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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIMYCOTICS FOR SYSTEMIC USE › ANTIMYCOTICS FOR SYSTEMIC USE › Antibiotics
amphotericin B
J02AA01
Forms & Strengths
- Injection, Powder for Reconstitution (Conventional): 50 mg
- Injection, Lipid Complex (ABLC): 100 mg/20 mL
- Injection, Liposomal (L-AmB): 50 mg
Adult Dosing
- Conventional: 0.25 to 1.5 mg/kg IV once daily
- Liposomal: 3 to 5 mg/kg IV once daily
- Lipid Complex: 5 mg/kg IV once daily
Pediatric Dosing
- Conventional: 0.25 to 1 mg/kg IV once daily (infants and children)
- Liposomal: 3 to 5 mg/kg IV once daily (infants and children >= 1 month)
Indications
- Severe systemic fungal infections (e.g., aspergillosis, candidiasis, cryptococcosis, histoplasmosis)
- Empirical therapy for presumed fungal infection in febrile neutropenic patients
- Visceral leishmaniasis
Mechanism of Action
- Binds to ergosterol in fungal cell membranes, forming pores that lead to increased permeability, leakage of intracellular ions, and cell death
Contraindications
- Hypersensitivity to amphotericin B deoxycholate or its lipid formulations, unless the benefit outweighs the risk
Adverse Reactions
- Infusion-related reactions (fever, chills, rigors, hypotension)
- Nephrotoxicity (elevated serum creatinine, azotemia, renal tubular acidosis, hypokalemia, hypomagnesemia)
- Anemia (normocytic, normochromic due to decreased erythropoietin production)
- Hepatotoxicity
- Thrombophlebitis at injection site
Drug Interactions
- Nephrotoxic drugs (aminoglycosides, cyclosporine, tacrolimus, NSAIDs) increase risk of renal impairment
- Corticosteroids increase risk of severe hypokalemia
- Digitalis glycosides toxicity risk increased by amphotericin B-induced hypokalemia
- Skeletal muscle relaxants effects may be enhanced by hypokalemia
Curated Content: Needs Vetting Before Put to Clinical Use