Low
NA
$500+/day
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
K
Mg
HCO3
Liver enzymes
CBC
Frequency depends on course, but daily reasonable during initiation
Same toxicities as conventional Amphotericin B but with less frequency.
Nephrotoxicity ++
Anemia
Phlebitis
Arachnoiditis
Urinary retention
Paresthesias
Infusion related symptoms
Fever
Rigors
N/V
Headache
See additional information
Electrolyte abnormalities
HypoK and HypoMg
Loss of bicarb
See additional information
Main concern is concomitant nephrotoxins - use should be minimized during amphotericin therapy
Digoxin - increased digoxin toxicity with hypokalemia
Lipid associated AmB is taken up preferentially by phagocytic cells and concentrated at sites of infection while minimizing renal exposure.
Routine premedication no longer recommended. Manage infusion-related reaction symptoms if needed with acetaminophen and/or diphenhydramine.
Meperidine may be used for rigors.
Careful attention to electrolyte and fluid status with boluses (usually 500mL) before and after infusion, as well as K and Mg supplementation PRN.
Antimicrobial class: Antifungal - polyene - Lipid formulations (designed to minimize toxicity)
Average serum half life: 150.0
Urine penetration: Poor
Lung penetration: Therapeutic
Biliary penetration: Therapeutic
