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amphotericin B liposomal

Generic Name: amphotericin B liposomal (AM foe TER i sin B LYE poe SOE mal)
Brand Name: AmBisome

What is amphotericin B liposomal?

Amphotericin B liposomal is an antifungal antibiotic that fights infections caused by fungus.

Amphotericin B liposomal is used to treat serious, life-threatening fungal infections including leishmaniasis, and a certain form of meningitis in people infected with HIV (human immunodeficiency virus). Amphotericin B liposomal is not for treating a minor fungal infection such as a yeast infection of the mouth, esophagus, or vagina.

Amphotericin B liposomal may also be used for purposes not listed in this medication guide.

What is the most important information I should know about amphotericin B liposomal?

To make sure you can safely receive amphotericin B liposomal, tell your doctor if you have kidney or liver disease, or if you are allergic to amphotericin B (Abelcet, AmBisome, Amphotec, or Fungizone).

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Amphotericin B liposomal may need to be given for up to several weeks or months, depending on the infection being treated.

Some people receiving a amphotericin B liposomal injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, nauseated, light-headed, sweaty, hot or cold, or if you have a fast heartbeat, chest tightness, or trouble breathing.

What should I discuss with my healthcare provider before receiving amphotericin B liposomal?

To make sure you can safely receive amphotericin B liposomal, tell your doctor if you are allergic to amphotericin B (Abelcet, AmBisome, Amphotec, or Fungizone), or if you have:

  • kidney disease; or

  • liver disease.

FDA pregnancy category B. Amphotericin B liposomal is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether amphotericin B liposomal passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using amphotericin B liposomal.

How is amphotericin B liposomal given?

Amphotericin B liposomal is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Amphotericin B liposomal must be given slowly, and the IV infusion can take 1 or more hours to complete.

Amphotericin B liposomal may need to be given for up several weeks or months, depending on the infection being treated.

Your breathing, blood pressure, and other vital signs will be watched closely while you are receiving amphotericin B liposomal.

To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Your liver and kidney function may also need to be tested.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using amphotericin B liposomal.

What happens if I miss a dose?

Since amphotericin B liposomal is usually given while you are in the hospital, you are not likely to miss a dose.

If you are receiving amphotericin B liposomal in an outpatient clinic, call your doctor if you will miss an appointment for your amphotericin B liposomal injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving amphotericin B liposomal?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Amphotericin B liposomal side effects

Some people receiving a amphotericin B liposomal injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, nauseated, light-headed, sweaty, hot or cold, or if you have a fast heartbeat, chest tightness, or trouble breathing.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • chest pain, pounding heartbeats or fluttering in your chest;

  • feeling light-headed or short of breath;

  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, limp feeling);

  • loss of appetite, vomiting, urinating less than usual or not at all;

  • swelling, rapid weight gain;

  • pale skin, weakness, rapid heart rate, trouble concentrating; or

  • muscle pain, tenderness, or weakness (especially if you also have fever, unusual tiredness, and dark colored urine).

Less serious side effects may include:

  • chills;

  • nausea, diarrhea;

  • stomach pain;

  • headache;

  • flushing (warmth, redness, or tingly feeling);

  • sleep problems (insomnia); or

  • mild skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Amphotericin B liposomal dosing information

Usual Adult Dose for Aspergillosis -- Invasive:

Systemic fungal infections: 3 to 5 mg/kg IV once a day

Doses as high as 10 mg/kg have been used in patients with documented Aspergillus infection.

The addition of flucytosine 25 to 37.5 mg/kg orally every 6 hours may be considered in HIV-infected patients with invasive candidiasis.

The total dose administered or duration of therapy will vary and depend on the nature and severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Adult Dose for Candidemia:

Systemic fungal infections: 3 to 5 mg/kg IV once a day

Doses as high as 10 mg/kg have been used in patients with documented Aspergillus infection.

The addition of flucytosine 25 to 37.5 mg/kg orally every 6 hours may be considered in HIV-infected patients with invasive candidiasis.

The total dose administered or duration of therapy will vary and depend on the nature and severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Adult Dose for Cryptococcosis:

Systemic fungal infections: 3 to 5 mg/kg IV once a day

Doses as high as 10 mg/kg have been used in patients with documented Aspergillus infection.

The addition of flucytosine 25 to 37.5 mg/kg orally every 6 hours may be considered in HIV-infected patients with invasive candidiasis.

