Amphotericin b
DefinitionThis section has been translated automatically.
Polyene antimycotic from Streptomyces nodosus.
IndicationThis section has been translated automatically.
Severe cutaneous and systemic infections caused by yeasts, in particular Aspergillus fumigatus, Blastomyces dermatitidis, Candida species, Coccidiodes immitis, Cryptococcus neoformans, Histoplasma capsulatum, Paracoccidioides brasiliensis, Rhizopus species, Sporotrix schenckii.
Limited indicationThis section has been translated automatically.
Pregnancy (only in the case of the most severe life-threatening mycoses, as abortions and premature births have been described), lactation.
Dosage and method of useThis section has been translated automatically.
- For candidiasis of the oral mucosa and enteral candidiasis as a reserve preparation: 4 times/day 100-200 mg as suspension or tablets.
- For systemic infections: first a test dose of 1-2 mg i.v., then 0.1 mg/kg bw i.v. with gradual increase to a maximum of 1 mg/kg bw/day.
- Children from 3 months: 0.25-1 g/day i.v., infusion for at least 6 hours.
Notice! In case of i.v.-application administration of 1-2 mg in 20 ml 5% dextrose as test dose, observation of the patients over 4 hours, if well tolerated, therapy can be started!
Standard concentrationThis section has been translated automatically.
3% in water-absorbing ointments (absorption bases), hydrophilic ointments, hydrophilic creams, hydroxyethyl cellulose gel, water-containing polyacrylate gel for candidiasis of the skin and mucous membranes and Paronychia candidamycetica 1-3 times/day thinly apply.
Undesirable effectsThis section has been translated automatically.
In systemic application, electrolyte disorders such as hypokalemia, renal tubular acidosis, and urea and creatinine elevation are among the most common ADRs. Often also fever, malaise, chills, allergic skin reactions up to anaphylaxis, headache, rigor, phlebitis, thrombophlebitis, anemia, weight loss, vomiting, visual disturbances, arthralgias, myalgias, severe feeling of illness. Haemato- and nephrotoxicity (see below acute tubulointerstitial nephritis) with parenteral application.
Notice! Pay attention to paragroup allergy in finished preparations.
Notice! During the first 4 weeks of therapy the following laboratory parameters should be checked twice a week and then weekly: haematocrit, electrolytes, blood count, creatinine, urine status and sediment. A dosage of > 4 g over 6 weeks generally leads to irreversible damage to kidney function!
InteractionsThis section has been translated automatically.
s. Table 1.
ContraindicationThis section has been translated automatically.
Severe liver and kidney dysfunction, Amphotericin B intolerance.
PreparationsThis section has been translated automatically.
Ampho-Moronal, Amphotericin B
TablesThis section has been translated automatically.
Major interactions of Amphotericin B
Acetylcysteine |
incompatible |
ACTH |
Hypokalemia |
Aminoglycosides |
Nephro- and ototoxicity ↑ |
Amiodarone |
Torsades de pointes in hypokalemia |
Ciclosporin A |
Nephrotoxicity ↑ |
Foscarnet |
Nephrotoxicity ↑ |
Ganciclovir |
BB changes, mutual impact ↑ |
Glucocorticoids |
Hypokalemia, superinfection |
Cardiac glycosides |
Hypokalemia, cardiac glycoside toxicity ↑ |
Pentamidine diisethionate |
Nephrotoxicity ↑ |
Thiazide diuretics |
Hypokalemia |
Zalcitabine |
Zalcitabine toxicity ↑ |
Zidovudine |
Mutual toxicity ↑ |