Pharmacology · Chemotherapy supportive agents
Amifostine !
A thiol cytoprotectant that protects the kidney from cisplatin and the salivary glands from radiotherapy. It has been discontinued in the US.
Updated 2026-11-01
Also called: ethiofos
Mechanism of action
Amifostine is a thiophosphate cytoprotective agent, a sulfur (thiol) compound that protects normal tissues against the harmful effects of chemotherapy and radiation. With repeated cisplatin it reduces kidney toxicity; with radiotherapy of the head and neck it reduces dry mouth.
- Amifostine is given just before chemotherapy or radiation
- Its thiol protects normal tissue
- Less kidney damage from cisplatin; less dry mouth from radiotherapy
Pharmacokinetics
- Absorption
- Intravenous infusion, started shortly before cisplatin or each radiotherapy session.
Indications
- Protecting the kidneys from cisplatin in ovarian cancer. Ovarian cancer →
- Reducing dry mouth from postoperative radiotherapy for head and neck cancer. Head and neck squamous cell carcinoma (oral cavity and oropharynx, HPV) →
Adverse effects
Common
- Nausea and vomiting
- Flushing or warmth, chills, fever
- Tiredness, drowsiness, sneezing, hiccups
Contraindications
- Allergy to amifostine
Key interactions
- Antihypertensive drugs
- They are usually stopped before the infusion, as instructed by the treating team.
- Other thiol compounds (e.g. mesna)
- Hypersensitivity reactions have been reported with both.
What is monitored
- Blood pressure before and during the infusion
- Skin reactions
- Hydration and nausea control
Administration and safety
- Given intravenously by a clinician shortly before cisplatin or radiotherapy.
- Antihypertensives are reviewed and usually held before the infusion.
Nursing care
- Check blood pressure before and during the infusion; keep the patient lying down if dizzy.
- Give antiemetics as ordered and encourage fluids.
- Teaching: report rash, blistering, chest pain or fainting.
Test yourself
Think of the answer, then tap the question to see it.
Against which chemotherapy toxicity does amifostine protect?
Cumulative kidney toxicity from cisplatin.
Which radiotherapy complication can amifostine reduce?
Dry mouth (xerostomia) after radiotherapy for head and neck cancer.
Why are blood-pressure medicines reviewed before amifostine?
They are usually stopped beforehand, and amifostine itself can cause dizziness and fainting.
Related drugs
Related conditions
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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Amifostine Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2025); DailyMed - MESNA injection, solution (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 70 (McGraw Hill, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.