The total dose administered or duration of therapy will vary and depend on the nature and severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Adult Dose for Febrile Neutropenia:

Empirical therapy: 3 mg/kg IV once a day

The total dose administered or duration of therapy will vary and depend on the severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Adult Dose for Cryptococcal Meningitis -- Immunosuppressed Host:

HIV-infected patient: 6 mg/kg IV once a day

The addition of flucytosine 25 mg/kg orally every 6 hours may be considered.

The total dose administered or duration of therapy will vary and depend on the nature and severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Adult Dose for Leishmaniasis:

Visceral leishmaniasis:
Immunocompetent patient: 3 mg/kg IV once a day on day 1 through 5, day 14, and day 21
Immunocompromised patient: 4 mg/kg IV once a day on day 1 through 5, day 10, day 17, day 24, day 31, and day 38

If the immunocompetent patient does not achieve parasitic clearance, a repeat course of therapy may be effective. If the immunocompromised patient does not achieve parasitic clearance or experiences a relapse, expert advice regarding future treatment is recommended.

Usual Pediatric Dose for Aspergillosis -- Invasive:

1 month or older:
Systemic fungal infections: 3 to 5 mg/kg IV once a day

Doses as high as 10 mg/kg have been used in patients with documented Aspergillus infection.

The addition of flucytosine 25 to 37.5 mg/kg orally every 6 hours may be considered for HIV-infected patients with invasive candidiasis.

The total dose administered or duration of therapy will vary and depend on the nature and severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Pediatric Dose for Candidemia:

1 month or older:
Systemic fungal infections: 3 to 5 mg/kg IV once a day

Doses as high as 10 mg/kg have been used in patients with documented Aspergillus infection.

The addition of flucytosine 25 to 37.5 mg/kg orally every 6 hours may be considered for HIV-infected patients with invasive candidiasis.

The total dose administered or duration of therapy will vary and depend on the nature and severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Pediatric Dose for Cryptococcosis:

1 month or older:
Systemic fungal infections: 3 to 5 mg/kg IV once a day

Doses as high as 10 mg/kg have been used in patients with documented Aspergillus infection.

The addition of flucytosine 25 to 37.5 mg/kg orally every 6 hours may be considered for HIV-infected patients with invasive candidiasis.

The total dose administered or duration of therapy will vary and depend on the nature and severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Pediatric Dose for Febrile Neutropenia:

1 month or older:
Empirical therapy: 3 mg/kg IV once a day

The total dose administered or duration of therapy will vary and depend on the severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Pediatric Dose for Cryptococcal Meningitis -- Immunosuppressed Host:

1 month or older:
HIV-infected patient: 6 mg/kg IV once a day

The addition of flucytosine 25 mg/kg orally every 6 hours may be considered.

The total dose administered or duration of therapy will vary and depend on the nature and severity of the infection and the patient's tolerance to amphotericin B liposomal.

Usual Pediatric Dose for Leishmaniasis:

1 month or older:
Visceral leishmaniasis:
Immunocompetent patient: 3 mg/kg IV once a day on day 1 through 5, day 14, and day 21
Immunocompromised patient: 4 mg/kg IV once a day on day 1 through 5, day 10, day 17, day 24, day 31, and day 38

If the immunocompetent patient does not achieve parasitic clearance, a repeat course of therapy may be effective. If the immunocompromised patient does not achieve parasitic clearance or experiences a relapse, expert advice regarding future treatment is recommended.

What other drugs will affect amphotericin B liposomal?

Amphotericin B liposomal can harm your kidneys. This effect is increased when you also use other medicines harmful to the kidneys. You may need dose adjustments or special tests if you have recently used:

  • medicines to treat a bowel disorder;

  • medication to prevent organ transplant rejection;

  • antiviral medications;

  • chemotherapy;

  • pain or arthritis medicines; or

  • any other injected antibiotics.

Tell your doctor about all other medicines you use, especially:

  • digoxin (digitalis, Lanoxin, Lanoxicaps);

  • flucytosine (Ancobon);

  • antifungal medication such as clotrimazole (Mycelex Troche), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);

  • any cancer medications; or

  • steroid medication (prednisone and others).

This list is not complete and other drugs may interact with amphotericin B liposomal. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about amphotericin B liposomal.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02. Revision Date: 2013-12-03, 11:56:52 AM.

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