Antimicrobials
Amphotericin B - lipid associated

Amphotericin B - lipid associated

Restricted

Low
N/A

Spectrum of Activity

Dosing

General Information

  • Infectious Diseases consultation recommended
  • Fungicidal therapy of yeast/fungus/mold infection
  • Invasive candidiasis, aspergillosis, cryptococcosis
  • Visceral/mucocutaneous Leishmaniasis
  • Induction therapy for dimorphic fungii (cocci, blasto, histo)
  • Not for use in urinary tract infection (use conventional amphotericin B deoxycholate in UTI)
  • Renal Function
  • K
  • Mg
  • HCO3
  • CBC
  • Liver profile

Same toxicities as conventional Amphotericin B but with less frequency.

  • Nephrotoxicity ++
  • Anemia
  • Phlebitis
  • Arachnoiditis
  • Urinary retention
  • Paresthesias
  • Infusion related symptoms are common: fever/rigors/N/V/headache
    • They usually diminish with subsequent doses
  • Electrolyte abnormalities - hypoK and hypoMg, renal tubular acidosis
  • Main concern is concomitant nephrotoxins - use should be minimized during amphotericin therapy
  • Digoxin - increased digoxin toxicity with hypokalemia

Careful attention to electrolyte and fluid status with boluses (usually 500 mL) of NS before and after infusion, as well as K and Mg supplementation as needed.

Antimicrobial class: Antifungal - polyene - Lipid formulations (designed to minimize toxicity)

Pregnancy category: B

Biliary penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor - use traditional Amphotericin