Dosing & Uses
Dosage Forms & Strengths
powder for injection
- 50mg/vial
Systemic Fungal Infections
Test dose: 1 mg in 20 mL of 5% dextrose solution IV over 20-30 min; patient's temperature, pulse, respiration, and blood pressure should be recorded every 30 minutes for 2 to 4 hours
Loading dose in patients with well tolerated test dose and good cardio-renal function: 0.25 mg/kg IV qDay
Severe and rapidly progressive fungal infection: 0.3 mg/kg IV qDay
Impaired cardio-renal function or severe reaction to test dose: Initiate therapy with smaller daily doses, ie, 5 - 10 mg
Maintenance: Depending on the patient's cardio-renal status, doses may gradually be increased by 5 to 10 mg per day to final daily dosage of 0.5 to 0.7 mg/kg
insufficient data available to define total dosage requirements and duration of treatment necessary for eradication of specific mycoses; optimal dose unknown; total daily dosage may range up to 1.0 mg/kg/day or up to 1.5 mg/kg when given on alternate days
Sporotrichosis: Length of therapy may range for up to 9 months with total dose of up to 2.5 g
Aspergillosis: Length of therapy may range for up to 11 months with total dose of up to 3.6 g
Renal Impairment
CrCl <10 mL/min: 0.5-0.7 mg/kg IV q24-48hr
Consider other antifungal agents that may be less nephrotoxic
Intermittent hemodialysis: 0.5-1 mg/kg IV q24hr after dialysis session
Continuous renal replacement therapy: 0.5-1 mg/kg IV q24hr
Other Indications & Uses
Aspergillosis, cryptococcosis, blastomycosis, systemic candidiasis, coccidioidomycosis, histoplasmosis, zygomycosis, sporotrichosis, leishmaniasis (not drug of choice)
Infections of Mucor, Rhizopus, Absidia, Conidiobolus, Basiobolus spp.
Off-label: amoebic meningoencephalitis (Naegleria fowleri); ocular aspergillosis; candidal cystitis; severe meningitis (intrathecal); coccidioidal arthritis (intra-articular or IM)
Dosage Forms & Strengths
powder for injection
- 50mg/vial
Systemic Fungal Infections
Test dose: 0.1 mg/kg IV, not to exceed 1 mg; administer over 20-60 min
Initial dose: 0.25 mg/kg/dose IV qDay/qOD
Maintenance: Increase by 0.25 mg/day increments as tolerated to 1-1.5 mg/kg/day
Candida auris (Off-label)
The CDC recommends amphotericin B deoxycholate as the initial treatment of choice for neonates and infants aged <2 months
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (9)
- amikacin
amikacin and amphotericin B deoxycholate both increase nephrotoxicity and/or ototoxicity. Contraindicated.
- cidofovir
amphotericin B deoxycholate and cidofovir both increase nephrotoxicity and/or ototoxicity. Contraindicated.
- contrast media (iodinated)
amphotericin B deoxycholate and contrast media (iodinated) both increase nephrotoxicity and/or ototoxicity. Contraindicated.
- cyclosporine
amphotericin B deoxycholate and cyclosporine both increase nephrotoxicity and/or ototoxicity. Contraindicated.
- ioversol
amphotericin B deoxycholate and ioversol both increase nephrotoxicity and/or ototoxicity. Contraindicated.
- neomycin PO
amphotericin B deoxycholate and neomycin PO both increase nephrotoxicity and/or ototoxicity. Contraindicated.
- streptozocin
amphotericin B deoxycholate and streptozocin both increase nephrotoxicity and/or ototoxicity. Contraindicated.
- tacrolimus
amphotericin B deoxycholate and tacrolimus both increase nephrotoxicity and/or ototoxicity. Contraindicated.
- teicoplanin
amphotericin B deoxycholate and teicoplanin both increase nephrotoxicity and/or ototoxicity. Contraindicated.
