You are on page 1of 4

Preterm neonates (GA: 27.

4 ± 5 weeks): High interpatient variability; 40% to 90% of


serum concentrations (Baley 1990)

Adults: Poor (inflamed or noninflamed meninges)

Vd: Pediatric patients (0 to 18 years): Highly variable; reported range: 0.38 to 3.99
L/kg (Benson 1989; Koren 1988)

Protein binding, plasma: 90%

Half-life elimination:

Premature neonates (GA: 27.4 ± 5 weeks): 14.8 hours (range: 5 to 82 hours) (Baley 1990)

Infants and Children (4 months to 14 years): 18.1 ± 6.6 hours (range: 11.9 to 40.3 hours)
(Benson 1989)

Adults: Biphasic: Initial: 15 to 48 hours; Terminal: 15 days

Time to peak: Within 1 hour following a 4- to 6-hour dose

Excretion: Urine (2% to 5% as biologically active form); ~40% eliminated over a 7-day period
and may be detected in urine for at least 7 weeks after discontinued use

Clearance (Benson, 1989):

Infants and Children (8 months to 9 years): 0.57 ± 0.152 mL/minute/kg

Children and Adolescents (10 to 14 years): 0.24 ± 0.02 mL/minute/kg

Pricing: US

Solution (reconstituted) (Amphotericin B Intravenous)

50 mg (per each): $54.63

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as
reference price only. A range is provided when more than one manufacturer's AWP price is
available and uses the low and high price reported by the manufacturers to determine the
range. The pricing data should be used for benchmarking purposes only, and as such should
not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or
considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly
disclaims all warranties of any kind or nature, whether express or implied, and assumes no
liability with respect to accuracy of price or price range data published in its solutions. In no
event shall Medi-Span be liable for special, indirect, incidental, or consequential damages
arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International


Amfucin (PH); Ampho-Moronal (CH); Amphocil (MX); Ampholin (TH); Ampholip (PH); Amphotret
(PH, ZW); Anfotericina B (DO, GT, PA); Fungilin (QA); Fungilin Lozenges (AU, NZ); Fungitericin
(PH); Fungizon (CN, HN); Fungizona (ES); Fungizone (CH, CO, DE, DK, FI, FR, GB, GR, HK, HU, IE,
IN, IT, JO, KE, KR, NG, NL, PE, PL, PT, QA, SE, SI, TR, TW, TZ, UY, VE, VN, ZA); Photericin B (EG);
Tericin (BD); Terix (MX)

For country abbreviations used in Lexicomp ( show table)

Use of UpToDate is subject to the Subscription and License Agreement.

REFERENCES

1. American Academy of Pediatrics (AAP). In: Kimberlin DW, Brady MT, Jackson MA, Long SA, eds. Red Book: 2015
Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics;
2015.

2. Amphotericin B [prescribing information]. Big Flats, NY: X-Gen Pharmaceuticals; April 2010.
3. Amsden JR, Slain D. Antifungal dosing in obesity: a review of the literature. Curr Fungal Infect Rep. 2011;5:83-91.
doi:10.1007/s12281-011-0049-7

4. Aronson N, Herwaldt BL, Libman M, et al. Diagnosis and treatment of Leishmaniasis: clinical practice guidelines
by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene
(ASTMH). Clin Infect Dis. 2016;63(12):1539-1557. doi: 10.1093/cid/ciw742. [PubMed 27941143]

5. Arsura EL, Ismail Y, Freedman S, et al, “Amphotericin B-Induced Dilated Cardiomyopathy,” Am J Med, 1994,
97(6):560-2. [PubMed 7985716]

6. Aydin S, Ertugrul B, Gultekin B, Uyar G, Kir E. Treatment of two postoperative endophthalmitis cases due to
Aspergillus flavus and Scopulariopsis spp. with local and systemic antifungal therapy. BMC Infect Dis. 2007;7:87.
[PubMed 17672897]

7. Baley JE, Meyers C, Kliegman RM, et al, "Pharmacokinetics, Outcome of Treatment, and Toxic Effects of
Amphotericin B and 5-Fluorocytosine in Neonates," J Pediatr, 1990, 116(5):791-7.

