Generic Name and Formulations:
Amphotericin B (as liposome) 50mg/vial; pwd for IV infusion after reconstitution, filtration, and dilution.
Astellas Pharma US, Inc.
Indications for AMBISOME:
Empiric treatment of presumed fungal infections in febrile, neutropenic patients. Treatment of cryptococcal meningitis in HIV-infected patients. Aspergillus, Candida, or Cryptococcus infections in patients who are refractory to or intolerant of amphotericin B deoxycholate. Treatment of visceral leishmaniasis.
Adults and Children:
Give by IV infusion over 2hrs; may reduce duration to 1 hr if well-tolerated or increase if discomfort occurs. Stop infusion immediately if severe anaphylactic reaction occurs. <1 month: consult manufacturer. ≥1 month: Empiric therapy in febrile neutropenia: 3mg/kg per day. Cryptococcal meningitis: 6mg/kg per day. Aspergillus, Candida or Cryptococcus: 3–5mg/kg per day. Visceral leishmaniasis: immunocompetent: 3mg/kg per day on days 1–5, and 14, 21 (may repeat if parasites remain); immunocompromised: 4mg/kg per day on days 1–5, and 10, 17, 24, 31, 38 (obtain consult if parasites remain or relapse occurs).
Administer only by appropriately trained personnel. Be fully familiar with this drug's toxicity before use. Monitor renal and hepatic function, CBCs, and electrolytes (esp. K+, Mg++). Elderly. Pregnancy (Cat.B). Nursing mothers: not recommended.
Caution with antineoplastics (renal toxicity, bronchospasm, hypotension), corticosteroids and ACTH (monitor electrolytes, cardiac function), azole antifungals (resistance), leukocyte transfusions (acute pulmonary toxicity), other nephrotoxic agents. May potentiate skeletal muscle relaxants, digitalis (monitor K+). May increase flucytosine toxicity. Azoles may increase fungal resistance. May cause false elevations of serum phosphate with the PHOSm assay analyzer.
Infusion reactions, chills, bronchospasm, hypotension, GI disturbances, electrolyte disturbances; cardiovascular, respiratory, and dermatological effects; renal dysfunction, edema, increased liver enzymes, anaphylaxis, others.
Clinical Pain Advisor Articles
- Abuse-Deterrent Opioid Formulations: Barriers to Broader Use
- Notifications by PDMPs May Not Effectively Reduce Opioid Misuse
- Virtual Reality May Effectively Reduce Sensory, Affective, and Cognitive Pain During Labor
- Medical Cannabis Legalization Associated With Reduced Schedule III Opioid Prescriptions
- Electroacupuncture May Help Reduce Opioid Use in Chronic Musculoskeletal Pain
- Neuropathic Pain Medications
- Higher Buprenorphine Dose May Not Increase Severity of Neonatal Abstinence Syndrome
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Ketamine Infusions May Be Effective for Refractory Headache
- Physical, Psychosocial Activity May Be Protective Against Development of Chronic Pain in Older Adults
- Opioid Use Disorder Prevalence at Delivery on the Rise in the US, According to CDC
- Suprazygomatic Sphenopalatine Ganglion Block May Quickly Relieve Status Migrainosus Pain
- Pharmacologically Induced Headache Accompanied by Dilated Cephalic Vessels
- IV Lidocaine May Be Safe, Efficacious for Pediatric Status Migraine
- Gray Matter Changes in Migraine Associated With Clinical Characteristics