Low
NA
Dose adjustment is unnecessary for pre-existing renal dysfunction however, decreased renal function caused by amphotericin may warrent a dose adjustment (e.g. a 50% reduction of the total daily dose or dosing every 48 hr)
Fungizone - 0.3-1.5mg/kg IV daily, infused over several hours.
Treatment of patients with progressive, potentially life-threatening fungal infections: Aspergillosis, cryptococcosis (torulosis), North American blastomycosis, systemic candidiasis, coccidioidomycosis, histoplasmosis, zygomycosis (including mucormycosis due to susceptible species of the genera Absidia, Mucor, and Rhizopus), and infections due to related susceptible species of Conidiobolus, Basidiobolus, and sporotrichosis.
Laboratory
Every 48 hr when treatment initiated - SCr, BUN, K, Mg
Weekly - Liver enzymes, CBC
Clinical
Nephrotoxicity ++
Anemia
Phlebitis
Arachnoiditis
Urinary retention
Paresthesias
Infusion related symptoms
Fever
Rigors
N/V
Headache
Electrolyte abnormalities -
HypoK and HypoMg
Loss of bicarb
See "Additional Information"
Main concern is concomitant nephrotoxins. Use should be minimized during amphotericin therapy.
Increased digoxin toxicity with hypokalemia.
Premedication with NSAIDs, diphenhydramine or hydrocortisone are used.
Meperidine may be used for rigors.
Pay careful attention to electrolyte and fluid status with boluses (usually 500mL) of NS before and after infusion, as well as K and Mg supplementation PRN.
Antimicrobial class: Antifungal. Polyene
Pregnancy category: B
Average serum half life: 24 hours
CSF penetration: Therapeutic
Lung penetration: Therapeutic
Urine penetration: Therapeutic
