Antimicrobials
Amphotericin - lipid associated

Amphotericin - lipid associated

Restricted

Low
N/A

Spectrum of Activity

General Information

  • Fungicidal therapy of yeast/fungus/mold infection (not for use in urinary tract infection)
  • Invasive candidiasis, aspergillosis, cryptococcosis
  • Visceral/mucocutaneous Leishmaniasis
  • Induction therapy for dimorphic fungii (cocci, blasto, histo)

Renal function, fluid status, serum electrolytes (K, Mg).

Liver enzymes, CBC with differential.

  • Infusion related symptoms: fever/rigors/N/V/headache
  • Electrolyte abnormalities - hypokalemia and hypomagnesemia, loss of bicarb
  • Nephrotoxicity ++
  • Anemia
  • Phlebitis
  • Paresthesias

Enhance nephrotoxic effect with concomitant use of other nephrotoxins - use should be minimized during amphotericin therapy.

Lipid formulations of AmB (Ambisome, Abelcet) are NOT interchangable.

Premedication with acetaminophen, diphenhydramine, or hydrocortisone for infusion related symptoms.

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

Average serum half life: • No pediatric data.

  • Liposomal: Adults: 100-153 hours (terminal half life).
  • Lipid Complex: Adults: 173 hours (terminal half life).

Route of Elimination: Lipid Complex: 0.9% of drug excreted in urine over 24h; effects of hepatic and renal impairment on drug disposition are unknown.