Initial dose:
IV 0.25-0.5 mg/kg/DAY given as a single daily dose. Increase dose gradually to reach desired dose, usually in 0.25 mg/kg increments.Maintenance dose:
IV 0.25-1 mg/kg/DAY given as a single daily dose or 1-1.5 mg/kg/DOSE every 2 days. MAX daily dose: 1.5 mg/kg/DAY.
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, fluid status, serum electrolytes (K, Mg).
Liver enzymes, CBC with differential.
Infusion related symptoms: fever/rigors/N/V/headache
Electrolyte abnormalities - hypoKalemia and hypoMagnesemia, loss of bicarb
Nephrotoxicity ++
Anemia
Phlebitis
Enhance nephrotoxic effect with concomitant use of other nephrotoxins - use should be minimized during amphotericin therapy.
Premedication with acetaminophen, diphenhydramine, or hydrocortisone for infusion related symptoms.
Antimicrobial class: Antifungal - polyene
Average serum half life:
Premature neonates (GA: 27.4 ± 5 weeks): 14.8 hours (range: 5 to 82 hours)
Infants and Children (4 months to 14 years): 18.1 ± 6.6 hours (range: 11.9 to 40.3 hours)
Route of Elimination: Urine (2% to 5% unchanged); ~40% eliminated over 7-day period and may be detected in urine for up to 8 weeks after discontinued use
