Amphotericin B, Liposomal
Spectrum Of Activity
Neutropenic feverSystemic fungal infection (aspergillosis, candidiasis, cryptococcosis)Cryptococcal meningitis in HIV-infected patientsVisceral leishmaniasis in immunocompetent patientsVisceral leishmaniasis in immunocompromised patients3 mg/kg IV q24h3-5 mg/kg IV q24h6 mg/kg IV q24h3 mg/kg IV q24h x5d, then 3 mg/kg IV at day 14 & 214 mg/kg IV q24h x5d, then 4 mg/kg IV at day 10, 17, 24, 31, 48No renal dose adjustment
Neutropenic feverSystemic fungal infection (aspergillosis, candidiasis, cryptococcosis)Cryptococcal meningitis in HIV-infected patients3 mg/kg IV q24h3-5 mg/kg IV q24h6 mg/kg IV q24hNo renal dose adjustment
No dose adjustment
Fungicidal therapy of yeast/fungus/mold infection.
Invasive candidiasis, aspergillosis, cryptococcosis.
Induction therapy for dimorphic fungii (cocci, blasto, histo).
Not for use in urinary tract infection.
Monitor serum electrolytes, particularly magnesium and potassium.
Evaluate renal and hepatic functions.
Monitor cardiac function in patients using concomitant potassium-depleting agents, including corticosteroids.
Same toxicities as conventional Amphotericin B but with less frequency.
HypoK and HypoMg
Loss of bicarb
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Main concern is concomitant nephrotoxins. Use should be minimized during amphotericin therapy.
Increased digoxin toxicity with hypokalemia.
Antimicrobial class: Antifungal, Polyene (Lipid formulations designed to minimize toxicity)
Pregnancy category: B
Average serum half life: 100-153 hours
Biliary penetration: Therapeutic
Lung penetration: Therapeutic
Urine penetration: Poor
Lipid associated AmB is taken up preferentially by phagocytic cells and concentrated at sites of infection while minimizing renal exposure.
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) before and after infusion, as well as K and Mg supplementation PRN.