**Amphotericin B lipid complex 5 mg/kg IV daily plus flucytosine 25 mg/kg orally 4 times daily
**Amphotericin B lipid complex 5 mg/kg IV daily plus flucytosine 25 mg/kg orally 4 times daily
**Amphotericin B deoxycholate 0.7 to 1 mg/kg IV daily plus flucytosine* 25 mg/kg orally 4 times daily
**Amphotericin B deoxycholate 0.7 to 1 mg/kg IV daily plus flucytosine* 25 mg/kg orally 4 times daily
=====Candidemia un Non-Neutropenic Patients=====
*Dosage <ref>{{cite web|url=http://cid.oxfordjournals.org/content/48/5/503.1.full.pdf+html|url=Clinical Practice Guidelines for the Management of Candidiasis: 2009 Update by the Infectious Diseases Society of America}}</ref>
**Amphotericin B deoxycholate: 0.5–1.0 mg/kg daily IV
**Amphotericin B Lipid Formulation: 3–5 mg/kg daily IV
=====Febrile Neutropenia<ref>{{cite web|url=http://www.uphs.upenn.edu/bugdrug/antibiotic_manual/idsaneutropenicfever2010.pdf|title=Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America}}</ref>=====
|offLabelAdultNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Amphotericin B in adult patients.
|offLabelAdultNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Amphotericin B in adult patients.
|fdaLIADPed======Condition1=====
|fdaLIADPed======Condition1=====
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**Amphotericin B deoxycholate: 0.5–1.0 mg/kg daily IV
**Amphotericin B deoxycholate: 0.5–1.0 mg/kg daily IV
**Amphotericin B Lipid Formulation: 3–5 mg/kg daily IV
**Amphotericin B Lipid Formulation: 3–5 mg/kg daily IV
|offLabelPedNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Amphotericin B in pediatric patients.
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Black Box Warning
WARNING
See full prescribing information for complete Boxed Warning.
This drug should be used primarily for treatment of patients with progressive and potentially life-threatening fungal infections; it should not be used to treat noninvasive forms of fungal disease such as oral thrush, vaginal candidiasis and esophageal candidiasis in patients with normal neutrophil counts.
Amphotericin B for Injection should no be given in doses greater than 1.5 mg/kg.
EXERCISE CAUTION to prevent inadvertent overdosage, which may result in potentially fatal cardiac or cardiopulmonary arrest. Verify the product name and dosage pre-administration, especially if dose exceeds 1.5 mg/kg.
Amphotericin B for Injection should be administered by slow intravenous infusion. Intravenous infusion should be given over a period of approximately 2 to 6 hours (depending on the dose) observing the usual precautions for intravenous therapy. The recommended concentration for intravenous infusion is 0.1 mg/mL (1mg/10mL). Since patient tolerance varies greatly, the dosage of amphotericin B must be individualized and adjusted according to the patient's clinical status (e.g., site and severity of infection, etiologic agent, cardio-renal function, etc.). A single intravenous test dose (1 mg in 20 mL of 5% dextrose solution) administered over 20 to 30 minutes may be preferred. The patient's temperature, pulse, respiration, and blood pressure should be recorded every 30 minutes for 2 to 4 hours.
In patients with good cardio-renal function and a well tolerated test dose, therapy is usually initiated with a daily dose of 0.25 mg/kg of body weight. However, in those patients having severe and rapidly progressive fungal infection, therapy may be initiated with a daily dose of 0.3 mg/kg of body weight. In patients with impaired cardio-renal function or a severe reaction to the test dose, therapy should be initiated with smaller daily doses (i.e., 5 to 10 mg). Depending on the patient's cardio-renal status, doses may gradually be increased by 5 to 10 mg per day to final daily dosage of 0.5 to 0.7 mg/kg.
There are insufficient data presently available to define total dosage requirements and duration of treatment necessary for eradication of specific mycoses. The optimal dose is unknown. Total daily dosage may range up to 1.0 mg/kg per day or up to 1.5 mg/kg when given on alternate days.
Sporotrichosis: Therapy with intravenous amphotericin B for sporotrichosis has ranged up to nine months with a total dose up to 2.5 g.
Aspergillosis: Aspergillosis has been treated with amphotericin B intravenously for a period up to 11 months with a total dose up to 3.6 g.
Rhinocerebral phycomycosis: This fulminating disease generally occurs in association with diabetic ketoacidosis. It is, therefore, imperative that diabetic control be restored in order for treatment with Amphotericin B for Injection to be successful. In contradistinction, pulmonary phycomycosis, which is more common in association with hematologic malignancies, is often an incidental finding at autopsy. A cumulative dose of at least 3 g of amphotericin B is recommended to treat rhinocerebral phycomycosis. Although a total dose of 3 to 4 g will infrequently cause lasting renal impairment, this would seem a reasonable minimum where there is clinical evidence of invasion of deep tissue. Since rhinocerebral phycomycosis usually follows a rapidly fatal course, the therapeutic approach must necessarily be more aggressive than that used in more indolent mycoses.
Amphotericin B deoxycholate: 0.5–1.0 mg/kg daily IV
Amphotericin B Lipid Formulation: 3–5 mg/kg daily IV
Non–Guideline-Supported Use
There is limited information regarding Off-Label Non–Guideline-Supported Use of Amphotericin B in pediatric patients.
Contraindications
Condition1
Warnings
WARNING
See full prescribing information for complete Boxed Warning.
This drug should be used primarily for treatment of patients with progressive and potentially life-threatening fungal infections; it should not be used to treat noninvasive forms of fungal disease such as oral thrush, vaginal candidiasis and esophageal candidiasis in patients with normal neutrophil counts.
Amphotericin B for Injection should no be given in doses greater than 1.5 mg/kg.
EXERCISE CAUTION to prevent inadvertent overdosage, which may result in potentially fatal cardiac or cardiopulmonary arrest. Verify the product name and dosage pre-administration, especially if dose exceeds 1.5 mg/kg.
Description
Precautions
Description
Adverse Reactions
Clinical Trials Experience
There is limited information regarding Clinical Trial Experience of Amphotericin B in the drug label.
Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous
Postmarketing Experience
There is limited information regarding Postmarketing Experience of Amphotericin B in the drug label.
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