We were given the Medimmune booklet on Amifostine (Ethyol) and they emphasize several things about adminsitering it:

1) adequate hydraton, they recommend drinking 20-32 oz. of liquid (jello counts as a liquid) in the 90 minutes prior to the injections. (My husband found this to be the most difficult part of a difficult drug -- especially as it became harder to swallow.) The hydration is to prevent blood pressure drop, sometimes seen with this drug. The nurse will carefuly monitor BP before and after injections.

2) taking an anti-nausea drug 90 minutes prior to the injections -- (my husband was given Zofran. Compazine did not work for him and I have heard from others it wasn't strong enough.) This is imperative -- the most common reaction I have heard of with amifostine is nausea, sometimes violent.

3) Ethyol to be given by injection -- 500 mg in saline -- usually two separate injections each time -- 30 minutes to 60 minutes before the radiation. This requires good coordination between the oncology nurse and the radiation technicians. Be sure they check that the radiation techs are running on schedule before administering the Ethyol, and you have a half-hour window of effectiveness (per Medimmune).

4) A rash may develop at the site of the injections --Medimmue suggests taking Benedryl but our RO found rubbing hydrocortisone cream immediately into the injection site works as well.

Our radiation onc told us that most of the patients at Hopkins try the amifostine but few make it al the way through, developing a generalized rash or unremitting nausea, at which time the treatments are stopped. They do try to avoid problems by, say, not giving amifostine on chemo days (which they did for my husband) or going to every other day, Apparently even a partial series of treatments can help preserve salivary function.

Gail