Amphotericin B
Amphotericin B

Amphotericin B

Restricted

Low
N/A
See Additional Information

Spectrum of Activity

General Information

  • Premedicate 30 to 60 minutes prior to drug administration with acetaminophen ± diphenhydramine or ibuprofen ± diphenhydramine
  • If patient experiences rigors during the infusion, HYDROmorphone may be administered
  • Administration of 500 to 1,000 mL of normal saline reduces the risk of nephrotoxicity
  • Renal function (BUN/SCr)
  • Electrolytes: K+, Mg++
  • LFTs
  • CBC
  • Hypotension, tachycardia, hypertension, chest pain
  • Hypokalemia, hypomagnesemia
  • Acute kidney injury
  • Injection site pain, phlebitis
  • Fever
  • Infusion-related: chills, headache, malaise
  • Diarrhea, anorexia, nausea, vomiting, abdominal pain, constipation, anorexia
  • Insomnia
  • Anxiety, confusion
  • Anemia, leukopenia, thrombocytopenia
  • Elevated LFTs

Monitor carefully with concomitant nephrotoxins

Deoxycholate = Fungizone IV Liposomal = AmBisome

  • Absorption: Poor oral absorption
  • Distribution: Minimal amounts enter the aqueous humor, bile, pericardial fluid, pleural fluid, and synovial fluid
  • CNS penetration: Poor (inflamed or noninflamed meninges)
  • Protein binding: 90%
  • Half-life elimination:

    • Deoxycholate: Initial: 15 to 48 hours; Terminal: 15 days
    • Liposomal: 7 to 10 hours; Terminal half to life: 100 to 153 hours
  • Time to peak: Within 1 hour

  • Excretion: Urine (2% to 5% as biologically active form)

Cost:

  • Liposomal (Ambisome): $$$ ($101-$200/day)
  • Deoxycholate (Fungizone): $$ ($26-$100/day)