Amphotericin B - lipid associated

Restricted
C. diff Risk

Low

Oral Bioavailability

NA

Dosing

Ampho B liposomal (Ambisome):
3-5 mg/kg IV q24h

Ampho B lipid complex (Abelcet):
5 mg/kg IV q24h

NOTE: Do not mistake for conventional Amphotericin B, formulations are NOT interchangeable.

No dose adjustment

General Information

Additional Information

Careful attention to electrolyte and fluid status with boluses (usually 500 mL) of NS before and after infusion, as well as K and Mg supplementation as needed.

Adverse Effects

Same toxicities as conventional Amphotericin B but with less frequency.

Infusion related symptoms are common: fever/rigors/N/V/headache. They usually diminish with subsequent doses.

Electrolyte abnormalities - hypoK and hypoMg, renal tubular acidosis.

Nephrotoxicity

Common Usage

Infectious Diseases consultation recommended.

Drug Monitoring

CBC, K, HCO3, Mg, liver profile.

Major Interactions

Main concern is concomitant nephrotoxins - use should be minimized during amphotericin therapy.

Digoxin - increased digoxin toxicity with hypokalemia.

Pharmacology

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

Pregnancy category: B