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Updated 11 February 2013

Amphotericin B

Amphotericin is an anti-fungal antibiotic effective in treating most fungal and yeast infections and is the drug of choice in treating serious systemic fungal infection.

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Amphotericin B is the active ingredient of AmBisome and Fungizone.

General information

Amphotericin is an anti-fungal antibiotic effective in treating most fungal and yeast infections and is the drug of choice in treating serious systemic fungal infection. The oral form is used in the treatment of candidiasis (thrush) in the mouth, and other oral infections complicated by candida.

Because little of the drug is absorbed systemically when given orally, adverse effects to the oral form of this drug is rare. As a downside, the oral form is not effective in treating systemic infections.

Amphotericin is eliminated very slowly from the body and may be detected in the urine for up to 7 weeks after therapy is stopped.

How does amphotericin B work?

Amphotericin B injures the fungal cell membrane of sensitive species, rendering it more permeable. Fluid may penetrate the cell easier causing it to rupture.

Fast facts

Drug schedule: schedule 4

Available as: amphotericin B is available as lozenges or oral use and as injection

What does it do? amphotericin B has an anti-fungal action

Overdose risk: low (oral form)

Dependence risk: low

Is amphotericin B available as a generic? yes (injection)

Is amphotericin B available on prescription only? yes

User information

Onset of effect: improvement may be noticed within 4 days of start of treatment

Duration of action: up to 8 hours

Dietary advice: patients receiving amphotericin by injection are advised to take magnesium and potassium supplements

Stopping this medicine: the prescribed course of amphotericin B should be completed even if improvement is noticed after a few days. Premature stoppage may cause the original infection to recur.

Prolonged use: prolonged use of this medication in the injectable form may lead to kidney and blood disorders. Blood levels of potassium and magnesium may also be depleted. Frequent blood tests may be required. The oral form has few adverse effects.

Special precautions

Consult your doctor before using this drug if:

  • you have a liver or kidney condition
  • you are taking any other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.

Infants and children: a reduced dose should be prescribed according to body weight.

The elderly: dosage may need to be adjusted.

Driving and hazardous work: no special precautions need to be taken.

Alcohol: no special precautions need to be taken.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

nausea/ vomiting

x

x

diarrhoea/ abdominal cramping

x

x

skin rash/ itch

x

x

headache

x

x

loss of appetite

x

x

fever/chills

x

x

muscle and joint pain

x

x

hearing loss

x

x

swelling

x

x

Interactions

Drug interactions

corticosteroids

increased risk of cardiac toxicity

ciclosporin

risk of kidney damage

digitalis/ digoxin

risk of digitalis toxicity

diuretics

increased risk of potassium loss

miconazole

reduced effect of amphotericin

tacrolimus

increased risk of kidney toxicity

Disease interactions

Consult your doctor before using this drug if you have a liver or kidney condition.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage

Adults: Lozenges: 40-80mg daily; Injection: Maximum daily dose of 1.5mg/kg - The dose should however be determined for each individual case.

Interesting fact

Yellowing of the teeth may occur when using the oral form of this drug. It can easily be removed by brushing.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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