• Renal function
• K+
• Mg++
• Liver enzymes
• CBC

Frequency depends on course, but daily reasonable during initiation.

Same toxicities as conventional Amphotericin B but with less frequency.

• Nephrotoxicity ++
• Anemia, leukopenia, thrombocytopenia
• Phlebitis
• Paresthesia

Infusion-related symptoms

• Fever
• Rigors
• N/V
• Headache

Electrolyte abnormalities

• HypoK and HypoMg

Main concern is concomitant nephrotoxins. Use should be minimized during amphotericin therapy.

• Increased digoxin toxicity with hypokalemia
• Increased risk of nephrotoxicity with cyclosporine

• Lipisomal AmB is taken up preferentially by phagocytic cells and concentrated at sites of infection while minimizing renal exposure.
• Premedication with acetaminophen, diphenhydramine, or hydrocortisone may be used. Meperidine may be used for rigors.
• Pay careful attention to electrolyte and fluid status with boluses (usually 500mL) before and after infusion, as well as K and Mg supplementation PRN.
• Cost based on average adult dose (70kg) of 5mg/kg IV q24h.