlorpromazine, clozapine (Clozaril, FazaClo), perphenazine, prochlorperazine (Compro), risperidone (Risperdal), and thioridazine
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Bromocriptine (Cycloset, Parlodel)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Clonidine (Catapres, Kapvay)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate)
• Medicines to treat pulmonary hypertension such as epoprostenol (Flolan, Veletri), iloprost (Ventavis), riociguat (Adempas), and treprostinil (Orenitram, Remodulin, Tyvaso)
• Methyldopa
• Natural remedies such as black cohosh, California poppy, goldenseal, hawthorn, mistletoe, periwinkle, and shepherd’s purse
• Parkinson's disease medicines such as apomorphine (Apokyn), bromocriptine (Cycloset, Parlodel), levodopa/carbidopa (Duopa, Rytary, Sinemet), pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro)
• Phenoxybenzamine (Dibenzyline)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Quinine
• Vasodilators such as hydralazine, isosorbide (Dilatrate, Isordil, Monoket), isoxsuprine, minoxidil, nesiritide (Natrecor), and nitroglycerin (Minitran, Nitro-Dur, Nitrostat)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.