Amphotericin B is beneficial in the treatment of life-threatening systemic fungal infections.
Uses of Amphotericin B
- Fungal infections in patients with febrile neutropenia (raised temperature and neutropenia- decreased number of white blood cells)
- In fungal infections of deep organs of body
- Visceral leishmaniasis (parasite) causing Kala azar
Contraindications of Amphotericin B
When should one not use Amphotericin B
- Allergic reaction to the medicine or its excipients
- Breastfeeding mother
- Patients receiving Antineoplastics (anticancer drugs)
- Co-administration with other drugs that cause low potassium (Digoxin, Corticosteroids, Diuretics, Tubocurarine, etc.)
- Co-administration with other medicines that cause Kidney problems (Ciclosporin, Aminoglycosides, Polymixins, Tacrolimus, and Pentamidine)
Side effects of Amphotericin B
Common side effects of this drug are:
- Nausea and vomiting
- Stomach pain
- Loss of appetite
- Pain or sometimes swelling at the injection site
- Weight loss
- Fever, chills or shivering
- Decrease in BP
- Heart rate increased than normal
- High blood sugar levels
- Easy bruising/bleeding
- Chest pain, Back pain
- Severe allergic reactions - difficulty in breathing, itching, swelling (especially in face/tongue/throat)
- Anaemia (low red blood cell levels): tiredness, pale skin
- Thrombophlebitis of the injected vein
- Kidney problems – little urination, swelling of feet and ankle
- Liver problems- jaundice
- Low potassium – confusion, uneven heartbeats, muscle cramps, etc
- Low magnesium, calcium or sodium blood levels-tired, confused, muscle weakness/cramps
- New infection – fever, chills, mouth ulcers, etc
Precautions and Warnings of Amphotericin B
Can I take Amphotericin B during pregnancy?
There are no adverse effects noted on using Amphotericin B during pregnancy. Consult with your doctor.
Can I take Amphotericin B while breastfeeding?
It is advised not to recommend Amphotericin B during breastfeeding. Inform your doctor if you are breastfeeding.
Can I drive if I have consumed Amphotericin B?
Do not drive until you feel well, as some of the possible side effects may affect your ability to drive.
Can I consume alcohol with Amphotericin B?
Avoid too much intake of alcohol while taking this medicine. Please consult with your doctor.
Other General Warnings
Talk to your doctor if
Amiodarone, Emtricitabine, Lopinavir, Ritonavir, Tenofovir, Efavirenz, Emtricitabine, Diatrizoate, Iothalamate, Deferasirox, Droperidol, etc. are some examples of medicines that can interact with Amphotericin B. Hence, inform your doctor about all the medications that you are taking.
Mode of Action of Amphotericin B
How Does It Work?
Amphotericin B kills fungal growth; thereby, it has a significant usage against fungal infections, especially those in the internal organs of the body. It binds to Sterols (lipid component) in the fungal cell membrane, leading to alterations in cell permeability and fungal cell death. Antifungal spectrum: active against fungi and yeasts - Blastomyces Dermatitidis, Candida Albicans, Histoplasma Capsulatum, Cryptococcus Neoformans, Torulopsis, Rhodotorula, Coccidioides Immitis, Aspergillus, Sporothrix, etc. Also active on Leishmania (parasite).
Interactions of Amphotericin B
Interactions with other medicines
Amiodarone, Emtricitabine, Lopinavir, Ritonavir, Tenofovir, Efavirenz, Emtricitabine, Diatrizoate, Iothalamate, Deferasirox, Droperidol, etc. these are some examples of numerous medicines that can interact with Amphotericin B. Hence, inform your doctor about all the medications that you are taking.
Interactions with food items
No specific interactions with food are in report yet.
Dosage of Amphotericin B
Inform your doctor in case of overdose. The effects of an overdose may be lethal and need immediate medical attention. The symptoms of overdose can be – fainting, trouble in breathing, blood in stools, seizures, etc.
Missed a Dose
If you miss a dose, take medicine as early as you remember and do not intake a double dose. Inform your doctor in case of a missed dose.
Frequently Asked Questions (FAQs)
Q: What should I discuss with my healthcare provider before taking Amphotericin B?
- Inform the doctor about your detailed medical and surgical history
- Inform your physician if you have any of the following conditions such as heart disease, kidney disease, liver disease, diabetes, electrolyte imbalance, if you have received blood transfusions, if you are receiving any radiation treatment or cancer medications, if you are pregnant, breastfeeding or planning a pregnancyread less
Q: How Amphotericin B affects kidney and liver, leading to toxicity?
A: Cholesterol (lipid component) present in Kidney and liver cells closely resembles the sterols (lipid component) of fungal cell membrane. Hence Amphotericin B affects the cells of the kidney and liver along with fungal cells leading to toxicity.
Q: How is Amphotericin B excreted?
A: Excretion occurs slowly in both urine and bile.
Q: How is Amphotericin B used?
A: The commonly used route is IV (intravenous) given by doctor or nurse into the vein over 30- 60 minutes period in drip infusion. It is given after the test dose to check for allergy. If no allergic reactions develop, the doctor or nurse will continue the injection. Topically Amphotericin B is used as gel or drops.
Last Updated on: 05 Oct 2020 | 10:47 PM (IST)
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