Andy --

I wouldn't rely on Compazine to alleviate the amiphostine nausea. It did zero, zip, nada for Barry -- he had to use Zofran -- and he was the only person in recent times at Hopkins to make it all the way through with the amiphostine -- most give up about 1/2 way through due to nausea. The cisplatin is more of a nausea problem (for many, but not all) than the carboplatin Barry had, as well. You must ask your doc about getting a scrip for one of the serotonin drugs like Zofran, Anzemet, or Kyril or you may not be be a happy camper! (Well, no one is a happy camper during chemoradiation but you get my point...)
This drug should be taken 90 minutes before the amiphostine (per Medimmune's administration directions), along with 20-32 oz. of clear liquid drunk in the 90 minutes leading up to the injection.) And definitely, sub cu injection, not IV!

Ativan may also make you very "out of it" -- Barry tried 1/2 tablet and that still made him too sleepy to drive -- test it at home.

Gail

Thanks for all the info. I do have prescriptions for Zofran, Ativan, and Compazine so hopefully that will cover most of it. I was going to take an Ativan for the anxiety, and then either a Compazine or Zofran for the nausea due to the Amiphostine. I just hope that this helps.

Andy

Andy --

What our radiation nurse recommended was to do teh amiphoistine with teh Zofran the first few times, and try it with Compazine. If you have no problem with it with Zofran, that is. Barry did OK with the Zofran, so tried amiphostine with Compazine, got quite nauseous in afternoon (he received the drug and radiation in late morning) and that was enough to switch him back to the Zofran -- expensive but as he said many times, "worth every penny!"

However two people got really sick (even with Zofran) the first time they took amiphostine so said, "no thanks!" Our RO (who is considered an expert on this drug) said it adds about 10-12% increased salivary sparing to IMRT so it is not the end of the world if you can't take it. That being said, Barry has excellent saliva 5 weeks' out so it undoubtedly helped him.

Gail

Hi Andy,
I just finished day 3 of radiation with Amiphostine. They used Zofran the first day. I was very sick. Day 2 they used zofran, gave me the Amiphostine, and I threw up right there. They then gave me a shot of Ativan so I could get through the radiation. Worked like a charm. They sent home a prescription for Ativan and it has been working for me so far.. They still start my IV with some Zofran. The actual treatments have not been bad at all. Feel free to email me([email protected]) if you want to talk more as we go through this. It's going to get pretty scarry, but reading everyone's enoucouging stories, I know we can do this. Hang in there. Eat lots of protein this week!! Have you started taking Salagen? -Kim

Kim --

Are you geting the amiphostine by IV or subcutaneous injection?

Medimmune (which makes amiphostine -- Ethyol) is pretty specific in recommending that it now be given by injection. There were too many side effects with IV, including serious blood pressure crashes. The Ethyol guys were at Hopkins and gave a talk, and they discussed that issue. They are supposedly trying to develop another delivery system that reduces the nausea but I have no idea what it is.

Re the Salagen, Hopkins doesn't start this (actually, they use Evoxac mostly now) until at least half-way, when you get a salivary evaluation. If you are OK then, then you get another evaluation at end of treatment, and if still OK, one two months' out. Etc. Barry was OK first two meeting with dental onc, next one is Dec. 6. He doesn't think Barry will have to use any meds for saliva -- and he is very pro-amiphostine, by the way, based on his research -- but will monitor things over time.

Good luck to you both (Andy and Kim) -- it is hard road but a necessary one...
Gail

Kim, its good to know I have someone that is going thru this at the same time. I know everyone on here really cares about each other and that is why I am grateful to have found this site.

My Dr. did give me a prescription for Evoxac which he recommends to take 3 times a day. I have all the drugs that everyone lists, but just need to figure out which combos will work for me. I was going to start with taking an Ativan for the anxiety, and a compazine just to see of if I can do that instead of Zofran. If the Compazine isn't cutting it I will step up to the Ativan and Zofran together. I just looked and I need to get another prescription for Zofran because the one they gave me while I was in the hospital for the Peg tube is only 4mg and the chemo sheet lists 8mg needed for after chemo.

Andy

Andy --

They will undoubtedly give you an IV anti-emetic like Anzemet just before chemo -- this lasts 24 hours (about) -- so it is often after this that the chemo nausea can strike.

Hpkins didn't give my husband amiphostine on chemo days as they said it would "lay him out" so ask your Drs. about this -- as well as asking your radiation and chemo nurses or doctors about proper ways to handle your meds. We did a lot of "tweaking" to get the right approach, which varies from patient to patient.

Best, Gail

Well, I had the first of 35 rad treatments today with the Amiphostine injection and it went smoothly. I sincerely hope this continues for a while. Tomorrow will be the first chemo so we will now see how I handle that.

Andy
Thanks again for all your support from everyone....

Andy,
Here's hoping you have smooth seas on your voyage through the treatments. Keep us posted!

Andrea

Well, one week down, and I am hanging in there. The second and third day of the Cisplatin was extremely nauseous but i am dealing with it. At the moment, I have had the hiccups for the past 2 days steady and this afternoon the Dr prescribed Baclofen. Has anyone else had these hiccups like I have???

Andy