What's on this Page
Amphotericin B Brand Names
Amphocin | Fungizone
What is Amphotericin B
Amphotericin B is a parenteral antifungal antibiotic produced as a fermentation by-product of Streptomyces nodosus, a soil actinomycete.
Amphotericin B is an older drug of the polyene class similar to nystatin. Amphotericin B is named for its amphoteric properties, which are acquired from a carboxyl group on the main ring and a primary amino group on mycosamine.
These groups confer improved aqueous solubility in acidic and basic environments.
Despite having many well-known side effects and toxicities and the introduction of several antifungal agents of the imidazole class, amphotericin B remains the drug of choice for many serious systemic fungal infections. The FDA approved amphotericin B in 1957.
Amphotericin B is available as an injection, oral suspension, ointment, lotion, and cream. In the 1990s, lipid formulations of amphotericin B became available (see separate monograph).
Intranasal amphotericin B is being studied for treatment of chronic rhinosinusitis (CRS). Phase III studies with amphotericin B for CRS are underway with SinuNase™ (amphotericin B suspension nasal lavage, 100 mcg/mL), an investigational product by Accentia Biopharmaceuticals.
Indications
- Absidia sp.
- Acanthamoeba castellanii
- Acanthamoeba polyphaga
- Acremonium sp.
- allergic bronchopulmonary aspergillosis
- aspergillosis
- aspergillosis prophylaxis
- Aspergillus fumigatus
- Aspergillus sp.
- Basidiobolus sp.
- Blastomyces dermatitidis
- blastomycosis
- bone and joint infections
- Candida albicans
- Candida sp.
- candidemia
- candidiasis
- candidiasis prophylaxis
- candiduria
- chorioretinitis
- Coccidioides immitis
- coccidioidomycosis
- Conidiobolus sp.
- cryptococcal meningitis
- cryptococcosis
- Cryptococcus neoformans
- Cryptococcus sp.
- cystitis
- endocarditis
- endophthalmitis
- Entomophthora sp.
- esophageal candidiasis
- febrile neutropenia
- fungal keratitis
- Histoplasma capsulatum
- histoplasmosis
- infectious arthritis
- intraabdominal abscess
- intraabdominal infections
- Leishmania braziliensis
- Leishmania donovani
- Leishmania infantum
- Leishmania mexicana
- Leishmania sp.
- Leishmania tropica
- leishmaniasis
- meningitis
- Mucor mucedo
- Mucor sp.
- mucormycosis
- myocarditis
- Naegleria fowleri
- Naegleria sp.
- oropharyngeal candidiasis (thrush)
- osteomyelitis
- Paracoccidioides brasiliensis
- pericarditis
- peritonitis
- phycomycosis
- pneumonia
- pyelonephritis
- Rhizopus sp.
- Rhodotorula sp.
- Sporothrix schenckii
- sporotrichosis
- Talaromyces marneffei
- talaromycosis
- urinary tract infection (UTI)
Side Effects
- abdominal pain
- agranulocytosis
- anaphylactoid reactions
- anemia
- anorexia
- anuria
- arachnoiditis
- arrhythmia exacerbation
- arthralgia
- azotemia
- bronchospasm
- cardiac arrest
- chills
- coagulopathy
- cough
- diabetes insipidus
- diarrhea
- diplopia
- dysgeusia
- dyspepsia
- dysphagia
- dyspnea
- elevated hepatic enzymes
- encephalopathy
- eosinophilia
- fever
- flushing
- headache
- hearing loss
- heart failure
- hepatic failure
- hepatitis
- hyperbilirubinemia
- hyperkalemia
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hyposthenuria
- hypotension
- injection site reaction
- jaundice
- leukocytosis
- leukoencephalopathy
- leukopenia
- maculopapular rash
- malaise
- melena
- myalgia
- nausea
- nephrolithiasis
- oliguria
- paresthesias
- peripheral neuropathy
- phlebitis
- pneumonitis
- pruritus
- pulmonary edema
- rash
- renal failure (unspecified)
- renal tubular acidosis (RTA)
- seizures
- Stevens-Johnson syndrome
- tachypnea
- thrombocytopenia
- tinnitus
- toxic epidermal necrolysis
- ventricular fibrillation
- vertigo
- visual impairment
- vomiting
- weight loss
- wheezing
Monitoring Parameters
- CBC
- serum creatinine/BUN
- serum magnesium
- serum potassium
- serum sodium
Contraindications
- anemia
- breast-feeding
- children
- electrolyte imbalance
- hematological disease
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- infants
- infusion-related reactions
- leukopenia
- neonates
- potential for overdose or poisoning
- pregnancy
- renal disease
- renal impairment
- thrombocytopenia
Interactions
- Acetazolamide
- Acyclovir
- Amikacin
- Amiodarone
- Amlodipine; Celecoxib
- Aprotinin
- Arsenic Trioxide
- Atracurium
- Bacillus Calmette-Guerin Vaccine, BCG
- Bacitracin
- Bacitracin; Hydrocortisone; Neomycin; Polymyxin B
- Bacitracin; Neomycin; Polymyxin B
- Bacitracin; Polymyxin B
- Beractant
- Bumetanide
- Calfactant
- Capreomycin
- Cardiac glycosides
- Celecoxib
- Cidofovir
- Cisapride
- Cisatracurium
- Cisplatin
- Colfosceril; Cetyl Alcohol; Tyloxapol
- 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
- Gallium Ga 68 Dotatate
- Ganciclovir
- Gentamicin
- Gold
- Halofantrine
- Hyaluronidase, Recombinant; Immune Globulin
- Hydrocodone; Ibuprofen
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Immune Globulin IV, IVIG, IGIV
- Indapamide
- Indomethacin
- Inotersen
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Isoproterenol
- Isosulfan Blue
- Itraconazole
- Kanamycin
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole; Naproxen
- Levomethadyl
- Loop diuretics
- Mannitol
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methazolamide
- Mivacurium
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Neomycin
- Neuromuscular blockers
- Nilotinib
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Pancuronium
- Paromomycin
- Pentamidine
- Pimozide
- Piroxicam
- Polymyxin B
- Polymyxins
- Poractant Alfa
- Posaconazole
- Rapacuronium
- Rocuronium
- Rofecoxib
- Saccharomyces boulardii
- Salicylates
- Streptomycin
- Succinylcholine
- Sulindac
- Surfactants
- Tacrolimus
- Telavancin
- Telbivudine
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thiazide diuretics
- Tobramycin
- Tolmetin
- Torsemide
- Tubocurarine
- Valacyclovir
- Valdecoxib
- Valganciclovir
- Vancomycin
- Vecuronium
- Voriconazole
- Zalcitabine, ddC