Serious - Use Alternative (23)
- acyclovir
acyclovir and amphotericin B deoxycholate both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- atracurium
amphotericin B deoxycholate increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- capreomycin
amphotericin B deoxycholate and capreomycin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- carboplatin
amphotericin B deoxycholate and carboplatin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- cephaloridine
amphotericin B deoxycholate and cephaloridine both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- cisatracurium
amphotericin B deoxycholate increases effects of cisatracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- cisplatin
amphotericin B deoxycholate and cisplatin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- colistin
amphotericin B deoxycholate and colistin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- corticotropin
amphotericin B deoxycholate, corticotropin. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Potential for hypokalemia.
- digoxin
amphotericin B deoxycholate increases effects of digoxin by pharmacodynamic synergism. Avoid or Use Alternate Drug. Digoxin effects increased if hypokalemia results from Ampho B Tx.
- gentamicin
amphotericin B deoxycholate and gentamicin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- incobotulinumtoxinA
amphotericin B deoxycholate increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- onabotulinumtoxinA
amphotericin B deoxycholate increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- oxaliplatin
amphotericin B deoxycholate and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- pancuronium
amphotericin B deoxycholate increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- polymyxin B
amphotericin B deoxycholate and polymyxin B both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- rapacuronium
amphotericin B deoxycholate increases effects of rapacuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- rimabotulinumtoxinB
amphotericin B deoxycholate increases effects of rimabotulinumtoxinB by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- rocuronium
amphotericin B deoxycholate increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- Saccharomyces boulardii
amphotericin B deoxycholate decreases effects of Saccharomyces boulardii by unspecified interaction mechanism. Avoid or Use Alternate Drug. Systemic or oral antifungals may decrease activity of probiotic.
- succinylcholine
amphotericin B deoxycholate increases effects of succinylcholine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- tobramycin
amphotericin B deoxycholate and tobramycin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- vecuronium
amphotericin B deoxycholate increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
Monitor Closely (32)
- adefovir
adefovir and amphotericin B deoxycholate both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- beclomethasone, inhaled
beclomethasone, inhaled increases toxicity of amphotericin B deoxycholate by Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Corticosteroids may increase the hypokalemic effect of amphotericin B.
- benazepril
amphotericin B deoxycholate, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.
- captopril
amphotericin B deoxycholate, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.
- deflazacort
amphotericin B deoxycholate and deflazacort both decrease serum potassium. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and amphotericin B deoxycholate both decrease serum potassium. Use Caution/Monitor.
dichlorphenamide, amphotericin B deoxycholate. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis. - elvitegravir/cobicistat/emtricitabine/tenofovir DF
amphotericin B deoxycholate and elvitegravir/cobicistat/emtricitabine/tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- foscarnet
amphotericin B deoxycholate and foscarnet both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- ifosfamide
ifosfamide increases toxicity of amphotericin B deoxycholate by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with ifosfamide.
- lomustine
lomustine increases toxicity of amphotericin B deoxycholate by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with lomustine.
- mechlorethamine
mechlorethamine increases toxicity of amphotericin B deoxycholate by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with mechlorethamine.
- melphalan
melphalan increases toxicity of amphotericin B deoxycholate by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with melphalan.
- methoxyflurane
amphotericin B deoxycholate and methoxyflurane both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- mometasone inhaled
mometasone inhaled increases toxicity of amphotericin B deoxycholate by Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may enhance the hypokalemic effect of amphtericin B. .
- oxaliplatin
oxaliplatin increases toxicity of amphotericin B deoxycholate by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with oxaliplatin.
- paromomycin
amphotericin B deoxycholate and paromomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- pentamidine
amphotericin B deoxycholate and pentamidine both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- peramivir
amphotericin B deoxycholate increases levels of peramivir by decreasing renal clearance. Use Caution/Monitor. Caution when peramivir coadministered with nephrotoxic drugs.
- rituximab
amphotericin B deoxycholate and rituximab both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Caution should be exercised when concurrent therapy is used. Patients should be monitored for signs of renal failure.
