Ampho B liposomal (Ambisome):
3-5 mg/kg IV q24h
Ampho B lipid complex (Abelcet):
5 mg/kg IV q24h
NOTE: Do not mistake for conventional Amphotericin B, formulations are NOT interchangeable.
No dose adjustment
Infectious Diseases consultation recommended.
CBC, K, HCO3, Mg, liver profile.
Same toxicities as conventional Amphotericin B but with less frequency.
Infusion related symptoms are common: fever/rigors/N/V/headache. They usually diminish with subsequent doses.
Electrolyte abnormalities - hypoK and hypoMg, renal tubular acidosis.
Main concern is concomitant nephrotoxins - use should be minimized during amphotericin therapy.
Digoxin - increased digoxin toxicity with hypokalemia.
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.
Antimicrobial class: Antifungal - polyene - Lipid formulations (designed to minimize toxicity)
Pregnancy category: B