amphotericin b at a glance
Medicine class
Polyene antifungal antibiotic
How it is given
Intravenous infusion by trained healthcare staff
Key safety point
Liposomal amphotericin B and Fungizone are not interchangeable
Monitoring
Kidney function, electrolytes, liver function and blood counts require monitoring
What is amphotericin b used for?
Selected products are used for serious infections requiring specialist treatment.
Liposomal amphotericin B: severe systemic or deep fungal infections, including disseminated candidiasis, aspergillosis, mucormycosis and cryptococcal meningitis.
Liposomal amphotericin B: visceral leishmaniasis in immunocompetent adults and children.
Liposomal amphotericin B: presumed fungal infection in febrile neutropenic patients when broad-spectrum antibiotics have not resolved fever and investigations have not found a bacterial or viral cause.
Fungizone: progressive, potentially fatal infections including cryptococcosis, disseminated candidosis, aspergillosis, mucormycosis, disseminated histoplasmosis, coccidioidomycosis, blastomycosis and sporotrichosis.
Fungizone may help in American mucocutaneous leishmaniasis, but is not the preferred primary treatment.
How does amphotericin b work?
Amphotericin B binds mainly to ergosterol in fungal cell membranes, disrupting membrane permeability and inhibiting or killing susceptible fungi. Liposomal formulations enclose it in lipid particles, altering distribution and reducing, but not eliminating, kidney toxicity compared with conventional amphotericin B.
amphotericin b preparations and strengths
Dispersion for infusion
Route: Intravenous
Strengths: 50 mg
How to take amphotericin b
Selected products are not taken by mouth. They are prepared and given as an intravenous infusion by trained staff, with observation because allergic and infusion-related reactions can occur.
Ensure staff know the exact formulation prescribed; liposomal and conventional products must not be substituted.
Tell staff promptly about chills, fever, nausea, breathing difficulty, chest discomfort, flushing or dizziness during infusion.
Tell the clinical team about kidney or liver problems, pregnancy, breastfeeding and all other medicines before treatment.
amphotericin b side effects
Common or expected effects
- Chills, fever and other infusion-related symptoms
- Nausea or vomiting
- Low potassium; low magnesium can also occur
- Headache
- Low blood pressure, flushing or breathlessness
- Diarrhoea or abdominal discomfort
- Changes in kidney-function blood tests
- Rash, back pain or injection-site discomfort
Get urgent medical advice
- Severe allergic or anaphylactic reaction, including swelling, wheezing, collapse or severe breathing difficulty
- Marked kidney injury or failure
- Severe electrolyte disturbance causing weakness, confusion, palpitations or an abnormal heart rhythm
- Severe chest pain, bronchospasm or acute breathing problems during infusion
- Seizure
- Severe blistering or peeling skin reaction
amphotericin b in pregnancy
Experience in pregnancy is limited, particularly for liposomal amphotericin B. Conventional amphotericin B has been used for serious systemic fungal infections during pregnancy without an obvious fetal effect in reported cases, but evidence is insufficient to establish safety. A specialist should weigh treatment risks against the risks of untreated serious infection.
amphotericin b while breastfeeding
It is not known whether liposomal or conventional amphotericin B passes into human milk. Breastfeeding decisions require specialist assessment of the product used, potential infant risk, and the benefits of breastfeeding and maternal treatment; the Fungizone SmPC advises discontinuing breastfeeding.
amphotericin b interactions
Interaction risks mainly involve kidney injury, electrolyte disturbances or increased toxicity of another treatment.
Nephrotoxic medicines, including aminoglycosides, ciclosporin, tacrolimus, polymyxins and pentamidine
Combined use may increase kidney toxicity.
Loop or thiazide diuretics, corticosteroids and corticotropin
These can worsen amphotericin-associated potassium loss.
Common questions about amphotericin b
Answers are fully visible for fast scanning and source review.
Is amphotericin B an antibiotic or an antifungal?
It is a polyene antifungal antibiotic. Its clinical target is susceptible fungi rather than bacteria.
Why is amphotericin B usually given in hospital?
It requires intravenous preparation, laboratory monitoring and observation for serious infusion reactions, kidney injury and electrolyte disturbances.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.