- rituximab-hyaluronidase
amphotericin B deoxycholate and rituximab-hyaluronidase both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Caution should be exercised when concurrent therapy is used. Patients should be monitored for signs of renal failure.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b will increase the level or effect of amphotericin B deoxycholate by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of amphotericin B deoxycholate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of amphotericin B deoxycholate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
amphotericin B deoxycholate and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- streptomycin
amphotericin B deoxycholate and streptomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- tenofovir DF
amphotericin B deoxycholate and tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Combination may also increase tenofovir levels.
- tobramycin inhaled
tobramycin inhaled and amphotericin B deoxycholate both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension and amphotericin B deoxycholate both decrease serum potassium. Use Caution/Monitor.
- ustekinumab
ustekinumab, amphotericin B deoxycholate. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, normalizing the formation of CYP450 enzymes. Upon initiation or discontinuation of ustekinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- vancomycin
amphotericin B deoxycholate and vancomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- voclosporin
voclosporin, amphotericin B deoxycholate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- xipamide
xipamide, amphotericin B deoxycholate. pharmacodynamic synergism. Use Caution/Monitor. Risk of hypokalemia.
Minor (30)
- amobarbital
amobarbital decreases levels of amphotericin B deoxycholate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- budesonide
amphotericin B deoxycholate, budesonide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- butabarbital
butabarbital decreases levels of amphotericin B deoxycholate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- butalbital
butalbital decreases levels of amphotericin B deoxycholate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- cortisone
amphotericin B deoxycholate, cortisone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- cosyntropin
amphotericin B deoxycholate, cosyntropin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- deflazacort
amphotericin B deoxycholate, deflazacort. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- dexamethasone
amphotericin B deoxycholate, dexamethasone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- flucytosine
flucytosine increases effects of amphotericin B deoxycholate by pharmacodynamic synergism. Minor/Significance Unknown.
amphotericin B deoxycholate increases levels of flucytosine by decreasing elimination. Minor/Significance Unknown. - fludrocortisone
amphotericin B deoxycholate, fludrocortisone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- ganciclovir
ganciclovir increases toxicity of amphotericin B deoxycholate by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrocortisone
amphotericin B deoxycholate, hydrocortisone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- magnesium chloride
amphotericin B deoxycholate decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.
- magnesium citrate
amphotericin B deoxycholate decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.
- magnesium hydroxide
amphotericin B deoxycholate decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium oxide
amphotericin B deoxycholate decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium sulfate
amphotericin B deoxycholate decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.
- mestranol
amphotericin B deoxycholate decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.
- methylprednisolone
amphotericin B deoxycholate, methylprednisolone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- pentobarbital
pentobarbital decreases levels of amphotericin B deoxycholate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- phenobarbital
phenobarbital decreases levels of amphotericin B deoxycholate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- potassium acid phosphate
amphotericin B deoxycholate decreases levels of potassium acid phosphate by increasing renal clearance. Minor/Significance Unknown.
- potassium chloride
amphotericin B deoxycholate decreases levels of potassium chloride by increasing renal clearance. Minor/Significance Unknown.
- potassium citrate
amphotericin B deoxycholate decreases levels of potassium citrate by increasing renal clearance. Minor/Significance Unknown.
- prednisolone
amphotericin B deoxycholate, prednisolone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- prednisone
amphotericin B deoxycholate, prednisone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.
- primidone
primidone decreases levels of amphotericin B deoxycholate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- secobarbital
secobarbital decreases levels of amphotericin B deoxycholate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- valganciclovir
valganciclovir increases toxicity of amphotericin B deoxycholate by pharmacodynamic synergism. Minor/Significance Unknown.
- zidovudine
zidovudine increases toxicity of amphotericin B deoxycholate by pharmacodynamic synergism. Minor/Significance Unknown.
