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Amphotericin B Liposomal Dosage

Medically reviewed on November 27, 2017.

Applies to the following strengths: 50 mg

Usual Adult Dose for Aspergillosis - Invasive

3 to 5 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Uses: Treatment of Aspergillus species, Candida species and/or Cryptococcus species infections refractory to amphotericin B deoxycholate, or where renal impairment or toxicity precludes use of amphotericin B deoxycholate.

Usual Adult Dose for Candidemia

3 to 5 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Uses: Treatment of Aspergillus species, Candida species and/or Cryptococcus species infections refractory to amphotericin B deoxycholate, or where renal impairment or toxicity precludes use of amphotericin B deoxycholate.

Usual Adult Dose for Cryptococcosis

3 to 5 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Uses: Treatment of Aspergillus species, Candida species and/or Cryptococcus species infections refractory to amphotericin B deoxycholate, or where renal impairment or toxicity precludes use of amphotericin B deoxycholate.

Usual Adult Dose for Febrile Neutropenia

3 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Use: Empiric therapy for presumed fungal infection in febrile, neutropenic patients.

Usual Adult Dose for Cryptococcal Meningitis - Immunosuppressed Host

6 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Use: Treatment of Cryptococcal meningitis in HIV infected patients

Usual Adult Dose for Leishmaniasis

Immunocompetent patients: 3 mg/kg/day IV on days 1 through 5, and days 14 and 21
-Infuse over 120 minutes.
-If parasitic clearance is not achieved, a repeat course may be useful.

Immunocompromised patients: 4 mg/kg/day IV on days 1 through 5, and days 10, 17, 24, 31 and 38
-Infuse over 120 minutes.
-If parasitic clearance is not achieved or relapse occurs, seek expert advice regarding further treatment.

Comments:
-Relapse rates after initial clearance of parasites were high in immunocompromised patients treated with this drug.
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Use: Treatment of visceral leishmaniasis

Usual Adult Dose for Coccidioidomycosis

Severe, non-meningeal infection: 3 to 5 mg/kg/day IV
Duration of therapy: Until clinical improvement
-Follow with triazole

Use: Coccidioidomycosis

Usual Adult Dose for Blastomycosis

Moderate to severe pulmonary blastomycosis: 3 to 5 mg/kg/day IV
Duration of therapy: 1 to 2 weeks or until improvement is noted
-Follow with itraconazole

Moderate to severe extrapulmonary blastomycosis: 3 to 5 mg/kg/day IV
Duration of therapy: 1 to 2 weeks or until improvement is noted
-Follow with itraconazole

CNS blastomycosis: 5 mg/kg/day IV
Duration of therapy: 4 to 6 weeks
-Follow with an oral azole

Blastomycosis, immunosuppressed patient: 3 to 5 mg/kg/day IV
Duration of therapy: 1 to 2 weeks or until improvement is noted
-Follow with itraconazole

Blastomycosis during pregnancy: 3 to 5 mg/kg/day IV
Duration of therapy: 1 to 2 weeks or until improvement is noted
-Avoid azoles because of possible teratogenicity


Use: Blastomycosis

Usual Pediatric Dose for Aspergillosis - Invasive

1 month and older:
3 to 5 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Uses: Treatment of Aspergillus species, Candida species and/or Cryptococcus species infections refractory to amphotericin B deoxycholate, or where renal impairment or toxicity precludes use of amphotericin B deoxycholate.

Usual Pediatric Dose for Candidemia

1 month and older:
3 to 5 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Uses: Treatment of Aspergillus species, Candida species and/or Cryptococcus species infections refractory to amphotericin B deoxycholate, or where renal impairment or toxicity precludes use of amphotericin B deoxycholate.

Usual Pediatric Dose for Cryptococcosis

1 month and older:
3 to 5 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Uses: Treatment of Aspergillus species, Candida species and/or Cryptococcus species infections refractory to amphotericin B deoxycholate, or where renal impairment or toxicity precludes use of amphotericin B deoxycholate.

Usual Pediatric Dose for Febrile Neutropenia

1 month or older:
3 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Use: Empiric therapy for presumed fungal infection in febrile, neutropenic patients.

Usual Pediatric Dose for Cryptococcal Meningitis - Immunosuppressed Host

1 month or older:
6 mg/kg/day IV over 120 minutes

Comments:
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Use: Treatment of Cryptococcal meningitis in HIV infected patients

Usual Pediatric Dose for Leishmaniasis

1 month or older:
Immunocompetent patients: 3 mg/kg/day IV on days 1 through 5, and days 14 and 21
-Infuse over 120 minutes.
-If parasitic clearance is not achieved, a repeat course may be useful.

Immunocompromised patients: 4 mg/kg/day IV on days 1 through 5, and days 10, 17, 24, 31 and 38
-Infuse over 120 minutes.
-If parasitic clearance is not achieved or relapse occurs, seek expert advice regarding further treatment.

Comments:
-Relapse rates after initial clearance of parasites were high in immunocompromised patients treated with this drug.
-Individualize dosing and rate of infusion to ensure maximum efficacy and minimize toxicities or adverse events.

Use: Treatment of visceral leishmaniasis

Renal Dose Adjustments

Data not available
-This drug has been successfully administered to patients with pre-existing renal impairment.

Liver Dose Adjustments

Data not available

Precautions

Safety and efficacy have not been established in patients younger than 1 month.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available
-Hemodialysis or peritoneal dialysis do not appear to significantly affect elimination of this drug.

Other Comments

Administration advice:
-Administer over approximately 120 minutes using a controlled infusion device.
-Administration time can be reduced to 60 minutes if treatment is well tolerated.
-Administration time can be increased if the patient experiences discomfort.
-An inline filter may be used if mean pore diameter is not less than 1 micron.
-Existing IV line must be flushed with 5% dextrose prior to administration; if line cannot be flushed with 5% dextrose, administer through a separate line.

Storage requirements:
-Store at temperatures up to 77F.

Reconstitution/preparation techniques:
-The manufacturer product information should be consulted.


IV compatibility:
-Dilute with 5% dextrose.
-Not compatible with saline.
-Do not mix with other drugs.

General:
-Carefully observe patients during the initial dosing period.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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