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Amifostine Side Effects

In Summary

Commonly reported side effects of amifostine include: nausea. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to amifostine: intravenous powder for solution

In addition to its needed effects, some unwanted effects may be caused by amifostine. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking amifostine, check with your doctor or nurse immediately:

More common:
  • Blurred vision
  • confusion
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • fainting or loss of consciousness
  • fast or irregular breathing
  • itching
  • nausea and vomiting
  • red, scaly, swollen, or peeling areas of the skin
  • skin rash
  • sweating
  • swelling of the eyes or eyelids
  • tightness in the chest
  • trouble with breathing
  • unusual tiredness or weakness
  • wheezing
  • Abdominal cramps
  • blistering, peeling, or loosening of the skin
  • burning or tingling sensation
  • chills
  • convulsions
  • cough
  • cracks in the skin
  • diarrhea
  • difficulty in breathing
  • fast, slow, or irregular heartbeat or pulse
  • fever
  • joint or muscle pain
  • loss of bladder control
  • loss of heat from the body
  • muscle cramps in the hands, arms, feet, legs, or face
  • muscle spasm or jerking of all extremities
  • no blood pressure or pulse
  • numbness and tingling around the mouth, fingertips, or feet
  • palpitations
  • red irritated eyes
  • red skin lesions, often with a purple center
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • stopping of the heart
  • sudden loss of consciousness
  • tremor
  • unconsciousness
Incidence not known:
  • Difficulty in swallowing
  • hives or welts
  • hoarseness
  • slow or irregular breathing

Minor Side Effects

Some of the side effects that can occur with amifostine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common or rare:
  • Feeling unusually warm or cold
  • flushing or redness of the face or neck
  • headache
  • hiccups
  • nervousness
  • pounding in the ears
  • sleepiness (severe)
  • sneezing

For Healthcare Professionals

Applies to amifostine: intravenous powder for injection


Cardiovascular side effects include a transient reduction in blood pressure in 62% of patients. Arrhythmias such as atrial fibrillation/flutter and supraventricular tachycardia have been reported. (These have sometimes been associated with hypotension or allergic reactions.) Transient hypertension and exacerbations of preexisting hypertension, and short term, reversible loss of consciousness have been reported rarely.[Ref]

The mean time of onset until reduction in blood pressure was 14 minutes into the 15 minute amifostine infusion. The mean duration was six minutes. Blood pressure generally returned to normal within five to fifteen minutes.

In order to avoid hypotension, amifostine has sometimes been administered by the subcutaneous route.[Ref]


Gastrointestinal side effects frequently include nausea and/or vomiting which may be severe.[Ref]


These effects have not generally precluded the completion of therapy.[Ref]

Other side effects include flushing/feeling of warmth, fever, malaise, chills/feeling of coldness, dizziness, somnolence, hiccups, syncope, and sneezing.[Ref]


In case of an acute allergic reaction, amifostine should be immediately and permanently discontinued. Epinephrine and other measures should be available for the treatment of serious allergic events such as anaphylaxis.[Ref]

Hypersensitivity side effects have included hypotension, fever, chills/rigors, dyspnea, skin rashes, and urticaria. Anaphylactoid reactions including hypoxia, laryngeal edema, and chest tightness have also been reported. Anaphylactoid reactions associated with cardiac arrest have been reported rarely. A case of Stevens-Johnson syndrome has also been reported.[Ref]


Cutaneous eruptions have been commonly reported during clinical trials and were generally not serious.[Ref]

Dermatologic side effects include skin rashes, pruritus, urticaria, erythema multiforme, and rarely Stevens-Johnson Syndrome or toxic epidermal necrolysis.[Ref]

Nervous system

Nervous system side effects rarely include seizures.[Ref]


Musculoskeletal side effects including a case of amifostine-induced back pain have been reported.[Ref]


Metabolic side effects including hypocalcemia (up to 1%) have been reported.[Ref]


1. Koukourakis MI, Danielidis V "Preventing radiation induced xerostomia." Cancer Treat Rev 31 (2005): 546-54

2. "Product Information. Ethyol (amifostine)." Alza, Palo Alto, CA.

3. Boehme S, Wilson DB "Amifostine-induced fever: case report and review of the literature." Pharmacotherapy 24 (2004): 155-8

4. Astudillo L, Maachi B, Benyoucef A, Game X, Rives M, Bachaud JM "Stevens-Johnson syndrome after amifostine during radiotherapy." Int J Dermatol 43 (2004): 284-5

5. Atahan IL, Ozyar E, Sahin S, Yildiz F, Yalcin B, Karaduman A "Two cases of Stevens-Johnson syndrome: toxic epidermal necrolysis possibly induced by amifostine during radiotherapy." Br J Dermatol 143 (2000): 1072-3

6. Norales G, Maria V, de Guzman A, Leonard R, Aref A "Amifostine-induced back pain: a case report." Am J Health Syst Pharm 63 (2006): 381-2

Not all side effects for amifostine may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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