Brand Names:
Fungizone


Drug Type: Antifungal

Amphotericin B

Amphotericin B is a macrolide antifungal drug used most commonly for treatment of aspergillosis. It is also effective against: Coccidioides immitis, Cryptococcus neoformans, Histoplasma capsulatum, Rhodotorula, Blastomyces dermatitidis, Mucor mucedo, and Sporothrix schenckii. Additionally, amphotericin B has in vivo activity against some protozoa species, including Leishmania spp. and Naegleria spp.

Caution If administered rapidly or if overdosed, it can result in heart arrhythmias and cardio-respiratory arrest. Since the drug is eliminated by the kidneys, it has a high risk of causing kidney damage (nephrotoxicity) and thus should only be used for a short duration.

Storage/Stability: Vials of amphotericin B powder for injection should be stored in the refrigerator (2-8°C), protected from light and moisture. Reconstitution of the powder must be done with sterile water for injection.
  • Nebulized: 7 mg/mL for 15 min, every 12 hours
  • Intravenous: 1.5 mg/kg every 8 hours for 3-7 days
  • Intratracheal/nasal flush: 1 mg/kg every 8 to 12 hours, diluted to 1 mL with sterile water.
Available as an injectable solution (5 mg/ml) for slow IV administration, in sinus flushes, intratracheally, or nebulized in conjunction with another antifungal drug. There is also a lotion or cream (3%) available that is often used for fungal dermatitis or oral candidiasis that is resistant to nystatin. If Amphotericin B is applied topically, it can be very irritating and so needs to be diluted in water.
  • Will decrease potassium levels in the blood (hypokalemia), corticosteroids may exacerbate this effect.
  • Impaired renal function
  • Bone marrow damage
  • Depression
  • Irritation at the injection site
  • Anorexia
  • Acebutolol:The risk or severity of adverse effects can be increased when Amphotericin B is combined with Acebutolol.
  • Amikacin: Amphotericin B may increase the nephrotoxic activities of Amikacin.
  • Apramycin: Amphotericin B may increase the nephrotoxic activities of Apramycin.
  • Betamethasone:Betamethasone may increase the hypokalemic activities of Amphotericin B
  • Chlorothiazide: The risk or severity of adverse effects can be increased when Amphotericin B is combined with Chlorothiazide.
  • Chlorpromazine: The risk or severity of adverse effects can be increased when Amphotericin B is combined with Chlorpromazine.
  • Clomipramine: The risk or severity of adverse effects can be increased when Amphotericin B is combined with Clomipramine
  • Halothane: The risk or severity of adverse effects can be increased when Amphotericin B is combined with Halothane.
  • Gentamicin: Amphotericin B may increase the nephrotoxic activities of Gentamicin.
  • Furosemide: The risk or severity of adverse effects can be increased when Amphotericin B is combined with Furosemide.
  • Dexamethasone:Dexamethasone may increase the hypokalemic activities of Amphotericin B.
  • Cyclosporine: Amphotericin B may increase the nephrotoxic activities of Cyclosporine.
  • Clotrimazole:The therapeutic efficacy of Amphotericin B can be decreased when used in combination with Clotrimazole
  • Nystatin:The therapeutic efficacy of Amphotericin B can be decreased when used in combination with Nystatin.
  • Monensin:The therapeutic efficacy of Amphotericin B can be decreased when used in combination with Monensin.
  • Miconazole:The therapeutic efficacy of Amphotericin B can be decreased when used in combination with Miconazole.
  • Methylprednisolone: Methylprednisolone may increase the hypokalemic activities of Amphotericin B.
  • Magnesium Sulfate:The risk or severity of adverse effects can be increased when Amphotericin B is combined with Magnesium Sulfate.
  • Ketoconazole: The therapeutic efficacy of Amphotericin B can be decreased when used in combination with Ketoconazole.
  • Itraconazole:The therapeutic efficacy of Amphotericin B can be decreased when used in combination with Itraconazole.
  • Isoflurane: The risk or severity of adverse effects can be increased when Amphotericin B is combined with Isoflurane.
  • Streptomycin:Amphotericin B may increase the nephrotoxic activities of Streptomycin.
  • Prednisone:Prednisone may increase the hypokalemic activities of Amphotericin B.

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