Adverse Effects
>10%
Anorexia
Chills
Diarrhea
Fever
Headache
Hypokalemia
Hypomagnesemia
Hypotension
Malaise
Nausea
Pain (generalized)
Pain at injection site
Renal function abnormalities
Tachypnea
Vomiting
1-10%
Arachnoiditis
Delerium
Flushing
Hypertension
Leukocytosis
Lumbar nerve pain
Paresthesia
Urinary retention
<1%
Agranulocytosis
Anuria
Bone marrow suppression
Cardiac arrest
Coagulation defects
Convulsions
Dyspnea
Hearing loss
Leukopenia
Maculopapular rash
Renal failure
Thrombocytopenia
Vision changes
Warnings
Drug should be used primarily for treatment of patients with progressive and potentially life-threatening fungal infections; should not be used to treat noninvasive forms of fungal disease such as oral thrush, vaginal candidiasis and esophageal candidiasis in patients with normal neutrophil counts
Should not be given in doses greater than 1.5 mg/kg
Exercise caution to prevent inadvertent overdosage, which may result in potentially fatal cardiac or cardiopulmonary arrest
Verify the product name and dosage pre-administration, especially if dose exceeds 1.5 mg/kg
Contraindications
Hypersensitivity
Cautions
Therapy should be administered intravenously under close clinical observation by medically trained personnel; should be reserved for treatment of patients with progressive, potentially life-threatening fungal infections due to susceptible organisms
Indicated for patients with progressive and potentially fatal fungal infections
Do not use for noninvasive fungal infections (eg, oral thrush, vaginal candidiasis, esophageal candidiasis) in patients with normal neutrophil counts
Acute reactions including fever, shaking chills, hypotension, anorexia, nausea, vomiting, headache, and tachypnea are common 1 to 3 hours after starting an intravenous infusion; reactions are usually more severe with first few doses of amphotericin B and usually diminish with subsequent doses
Rapid intravenous infusion has been associated with hypotension, hypokalemia, arrhythmias, and shock and should, therefore, be avoided
Since acute pulmonary reactions have been reported in patients given therapy during or shortly after leukocyte transfusions, it is advisable to temporarily separate these infusions as far as possible and to monitor pulmonary function
Caution when coadministration with other drugs that cause hypokalemia (eg, corticosteroids, digoxin)
Cases of new-onset dilated cardiomyopathy with subsequent heart failure have been reported; symptoms normalized within 6 months of discontinuation
Leukoencephalopathy has been reported following use of amphotericin B; literature reports have suggested that total body irradiation may be a predisposition
Amphotericin B should be used with care in patients with reduced renal function; frequent monitoring of renal function is recommended; in some patients hydration and sodium repletion prior to administration may reduce risk of developing nephrotoxicity; supplemental alkali medication may decrease renal tubular acidosis complications; however, do not withhold if risk of infection outweighs renal risk
Whenever medication is interrupted for a period longer than seven days, therapy should be resumed by starting with the lowest dosage level, eg, 0.25 mg/kg of body weight, and increased gradually
Pregnancy & Lactation
Pregnancy Category: B
Lactation: Excretion in milk is unknown; due to the potential for serious adverse reactions in breast-fed infants, a decision should be made whether to discontinue nursing or whether to discontinue the drug, taking into account the importance of the drug to the mother
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Vd: 4 L/kg
Distribution: CholSO4 & lipid complex show lower kidney concs than conventional
Protein Bound: 90%
Half-Life, elimination: 15 days
Half-Life, plasma: 24 hr
Excretion: urine
Mechanism of Action
Acts by binding to sterols in fungal cell membrane, leading to alterations in cell permeability and cell death
Administration
IV Incompatibilities
Solution: D5/LR, D5/NS, LR, NS
Additive: amikacin, CaCl2, Ca-gluconate, chlorpromazine, cimetidine, ciprofloxacin, diphenhydramine, dopamine, CaNa2EDTA, gentamicin, kanamycin, MgSO4, meropenem, metaraminol, methyldopate, penicillin G Na/K, polymyxin B SO4, KCl, prochlorperazine, ranitidine, streptomycin, verapamil
Syringe: pantoprazole
