Low
NA
Fungicidal therapy of yeast/fungus/mold infection, especially of the urinary tract as lipid formulations are otherwise preferred to minimize toxicity.
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
Nephrotoxicity ++
Hypotension
Tachycardia
Tachypnea
CNS effects: headache, malaise, pain, delirium, paresthesias, arachnoiditis, neuralgias
GI disturbances: anorexia, diarrhea, nausea heartburn
Anemia
Urinary retention
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 acetaminophen, 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 with appropriate dosing but otherwise low. Remains effective for Cryptococcus.
Lung penetration: Therapeutic
Urine penetration: Therapeutic
