Antimicrobials
Amphotericin B deoxycholate

Amphotericin B deoxycholate

Low
N/A

Spectrum of Activity

General Information

Pregnancy:

  • Considered compatible with all stages of pregnancy, including the first trimester.
  • Amphotericin B has not been associated with any congenital malformations or other untoward outcomes.

Breastfeeding:

  • No data.
  • Amphotericin B is not absorbed orally.
  • PK properties make transfer into milk unlikely (large molecular weight, highly protein bound).
  • Consultation with infectious disease specialist recommended.
  • Fungicidal therapy of yeast/fungus/mold infection.
  • Lipid formulations of amphotericin B are usually preferred over deoxycholate to minimize toxicity (except in the setting of urinary tract infections).

Renal function, K, Mg, HCO3, liver enzymes, CBC.

Frequency depends on course, but daily reasonable during initiation.

  • Infusion related symptoms: fever/rigors/nausea/vomiting/headache (see additional information), phlebitis
  • Electrolyte abnormalities - hypoK and hypoMg, loss of bicarb (see additional information)
  • Nephrotoxicity ++ (see additional information)
  • Anemia
  • Concomitant nephrotoxins - use should be minimized during amphotericin therapy
  • Digoxin - increased digoxin toxicity with hypokalemia

Adequate hydration prior to infusion is recommended to reduce risk of nephrotoxicity.

  • K and Mg supplementation may be required.

Premedication with analgesics, antiemetics, antihistamines and hydrocortisone may be required for infusion related reactions.

If renal dysfunction is due to amphotericin, the daily total can be decreased by 50% or the dose can be given every other day.

Antimicrobial class: Antifungal - polyene