Classes
amphotericin B deoxycholate (Rx)
- Classes: Antifungals, Systemic
amphotericin B cholesteryl sulfate (Rx)
- Classes: Antifungals, Systemic
amphotericin B phospholipid complex (Rx)
- Classes: Antifungals, Systemic
amphotericin B liposomal (Rx)
- Classes: Antifungals, Systemic
Description
Polyene antifungal antibiotic similar to nystatin; despite many well-known systemic side effects and toxicities, IV amphotericin B remains the drug of choice for many serious systemic fungal infections; available as an injection, oral suspension, or in topical formulations.
One of 3 lipid-based IV amphotericin B formulations; increases tolerability (e.g., decrease nephrotoxicity); similar spectrum of activity and efficacy as conventional amphotericin B.
Indications
Indicated for treatment of invasive aspergillosis in patients where renal impairment or unacceptable toxicity precludes the use of amphotericin B deoxycholate (conventional) in effective doses, or where prior amphotericin B deoxycholate therapy has failed
Indicated for invasive fungal infection refractory to conventional amphotericin B desoxycholate therapy or when renal impairment or unacceptable toxicity precludes use conventional amphotericin B
Indicated for empiric therapy for presumed fungal infection in febrile, neutropenic patients
Contraindications
Hypersensitivity
Adverse Effects
- Chills (50-77%)
- Fever (33-55%)
- Hypokalemia (7-26%)
- Elevated serum creatinine (12-21%)
- Hyperbilirubinemia (2-19%)
- Hypotension (9-12%)
- Tachycardia (9-12%)
- Nausea (8-12%)
- Vomiting (6-11%)
- Abnormal LFTs (4-11%)
- Hypertension (7-9%)
- Hypoxia (5-9%)
- Dyspnea (4-9%)
- Headache (4-8%)
- Hypomagnesemia (4-7%)
- Increased alkaline phosphatase (3-7%)
- Thrombocytopenia (1-7%)
- Hyperglycemia (1-6%)
Warnings
Indicated for patients with progressive and potentially fatal fungal infections
Do not use for noninvasive fungal infections (eg, oral thrush, vaginal candidiasis, esophageal candidiasis) in patients with normal neurophil counts
Caution when coadministration with other drugs that cause hypokalemia (eg, corticosteroids, digoxin)
Caution with other nephrotoxic medications
Indicated for patients with progressive and potentially fatal fungal infections
Do not use for noninvasive fungal infections (eg, oral thrush, vaginal candidiasis, esophageal candidiasis) in patients with normal neurophil counts
Pregnancy and Lactation
Pregnancy Category: B
Lactation: Unknown whether distributed in breast milk, caution advised
Maximum Dosage
Maximum dosage is generally dependent on route of administration and the indication for use. General IV maximum dosage guidelines follow.
1—1.5 mg/kg/day IV.
1—1.5 mg/kg/day IV.
1—1.5 mg/kg/day IV.
Generally 1 mg/kg/day IV; occasional short term use of 1.5 mg/kg/day IV may be permissible in specific situations.
How supplied
Amphotericin B
powder for injection
- 50mg/vial
- 100mg/vial
injectable, lipid complex
- 5mg/mL
