3-6mg/kg IV every 24 hr infused over several hours
Dose adjustment is unnecessary for pre-existing renal dysfunction however, decreased renal function caused by amphotericin may warrent a dose adjustment (e.g. a 50% reduction of the total daily dose or dosing every 48 hr)
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.
Same toxicities as conventional Amphotericin B but with less frequency.
Infusion related symptoms
HypoK and HypoMg
Loss of bicarb
See additional information
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.
At least twice weekly - SCr, K, Mg
Weekly - Liver enzymes, CBC
Infusion related reactions
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.
Average serum half life: 150 hours
Biliary penetration: Therapeutic
Lung penetration: Therapeutic
Urine penetration: Poor