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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 medication 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?

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 while you are receiving this medicine.

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

You should not use this medicine if you are allergic to amphotericin B.

To make sure amphotericin B liposomal is safe for you, tell your doctor if you have:

  • kidney disease;

  • liver disease; or

  • low levels of calcium or potassium in your blood.

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 receiving 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.

While using amphotericin B liposomal, you may need frequent blood tests. Your liver and kidney function may also need to be tested.

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 side effects may occur during the injection. 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:

  • chest pain, fast heart rate;

  • shortness of breath, a light-headed feeling (like you might pass out);

  • signs of a kidney problem--little or no urinating; painful or difficult urination; swelling in your feet or ankles; feeling tired or short of breath;

  • low calcium--numbness or tingly feeling around your mouth, fast or slow heart rate, muscle tightness or contraction, overactive reflexes; or

  • low potassium--confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling.

Common side effects may include:

  • stomach pain, nausea, vomiting, diarrhea;

  • chills;

  • rash;

  • headache; or

  • abnormal liver function tests.

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.

Amphotericin B liposomal dosing information

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

What other drugs will affect amphotericin B liposomal?

Other drugs may interact with amphotericin B liposomal, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

See also: Side effects (in more detail)

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: 2.03.

Last reviewed: November 25, 2014
Date modified: October 13, 2017

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