Ortho-Preferred

Amphotericin B/Fungizone


 - for severe systemic fungal infections;
 - dose: 0.25mg/kg IV over 6hrs initially (infusion .1mg/ml);
 - gradually increase dose as tolerated up to 1-1.5mg/kg/24hrIV over 6hr;
 - note hypersensitivity, caution with nephrotoxic/antineoplastic agents;
 - monitor blood, liver, and renal function,
 - discontinue therapy if BUN >40mg/dl, Creatinine >3.0mg/dl, or if liver function test abnormalities are noted;
 - should be delivered via Central Line;
 - pretreatment with ASA, acetaminophren, and antihistamines (Benadryl) helps minimize adverse effects;
 - small amounts of heparin (1unit/ml) and hydrocortisone (2.5mg/mg Ampho) added to the infusion may help minimize phlebitis;
 - may consider 1mg test dose over 30min;
 - may also apply as a cream to supperficial Candida;
 - may also cause hypokalemia, fever; 
 - note diffusion from Blood into CSF is NIL even w/ Inflammation;
 - dosing regimens for patients with Renal Insufficiency: (Dose for 70kg Adult {gm/dosing interval in hours}):
           CrCl:>80:0.02-0.05/24; CrCl:50-79:0.02-0.05/24; CrCl:30-49:0.02-0.05/24; CrCl:10-29:0.02-0.05/24; 
 - 40% of drug excreted in urine over 7 days;
 - will interact with aminoglycosides (Incrnephrotoxicity), digitalis and neuromuscular blocking agents (due to Ampho induced Hypokalemia);
 - note: may cause HypoMagnesemia;
 - mixture interactions references 


Amphotericin B-loaded bone cement to treat osteomyelitis caused by Candida albicans

Amphotericin B Delivery From Bone Cement Increases With Porosity but Strength Decreases

Amphotericin B Is Cytotoxic at Locally Delivered Concentrations



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, November 30, 2012 1:40 pm