Amphotericin B - Lipid Associated

Restricted
C difficile risk
Low
Oral Bioavailability
N/A

Dosing

No dose adjustment recommended

Use must be approved by Infectious Diseases

Amphotericin B - liposomal and lipid complex (Ambisome and Abelcet) - 3-5mg/kg IV daily.

Use must be approved by Infectious Diseases.

Discuss dosing with Pharmacy

Amphotericin B - liposomal (Ambisome) - 3-6mg/kg IV daily infused over several hours

Amphotericin B - lipid complex (Abelcet) - 5mg/kg IV daily infused over several hours

Use must be approved by Infectious Diseases

Discuss dosing with Pharmacy

This antimicrobial is restricted to Infectious Diseases

General Information

Amphotericin B is often used as fungicidal therapy for various invasive fungal infections.

Daily serum CBC, creatinine and electrolytes, including magnesium levels, and liver enzymes.

Infusion related symptoms including fever, rigors, nausea, emesis and headache.

Electrolyte abnormalities, including hypokalemia and hypomagnesemia with loss of bicarbonate may occur.

Nephrotoxicity

Anemia

Phlebitis

Use of concomitant nephrotoxins may increase risk of nephrotoxicity.

Concomitant use of digoxin can increase risk of digoxin toxicity and hypokalemia.

Use must be approved by Infectious Diseases.

Lipid formulations of Amphotericin B carry lower risk of infusion related reactions, nephrotoxicity and electrolyte disturbances than Amphotericin B deoxycholate.

Monitor electrolytes and volume status closely. Pre- and post-infusion hydration with 500mL normal saline can reduce risk of renal injury.

Lipid formulations of Amphotericin B have poor urinary penetration.

DO NOT mistake lipid based Amphotericin B for Amphotericin B deoxycholate - FORMULATIONS ARE NOT INTERCHANGEABLE

Antimicrobial class: Antifungal - Polyene

Average serum half life: 150 hours

Biliary penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor