Amphotericin B liposomal at a glance
Medicine class
Liposomal polyene antifungal antibiotic.
How it is given
A doctor or nurse gives it as an intravenous infusion; it is not taken by mouth.
Important formulation warning
Liposomal amphotericin B must not be confused with non-liposomal products such as Fungizone.
Monitoring
Blood tests monitor kidney and liver function, blood cells, potassium and magnesium.
What is Amphotericin B liposomal used for?
UK-licensed uses for the selected product include:
Severe systemic or deep fungal infections, including disseminated candidiasis, aspergillosis, mucormycosis and cryptococcal meningitis.
Empirical treatment of presumed fungal infection in a patient with fever and neutropenia when broad-spectrum antibiotics have not worked and investigations have not identified a bacterial or viral cause.
Visceral leishmaniasis in immunocompetent adults and children.
Use in adults and children aged 1 month and over. It is not recommended below 1 month because evidence is lacking.
How does Amphotericin B liposomal work?
Amphotericin B binds to sterols in fungal cell membranes, making them leaky and damaging or killing the fungus. Liposomal encapsulation changes its distribution and reduces contact with kidney tubule cells compared with non-liposomal amphotericin B.
Amphotericin B liposomal preparations and strengths
Dispersion for infusion
Route: Intravenous
Strengths: 50 mg
How to take Amphotericin B liposomal
Trained healthcare staff prepare and administer this medicine as an infusion into a vein. The selected product is reconstituted with sterile water and diluted only with a compatible dextrose infusion.
It must not be taken by mouth or given by another route.
It is incompatible with saline and must not be mixed with other medicines or electrolytes.
Staff monitor you during every infusion because allergic and infusion-related reactions can occur.
Food does not affect administration because the medicine is given intravenously.
Amphotericin B liposomal side effects
Common or expected effects
- Fever, chills or shivering during the infusion
- Nausea or vomiting
- Low potassium or other electrolyte changes
- Headache
- Flushing, faster heartbeat or low blood pressure
- Breathlessness
- Diarrhoea or abdominal pain
- Rash or back pain
- Changes in kidney or liver blood-test results
Get urgent medical advice
- Severe allergy or anaphylaxis, including facial or airway swelling, wheezing, breathing difficulty, collapse or loss of consciousness
- Severe infusion reaction with chest pain, marked breathlessness or bronchospasm
- Irregular heartbeat or cardiac arrest
- Kidney injury or failure, which may cause tiredness and reduced urine output
- Severe potassium disturbance, which may cause weakness, cramps or an abnormal heart rhythm
- Seizure or severe muscle injury
Amphotericin B liposomal in pregnancy
Experience with liposomal amphotericin B during pregnancy is limited. A specialist may consider it when the expected benefit of treating a serious infection outweighs potential maternal and fetal risks. Discuss pregnancy with the prescribing team.
Amphotericin B liposomal while breastfeeding
It is not known whether liposomal amphotericin B passes into human milk. The specialist team should weigh the importance of treatment, benefits of breastfeeding and potential risk to the child before deciding whether breastfeeding should continue.
Amphotericin B liposomal interactions
Specific interaction studies are limited, but clinically important interactions known for amphotericin B include:
Ciclosporin, tacrolimus, aminoglycosides, polymyxins or pentamidine
Other kidney-toxic medicines may increase renal injury, requiring closer kidney monitoring.
Loop or thiazide diuretics, corticosteroids or corticotropin
These can increase the likelihood or severity of low potassium.
Digitalis glycosides, such as digoxin
Low potassium caused by amphotericin B may increase digitalis toxicity and abnormal heart rhythms.
Common questions about Amphotericin B liposomal
Answers are fully visible for fast scanning and source review.
Is amphotericin B liposomal an antibiotic or an antifungal?
It is a polyene antifungal antibiotic used against susceptible fungi; it does not treat bacterial infections.
Why is amphotericin B put into liposomes?
The lipid vesicles alter its distribution and reduce kidney toxicity compared with non-liposomal amphotericin B, although kidney injury can still occur.
More questions about Amphotericin B liposomal
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.