Amphotericin B - conventional

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

Dosing

0.3-1.0 mg/kg IV q24h

NOTE: Do not mistake for lipid associated Amphotericin B, formulations are NOT interchangeable.

No dose adjustment

General Information

Common Usage

Infectious Diseases consultation recommended.

Drug Monitoring

CBC, K, HCO3, Mg, liver profile.

Adverse Effects

Infusion related symptoms are common: fever/rigors/N/V/headache. They usually diminish with subsequent doses.

Electrolyte abnormalities - hypoK and hypoMg, renal tubular acidosis

Nephrotoxicity

Major Interactions

Main concern is concomitant nephrotoxins - use should be minimized during amphotericin therapy

Digoxin - increased digoxin toxicity with hypokalemia

Additional Information

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

If high risk of renal toxicity, consider liposomal amphotericin B formulation.

Pharmacology

Antimicrobial class: Antifungal - polyene

Pregnancy category: B