Amphotericin B Deoxycholate

C difficile risk
Low
Oral Bioavailability
N/A
Cost
$200/day

Dosing

Defined criteria for use and/or important safety considerations. See below for more information.

  • Use total body weight

  • Contact Pharmacy for dosing and pre-medication

0.3 - 1.5 mg/kg IV q24h

  • Contact Pharmacy for dosing

General Information

  • Primarily used for compounding

  • Preferred over other amphotericin formulations for neonates. See IWK Spectrum App

  • Renal function

  • K

  • Mg

  • HCO3

  • Liver enzymes

  • CBC

Frequency depends on course, but daily reasonable during initiation

  • Nephrotoxicity ++

  • Anemia

  • Phlebitis

  • Arachnoiditis

  • Urinary retention

  • Paresthesias

Infusion related symptoms

  • Fever

  • Rigors

  • N/V

  • Headache

Electrolyte abnormalities -

  • 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 or hydrocortisone are used. Meperidine may be used for rigors.

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

Antimicrobial class: Antifungal. Polyene

Pregnancy category: B

Average serum half life: 24 hours

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic

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