Y-site (partial list): allopurinol, amifostine, amsacarine, anidulafungin, aztreonam, bivalirudin, cefepine, cefpirone, cisatracurium(?), dexmedetomidine, docetaxel, doxorubicin liposomal, enalaprilat, etoposide PO4, fenoldopam mesylate, filgrastim, fluconazole, fludarabine, foscarnet, gatifloxacin, gemcitabine, granisetron, Hextend, lansoprazole, linezolid, melphalan, meropenem, ondansetron, paclitaxel, pemetrexed, piperacillin tazobactam, propofol, remifentanil(?), sargramostim(?), vinorelbine
IV Compatibilities
Solution: D5W, D10W
Additive: fluconazole, heparin, hydrocortisone Na-PO4; hydrocortisone Na-succinate; NaHCO3
Syringe: heparinY-site: aldesleukin, amiodarone, diltiazem, tacrolimus, teniposide, thiotepa, zidovudine
IV Preparation
Reconstitute 50 mg vial contents by adding 10 mL SWI without bacteriostatic agent to obtain a 5 mg/mL solution-add SWI rapidly & shake immediately until the colloidal dispersion is clear
For IV infusion, dilute further (usually to 0.1 mg/mL) with 500 mL D5W (pH >4.2)
Do not use if precipitate or foreign matter present
Store dry form at 36-46°F (2-8°C)
Protect from light
IV Administration
Use promptly after dilution
Infuse over 2-6 hr
May use an inline filter provided pore diameter >1 micron
Do not mix or piggyback with amphotericin B
Use IV site in distal vein
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| amphotericin B injection - | 50 mg vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
amphotericin B injection
AMPHOTERICIN - INJECTION
(AM-foe-TER-i-sin)
COMMON BRAND NAME(S): Fungizone
WARNING: Amphotericin should be used only to treat serious, possibly fatal fungal infections. This medication should not be used for less severe infections in limited areas of the body (such as fungal infection of the mouth/esophagus, vaginal yeast infections) in patients with normal white blood cell counts.
USES: See also Warning section.This medication is used to treat a variety of serious, possibly fatal fungal infections. It works by stopping the growth of fungi.
HOW TO USE: This medication is usually given by injection into a vein as directed by your doctor, usually given once a day or every other day. It should be injected slowly over 2 to 6 hours. Your doctor may give you a smaller dose first to test your response to the medication. Dosage is based on your medical condition, weight, response to the test dose, and response to therapy. If this medication is stopped for 7 days or longer, then it should be restarted at the lowest dose and slowly increased.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.It may be necessary to continue this medication for several weeks to several months in order to treat certain infections. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Fever, shaking, chills, flushing, loss of appetite, dizziness, nausea, vomiting, headache, shortness of breath, or fast breathing may occur 1 to 3 hours after the infusion is started. In some cases, other medications (including acetaminophen, diphenhydramine, corticosteroids such as hydrocortisone) may be necessary to prevent or relieve these side effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: swelling/pain at injection site, muscle/joint pain, unusual tiredness, weakness, muscle cramping, signs of kidney problems (such as change in the amount of urine, painful urination), numbness/tingling of arms/legs, vision changes, hearing changes (such as ringing in the ears), dark urine, severe stomach/abdominal pain, yellowing eyes/skin, swelling ankles/feet, fast/slow/irregular heartbeat, cold sweats, blue lips, easy bruising/bleeding, other signs of infection (such as sore throat that doesn't go away, fever), mental/mood changes, seizures, black stools, vomit that looks like coffee grounds.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using amphotericin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: white blood cell (leukocyte) transfusions, heart disease (such as irregular heartbeat, congestive heart failure), liver disease, kidney disease.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: anti-cancer drugs (such as mechlorethamine, nitrogen mustard), azole antifungals (such as ketoconazole, itraconazole), cidofovir, digoxin, flucytosine, medications that affect the kidneys (including pentamidine, tacrolimus, aminoglycosides such as gentamicin), muscle relaxants (such as tubocurarine), zidovudine.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: dizziness, fainting, slow heartbeat, trouble breathing.
NOTES: Lab and/or medical tests (such as kidney/liver function, potassium/magnesium levels, complete blood counts) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.
STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
