Antimicrobials
Amphotericin B Deoxycholate (Fungizone)

Amphotericin B Deoxycholate (Fungizone)

Restricted

Low
N/A
$131.71/Dose $658.56/5 Days

Spectrum of Activity

Dosing

General Information

  • Fungicidal therapy of yeast/fungus/mold infection, especially of the urinary tract as lipid formulations are otherwise preferred to minimize toxicity.
  • Induction therapy for dimorphic fungii (cocci, blasto, histo).
  • Infusion-related reactions
  • Renal function
  • Electrolytes (especially K and Mg)
  • Liver enzymes
  • CBC

Frequency depends on course, but daily reasonable during initiation.

  • Nephrotoxicity ++
  • Anemia
  • Phlebitis
  • Arachnoiditis
  • Urinary retention
  • Paresthesias

Infusion related symptoms (slow down infusion)

  • Fever
  • Rigors
  • N/V
  • Headache

Electrolyte abnormalities

  • Especially HypoK and HypoMg
  • Loss of bicarb
  • See "Additional Information"

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

Increased digoxin toxicity with hypokalemia.

Premedication with acetaminophen, diphenhydramine and/or hydrocortisone are used. Meperidine may be used for rigors.

Pay careful attention to electrolyte and fluid status with boluses (usually 500mL) before and/or after infusion, as well as K and Mg supplementation PRN.

Lipid-based and conventional amphotericin B (deoxycholate) formulations are not interchangeable and have different dosing recommendations.

Fungizone™️ restricted to Infectious Diseases (ID)/Antimicrobial Stewardship Program (ASP) and Oncology/Critical Care within 48 hours of being dispensed.

Antimicrobial class: Antifungal, Polyene

Pregnancy category: B

Average serum half life: 24 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Poor