Drug Information

 





Amphotericin-B

  












 

Pharmacokinetics

 

Amphotericin is not absorbed from the GIT, so can be used in intestinal
candidiasis without systemic toxicity. Administred I.V as a suspension
made with the help of a dispersing agent.It gets widely distributed in
the body but penetration in CSF is poor.It binds to steroids in tissues
and to lipoprotiens in plasma and stays in the body for long periods.The
terminal elimination half life is 15 days .

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Indication and Dosage


 

Amphotericin B is an antifungal drug acting against Histoplasma capsulatum,
Cryptococcus neoformans, Coccidiodes immitis, Blastomyces dermatitidis,
Candida albicans, torulopsis, rhodotorula and Sporothrix.

Amphotericin B
can be administered orally (50 to 100 mgs QID ) for intestinal moniliasis
.For systemic mycosis it is avialable as dry powder along with bile salt
(50mgs vial) for dispersion before use.It is first suspended in 10ml of
water then diluted in 500 ml of glucose solution .Initially 1 mg test dose
is injected over 20 mins I.V .If no serious reaction follows,0.3mg/kg is
infused over 4 to 8 hrs.Daily dose may be gradually increased to 0.7 mg /
kg depending on the tolerance of the patient .The total dose of AMB for
majority of cases is 3 to4 gm given over 2 to 3 months.Intrathecal
injection of 0.5mg twice weekly has been given for fungal meningitis.A
liposome encapsulated formulation of AMB is being developed in an attempt
to reduce toxicity.

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Action

 

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Interaction

 

Use of Antineoplastics, Antithyroid agents, Azathioprine, Chloramphenicol,
Colchicine, Cyclophosphamide, Flucytosine, Ganciclovir, Interferon,
Mercaptopurine, Zidovudine, radiotherapy : with concomitant amphotericin B
may increase the chance of blood disorders. Use of Gold salts, Indapamide,
Lithium, Streptozocin, Tiopronin, Thiazide diuretics with amphotericin B
may increase the risk of adverse effects affecting the renal system. Use
of Penicillamine with amphotericin B may increase the risk of blood
disorders and renal disorders.

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Adverse
Effect & Precaution
 



Nausea, vomiting, fever and breathlessness. Nephrotoxicity, anaemia and
thrombophlebitis.




Amphotericin B may cause thrombophlebitis of the injected veins. Dose
related nephrotoxicity occurs uniformly. Bone marrow depression can cause
slowly progressing anaemia, which is reversible.CNS toxicity can occur
following intrathecal administration.

Pregnancy: Use if clearly indicated

Breast Feeding: Use with caution

Man: May be used

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Brand
available in market

   













Amfocare
INJ 50mg Vial 407.63 Criticare
Amphocil
(Complex with
cholestryl sulphate)
INJ 50mg Vial 5500.00 Criticare
INJ 100mg Vial 11000.00 Criticare
Fungizone I.V.
INJ 50mg Vial 221.17 Sarabhai
Mycol
INJ 50mg Vial 357.00 VHB







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Drug Information
 


Amphotericin-B
  

 
Pharmacokinetics
 
Amphotericin is not absorbed from the GIT, so can be used in intestinal candidiasis without systemic toxicity. Administred I.V as a suspension made with the help of a dispersing agent.It gets widely distributed in the body but penetration in CSF is poor.It binds to steroids in tissues and to lipoprotiens in plasma and stays in the body for long periods.The terminal elimination half life is 15 days .

Top
  

Indication and Dosage
 
Amphotericin B is an antifungal drug acting against Histoplasma capsulatum, Cryptococcus neoformans, Coccidiodes immitis, Blastomyces dermatitidis, Candida albicans, torulopsis, rhodotorula and Sporothrix.

Amphotericin B can be administered orally (50 to 100 mgs QID ) for intestinal moniliasis .For systemic mycosis it is avialable as dry powder along with bile salt (50mgs vial) for dispersion before use.It is first suspended in 10ml of water then diluted in 500 ml of glucose solution .Initially 1 mg test dose is injected over 20 mins I.V .If no serious reaction follows,0.3mg/kg is infused over 4 to 8 hrs.Daily dose may be gradually increased to 0.7 mg / kg depending on the tolerance of the patient .The total dose of AMB for majority of cases is 3 to4 gm given over 2 to 3 months.Intrathecal injection of 0.5mg twice weekly has been given for fungal meningitis.A liposome encapsulated formulation of AMB is being developed in an attempt to reduce toxicity.

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Action
 

Top
 

Interaction
 
Use of Antineoplastics, Antithyroid agents, Azathioprine, Chloramphenicol, Colchicine, Cyclophosphamide, Flucytosine, Ganciclovir, Interferon, Mercaptopurine, Zidovudine, radiotherapy : with concomitant amphotericin B may increase the chance of blood disorders. Use of Gold salts, Indapamide, Lithium, Streptozocin, Tiopronin, Thiazide diuretics with amphotericin B may increase the risk of adverse effects affecting the renal system. Use of Penicillamine with amphotericin B may increase the risk of blood disorders and renal disorders.

Top
 

Adverse Effect & Precaution 

Nausea, vomiting, fever and breathlessness. Nephrotoxicity, anaemia and thrombophlebitis.


Amphotericin B may cause thrombophlebitis of the injected veins. Dose related nephrotoxicity occurs uniformly. Bone marrow depression can cause slowly progressing anaemia, which is reversible.CNS toxicity can occur following intrathecal administration.
Pregnancy: Use if clearly indicated
Breast Feeding: Use with caution
Man: May be used

Top
 

Amfocare

INJ

50mg

Vial

407.63

Criticare

Amphocil (Complex with cholestryl sulphate)

INJ

50mg

Vial

5500.00

Criticare

INJ

100mg

Vial

11000.00

Criticare

Fungizone I.V.

INJ

50mg

Vial

221.17

Sarabhai

Mycol

INJ

50mg

Vial

357.00

VHB


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By |2022-07-20T16:42:45+00:00July 20, 2022|Uncategorized|Comments Off on Amphotericin-B

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