Amphotericin B Cholesteryl Sulfate Dosage
Applies to the following strengths: 100 mg; 50 mg
Usual Adult Dose for:
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for Aspergillosis - Invasive
Initial dosage: 3 to 4 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The dosage may be increased to 6 mg/kg of actual body weight rounded to the nearest 10 mg every 24 hours if there is no improvement or if there is evidence of progression of the fungal infection. 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 cholesteryl sulfate.
Usual Adult Dose for Candidemia
Initial dosage: 3 to 4 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The dosage may be increased to 6 mg/kg of actual body weight rounded to the nearest 10 mg every 24 hours if there is no improvement or if there is evidence of progression of the fungal infection. 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 cholesteryl sulfate.
Usual Adult Dose for Febrile Neutropenia
Initial dosage: 3 to 4 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The dosage may be increased to 6 mg/kg of actual body weight rounded to the nearest 10 mg every 24 hours if there is no improvement or if there is evidence of progression of the fungal infection. 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 cholesteryl sulfate.
Usual Adult Dose for Histoplasmosis
Initial dosage: 3 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The dosage may be increased to 6 mg/kg of actual body weight rounded to the nearest 10 mg every 24 hours if there is no improvement or if there is evidence of progression of the fungal infection. 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 cholesteryl sulfate.
Usual Adult Dose for Leishmaniasis
Initial dosage: 2 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The duration of amphotericin B cholesteryl sulfate therapy for visceral leishmaniasis is 10 days.
Usual Pediatric Dose for Aspergillosis - Invasive
Initial dosage: 3 to 4 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The dosage may be increased to 6 mg/kg of actual body weight rounded to the nearest 10 mg every 24 hours if there is no improvement or if there is evidence of progression of the fungal infection. 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 cholesteryl sulfate.
Usual Pediatric Dose for Candidemia
Initial dosage: 3 to 4 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The dosage may be increased to 6 mg/kg of actual body weight rounded to the nearest 10 mg every 24 hours if there is no improvement or if there is evidence of progression of the fungal infection. 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 cholesteryl sulfate.
Usual Pediatric Dose for Febrile Neutropenia
Initial dosage: 3 to 4 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The dosage may be increased to 6 mg/kg of actual body weight rounded to the nearest 10 mg every 24 hours if there is no improvement or if there is evidence of progression of the fungal infection. 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 cholesteryl sulfate.
Usual Pediatric Dose for Histoplasmosis
Initial dosage: 3 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The dosage may be increased to 6 mg/kg of actual body weight rounded to the nearest 10 mg every 24 hours if there is no improvement or if there is evidence of progression of the fungal infection. 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 cholesteryl sulfate.
Usual Pediatric Dose for Leishmaniasis
Initial dosage: 2 mg/kg of actual body weight rounded to the nearest 10 mg intravenously every 24 hours. The duration of amphotericin B cholesteryl sulfate therapy for visceral leishmaniasis is 10 days.
Precautions
General infusion-related reactions such as fever and chills/rigors have been reported in 35% of patients. Symptoms usually begin within 1 to 3 hours of initiation of an amphotericin B cholesteryl sulfate infusion and diminish with subsequent infusions. Slowing the rate of infusion may control symptoms. Severe infusion-related side effects associated with conventional amphotericin B administration have been lessened by pretreatment/treatment with corticosteroids, acetaminophen, antihistamines, and meperidine.
Other Comments
The manufacture recommends a test dose immediately preceding the first dose when beginning all new courses of treatment. A small amount of drug (e.g., 10 mL of the final preparation containing between 1.6 to 8.3 mg) should be infused over 15 to 30 minutes and the patient carefully observed for the next 30 minutes.
The manufacturer's directions should be strictly followed when reconstituting and further diluting the drug. The intravenous infusion should be administered at a rate of 1 mg/kg/hr. The infusion time may be extended if the patient experiences discomfort or cannot tolerate the infusion volume. Also, the infusion time may be reduced to a minimum of 2 hours for patients in whom the treatment is well-tolerated.
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