Amphotericin B Deoxycholate

C difficile risk
Low
Oral Bioavailability
N/A

Spectrum Of Activity

Dosing

0.3-1.5mg/kg IV daily, infused over several hours.

Discuss dosing as well as premedication with pharmacy.

0.4-1mg/kg IV q24h, infused over several hours.

Discuss dosing as well as premedication with pharmacy.

0.3-1.5mg/kg IV daily, infused over several hours.

General Information

Fungicidal therapy of yeast/fungus/mold infection, especially of the urinary tract as lipid formulations are otherwise preferred to minimize toxicity.

Induction therapy for dimorphic fungii (cocci, blasto, histo).

  • 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