What's on this Page
Amphotericin B cholesteryl sulfate complex Brand Name
What is Amphotericin B cholesteryl sulfate complex
Amphotericin B is a polyene antifungal first isolated in 1955 from Streptomyces nodosus. In 1957, amphotericin B was approved for the treatment of progressive and potentially life threatening fungal infections.
Amphotericin B maintains a broad spectrum of activity with a low potential for resistance, yet despite its efficacy, the usefulness of amphotericin B has been limited by its severe toxicities.
To improve the tolerability of amphotericin B, three lipid-based formulations have been developed (amphotericin B lipid complex, amphotericin B cholesteryl sulfate complex, and amphotericin B liposomal injection). Amphotericin B cholesteryl sulfate complex (Amphotec, ABCD) was the second of three lipid amphotericin B preparations available in the US.
ABCD consists of a 1:1 molar ratio of amphotericin B and cholesteryl sulfate which, upon reconstitution, forms a colloidal dispersion of disc-shaped particles ranging in size from 120—140 nm.
Incorporating amphotericin B into a lipid complex decreases the toxicity and alters the pharmacokinetic properties of the drug without diminishing its efficacy.
Data from five open label studies involving patients refractory to or intolerant of conventional amphotericin B demonstrated effectiveness of ABCD in the treatment of Aspergillus infections.
In addition, treatment with ABCD resulted in equivalent efficacy and lower incidence of nephrotoxicity when compared to conventional amphotericin B for the treatment of invasive aspergillosis in immunocompromised patients. Of note, infusion-related toxicities occurred more frequently in those immunosuppressed patients receiving ABCD than in those receiving conventional amphotericin B.
ABCD is indicated for the treatment of invasive aspergillosis in patients who are refractory to or intolerant of conventional amphotericin B therapy. ABCD was FDA approved November 1996.
Indications
- aspergillosis
- Aspergillus fumigatus
- Aspergillus sp.
- blastomycosis
- Candida albicans
- Candida sp.
- candidemia
- candidiasis
- Coccidioides immitis
- coccidioidomycosis
- Cryptococcus neoformans
- endocarditis
- endophthalmitis
- esophageal candidiasis
- febrile neutropenia
- fungal keratitis
- histoplasmosis
- infectious arthritis
- Leishmania sp.
- leishmaniasis
- meningitis
- myocarditis
- osteomyelitis
- pericarditis
- peritonitis
- pneumonia
- sinusitis
- sporotrichosis
- tracheobronchitis
Side Effects
- abdominal pain
- acne vulgaris
- agitation
- alopecia
- amblyopia
- anaphylactoid reactions
- anemia
- anorexia
- anxiety
- apnea
- arrhythmia exacerbation
- arthralgia
- asthenia
- atrial fibrillation
- azotemia
- back pain
- bleeding
- bradycardia
- bullous rash
- cardiac arrest
- chest pain (unspecified)
- chills
- coagulopathy
- confusion
- constipation
- cough
- dehydration
- depression
- diarrhea
- dizziness
- drowsiness
- dysarthria
- dyspepsia
- dyspnea
- dysuria
- ecchymosis
- edema
- elevated hepatic enzymes
- epistaxis
- fecal incontinence
- fever
- GI bleeding
- gingivitis
- glossitis
- glycosuria
- hallucinations
- headache
- hearing loss
- heart failure
- hematemesis
- hematuria
- hemoptysis
- hepatic failure
- hyperbilirubinemia
- hyperglycemia
- hyperhidrosis
- hyperkalemia
- hyperlipidemia
- hypernatremia
- hypertension
- hypertonia
- hyperventilation
- hypervolemia
- hypocalcemia
- hypoglycemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypophosphatemia
- hypotension
- hypothermia
- hypoxia
- infection
- injection site reaction
- insomnia
- jaundice
- leukocytosis
- leukopenia
- maculopapular rash
- melena
- metabolic acidosis
- myalgia
- nausea
- ocular hemorrhage
- oliguria
- oral ulceration
- orthostatic hypotension
- paresthesias
- peripheral edema
- peripheral neuropathy
- peripheral vasodilation
- petechiae
- pharyngitis
- phlebitis
- pleural effusion
- pruritus
- psychosis
- pulmonary edema
- rash
- renal failure (unspecified)
- renal tubular acidosis (RTA)
- renal tubular necrosis
- rhinitis
- seizures
- sinus tachycardia
- sinusitis
- skin discoloration
- skin ulcer
- stomatitis
- supraventricular tachycardia (SVT)
- syncope
- tachypnea
- thrombocytopenia
- tinnitus
- tremor
- urinary incontinence
- urinary retention
- urticaria
- veno-occlusive disease (VOD)
- vesicular rash
- vomiting
- weight gain
- weight loss
- xerostomia
Monitoring Parameters
- CBC
- LFTs
- platelet count
- serum creatinine/BUN
- serum magnesium
- serum potassium
- serum sodium
Contraindications
- anemia
- breast-feeding
- cardiac disease
- electrolyte imbalance
- geriatric
- hematological disease
- hepatic disease
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypophosphatemia
- hypotension
- pregnancy
- renal disease
- renal failure
- renal impairment
- tachycardia
- thrombocytopenia
Interactions
- Acetazolamide
- Acyclovir
- Amikacin
- Amiodarone
- Amlodipine; Celecoxib
- Aprotinin
- Atracurium
- Bacillus Calmette-Guerin Vaccine, BCG
- Bacitracin
- Bacitracin; Hydrocortisone; Neomycin; Polymyxin B
- Bacitracin; Neomycin; Polymyxin B
- Bacitracin; Polymyxin B
- Bumetanide
- Capreomycin
- Cardiac glycosides
- Celecoxib
- Cidofovir
- Cisapride
- Cisatracurium
- Cisplatin
- Colistimethate, Colistin, Polymyxin E
- Conivaptan
- Corticosteroids
- Cyclophosphamide
- Cyclosporine
- Daunorubicin Liposomal
- Daunorubicin Liposomal; Cytarabine Liposomal
- Dichlorphenamide
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Digitoxin
- Digoxin
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dofetilide
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxacurium
- Doxorubicin Liposomal
- Dronabinol
- Droperidol
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Entecavir
- Esomeprazole; Naproxen
- Ethacrynic Acid
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Fluconazole
- Flucytosine
- Flurbiprofen
- Foscarnet
- Furosemide
- Gallium
- Ganciclovir
- Gentamicin
- Gold
- Halofantrine
- Hyaluronidase, Recombinant; Immune Globulin
- Hydrocodone; Ibuprofen
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Immune Globulin IV, IVIG, IGIV
- Indapamide
- Indomethacin
- Inotersen
- Isoproterenol
- Itraconazole
- Kanamycin
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole; Naproxen
- Levomethadyl
- Loop diuretics
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methazolamide
- Mivacurium
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Neomycin
- Neuromuscular blockers
- Nilotinib
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Pancuronium
- Paromomycin
- Pentamidine
- Pimozide
- Piroxicam
- Polymyxin B
- Polymyxins
- Rapacuronium
- Rocuronium
- Rofecoxib
- Salicylates
- Streptomycin
- Succinylcholine
- Sulindac
- Tacrolimus
- Telavancin
- Telbivudine
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thiazide diuretics
- Tobramycin
- Tolmetin
- Torsemide
- Tubocurarine
- Valacyclovir
- Valdecoxib
- Valganciclovir
- Vancomycin
- Vecuronium
- Voriconazole
- Zalcitabine, ddC
