Amphotericin B interactions

Conditions

Conditions in which Amphotericin B needs care, as documented in this source.

• Anemia

  Moderate

  Intravenous amphotericin B therapy may depress erythropoietin and red blood cell production and commonly causes a normocytic, normochromic anemia. Although the anemia is well tolerated by most patients and usually reverses completely within several months of stopping therapy, it may be problematic in patients with preexisting anemia. Intravenous therapy with amphotericin B should be administered cautiously in anemic patients or those predisposed to anemia. Frequent monitoring of blood counts and hemoglobin concentrations are recommended.

  7 sources

  1. Miller R, Bates J "Amphotericin B toxicity." Ann Intern Med 71 (1969): 1089-95
  2. Maddux M, Barriere S "A review of complications of amphotericin B therapy: recommendations for prevention and management." Drug Intell Clin Pharm 14 (1980): 177-81
  3. Struijk D, Krediet R, Boeschoten E, Rietra JG, Arisz L "Antifungal treatment of candida peritonitis in continuous ambulatory peritoneal dialysis patients." Am J Kidney Dis 9 (1987): 66-70
  4. "Amphotericin." Med Lett Drugs Ther 30 (1988): 30-2
  5. Lyman C, Walsh T "Systemically administered antifungal agents." Drugs 44 (1992): 9-35
  6. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  7. "Product Information. Fungizone (amphotericin B)." Bristol-Myers Squibb (2022):

• Kidney Diseases

  Moderate

  Intravenously administered amphotericin B is nephrotoxic and may commonly cause decreased renal function and abnormalities including azotemia, hypo- and hyperkalemia, hypomagnesemia, hyposthenuria, renal tubular acidosis, and nephrocalcinosis. Renal function should be closely monitored in all patients receiving intravenous therapy with amphotericin B but in particular, patients with preexisting renal impairment. Dosage reductions are recommended. Serum creatinine, BUN, potassium and magnesium levels should be evaluated frequently, and dosing adjusted or discontinued accordingly.

  16 sources

  1. McCurdy D, Frederic M, Elkinton JR "Renal tubular acidosis due to amphotericin B." N Engl J Med 268 (1968): 124-31
  2. Patterson R, Ackerman G "Renal tubular acidosis due to amphotericin B nephrotoxicity." Arch Intern Med 127 (1971): 241-4
  3. Rosch J, Pazin G, Fireman P "Reduction of amphotericin B nephrotoxicity with mannitol." JAMA 235 (1976): 1995-6
  4. Bullock W, Luke R, Nuttall C, Bhathena D "Can mannitol reduce amphotericin B nephrotoxicity?" Antimicrob Agents Chemother 10 (1976): 555-63
  5. Barton C, Pahl M, Vaziri N, Cesario T "Renal magnesium wasting associated with amphotericin B therapy." Am J Med 77 (1984): 471-4
  6. Arning M, Scharf R, Schneider W "Prevention of renal failure during long-term treatment with amphotericin-B." Klin Wochenschr 65 (1987): 1108
  7. Branch R, Jackson E, Jacqz E, et al. "Amphotericin-B nephrotoxicity in humans decreased by sodium supplements with coadministration of ticarcillin or intravenous saline." Klin Wochenschr 65 (1987): 500-6
  8. Sacks P, Fellner S "Recurrent reversible acute renal failure from amphotericin." Arch Intern Med 147 (1987): 593-5

  Show all 16 sourcesShow fewer sources

  9. "Amphotericin." Med Lett Drugs Ther 30 (1988): 30-2
  10. Branch R "Prevention of amphotericin B-induced renal impairment: a review on the use of sodium supplementation." Arch Intern Med 148 (1988): 2389-94
  11. Fisher MA, Talbot GH Maislin G, McKeon BP, Tynan KP, Strom BL "Risk factors for amphotericin B-associated nephrotoxicity." Am J Med 87 (1989): 547-52
  12. Clements J, Peacock J "Amphotericin B revisited: reassessment of toxicity." Am J Med 88 (1990): n22-7
  13. Morgan DJ, Ching MS, Raymond K, et al. "Elimination of amphotericin B in impaired renal function." Clin Pharmacol Ther 34 (1983): 248-53
  14. Chabot GG, Pazdur R, Valeriote FA, Baker LH "Pharmacokinetics and toxicity of continuous infusion amphotericin B in cancer patients." J Pharm Sci 78 (1989): 307-10
  15. Keane WF, Everett ED, Golper TA, Gokal R, Halstenson C, Kawaguchi Y "Peritoneal dialysis-related peritonitis treatment recommendations: 1993 update." Perit Dial Int 13 (1993): 14-28
  16. "Product Information. Fungizone (amphotericin B)." Bristol-Myers Squibb (2022):

• Water-Electrolyte Imbalance

  Moderate

  Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

  10 sources

  1. Miller R, Bates J "Amphotericin B toxicity." Ann Intern Med 71 (1969): 1089-95
  2. Patterson R, Ackerman G "Renal tubular acidosis due to amphotericin B nephrotoxicity." Arch Intern Med 127 (1971): 241-4
  3. Maddux M, Barriere S "A review of complications of amphotericin B therapy: recommendations for prevention and management." Drug Intell Clin Pharm 14 (1980): 177-81
  4. Barton C, Pahl M, Vaziri N, Cesario T "Renal magnesium wasting associated with amphotericin B therapy." Am J Med 77 (1984): 471-4
  5. Arning M, Scharf R, Schneider W "Prevention of renal failure during long-term treatment with amphotericin-B." Klin Wochenschr 65 (1987): 1108
  6. Branch R, Jackson E, Jacqz E, et al. "Amphotericin-B nephrotoxicity in humans decreased by sodium supplements with coadministration of ticarcillin or intravenous saline." Klin Wochenschr 65 (1987): 500-6
  7. "Amphotericin." Med Lett Drugs Ther 30 (1988): 30-2
  8. Branch R "Prevention of amphotericin B-induced renal impairment: a review on the use of sodium supplementation." Arch Intern Med 148 (1988): 2389-94

  Show all 10 sourcesShow fewer sources

  9. Clements J, Peacock J "Amphotericin B revisited: reassessment of toxicity." Am J Med 88 (1990): n22-7
  10. "Product Information. Fungizone (amphotericin B)." Bristol-Myers Squibb (2022):