Amphotericin - lipid associated

C difficile risk
Low
Oral Bioavailability
N/A
Cost
$500+/day

Dosing

Liposomal (Ambisome): IV: 3 to 5mg/kg/DAY given as a single daily doseLipid Complex (Abelcet): IV: 2.5 to 5 mg/kg/DAY given as a single daily dose.

Liposomal (Ambisome): IV: 3 to 5mg/kg/DAY given as a single daily dose. Lipid Complex (Abelcet): IV 2 to 5mg/kg/DAY given as a single daily dose.

Contact pharmacy for more information regarding use in renal impairment.

General Information

Fungicidal therapy of yeast/fungus/mold infection (not for use in urinary tract infection)

Invasive candidiasis, aspergillosis, cryptococcosis

Visceral/mucocutaneous Leishmaniasis

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

Paresthesias.

Enhance nephrotoxic effect with concomitant use of other nephrotoxins - use should be minimized during amphotericin therapy.

Lipid formulations of AmB (Ambisome, Abelcet) are NOT interchangable.

Premedication with acetaminophen, diphenhydramine, or hydrocortisone for infusion related symptoms.

Antimicrobial class: Antifungal - polyene - Lipid formulations (designed to minimize toxicity)

Average serum half life:

  • No pediatric data.

  • Liposomal: Adults: 100-153 hours (terminal half life).

  • Lipid Complex: Adults: 173 hours (terminal half life).

Route of Elimination: Lipid Complex: 0.9% of drug excreted in urine over 24h; effects of hepatic and renal impairment on drug disposition are unknown.