8. Baltimore RS, Gewitz M, Baddour LM, et al; American Heart Association Rheumatic Fever, Endocarditis; Kawasaki
Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and
Stroke Nursing. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart
Association. Circulation. 2015;132(15):1487-1515. doi: 10.1161/CIR.0000000000000298 [PubMed 26373317]

9. Bastani B, Westervelt FB Jr. Persistence of Candida despite seemingly adequate systemic and intraperitoneal
amphotericin B treatment in a patient on CAPD. Am J Kidney Dis. 1986;8(4):265-266. [PubMed 3766532]
10. Benson JM and Nahata MC, “Clinical Use of Systemic Antifungal Agents,” Clin Pharm, 1988, 7(6):424-38. [PubMed
3042267]

11. Benson JM and Nahata MC, “Pharmacokinetics of Amphotericin B in Children,” Antimicrob Agents Chemother,
1989, 33(11):1989-93. [PubMed 2610508]

12. Bradley JS, Nelson JD, Barnett E, et al. Nelson's Pediatric Antimicrobial Therapy. 22nd ed. American Academy of
Pediatrics; 2016.

13. Branch RA, “Prevention of Amphotericin B-Induced Renal Impairment. A Review on the Use of Sodium
Supplementation,” Arch Intern Med, 1988, 148(11):2389-94. [PubMed 3056312]

14. Chapman SW, Dismukes WE, Proia LA, et al. Clinical practice guidelines for the management of blastomycosis:
2008 update by the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(12):1801-1812. [PubMed
18462107]

15. Chiou CC, Wong TT, Lin HH, et al, "Fungal Infection of Ventriculoperitoneal Shunts in Children," Clin Infect Dis,
1994, 19(6):1049-53. [PubMed 7888533]

16. Cruz JM, Peacock JE Jr, Loomer L, et al, “Rapid Intravenous Infusion of Amphotericin B: A Pilot Study,” Am J Med,
1992, 93:123-30. [PubMed 1497007]

17. Devuyst O, Goffin E, and Van Ypersele de Strihou C, “Recurrent Hemiparesis Under Amphotericin B for Candida
albicans Peritonitis,” Nephrol Dial Transplant, 1995, 10(5):699-701. [PubMed 7566587]

18. Dupont B. Overview of the lipid formulations of amphotericin B. J Antimicrob Chemother. 2002;49(suppl 1):S31-
S36. doi:10.1093/jac/49.suppl_1.31 [PubMed 11801578]

19. Eriksson U, Seifert B, and Schaffner A, "Comparison of Effects of Amphotericin B Deoxycholate Infused Over 4 or
24 Hours: Randomised Controlled Trial," BMJ, 2001, 322(7286):579-82. [PubMed 11238151]

20. Fisher JF, Sobel JD, Kauffman CA, et al. Candida urinary tract infections – treatment. Clin Infect Dis. 2011;52(Suppl
6):S457-S466. [PubMed 21498839]

21. Gales MA and Gales BJ, “Rapid Infusion of Amphotericin B in Dextrose,” Ann Pharmacother, 1995, 29(5):523-9.
[PubMed 7655137]

22. Galgiani JN, Ampel NM, Blair JE, et al; Infectious Diseases Society of America. Coccidioidomycosis. Clin Infect Dis.
2005;41(9):1217-1223. doi: 10.1086/496991. [PubMed 16206093]

23. Gallis HA, Drew RH, and Pickard WW, “Amphotericin B: 30 Years of Clinical Experience,” Rev Infect Dis, 1990,
12(2):308-29. [PubMed 2184499]

24. Goodwin SD, Cleary JD, Walawander CA, et al, “Pretreatment Regimens for Adverse Events Related to Infusion of
Amphotericin B,” Clin Infect Dis, 1995, 20(4):755-61. [PubMed 7795069]

25. Gould FK, Denning DW, Elliott TS, et al, “Guidelines for the Diagnosis and Antibiotic Treatment of Endocarditis in
Adults: A Report of the Working Party of the British Society for Antimicrobial Chemotherapy,” J Antimicrob
Chemother, 2012, 67(2):269-89. [PubMed 22086858]

26. Gubbins PO, McConnell SA, and Penzak SR, "Current Management of Funguria," Am J Health Syst Pharm, 1999,
56(19):1929-35. [PubMed 10554910]
27. Harbarth S, Pestotnik SL, Lloyd JF, et al, "The Epidemiology of Nephrotoxicity Associated With Conventional
Amphotericin B Therapy," Am J Med, 2001, 111(7):528-34. [PubMed 11705428]

28. HHS. Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV-
infected children: recommendations from the National Institutes of Health, Centers for Disease Control and
Prevention, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious
Diseases Society, and the American Academy of Pediatrics. November 6, 2013. Available at http://aidsinfo.nih.gov

29. Hoenigl M, Krause R. Antifungal therapy of aspergillosis of the central nervous system and aspergillus
endophthalmitis. Curr Pharm Des.2013;19(20):3648-3668. [PubMed 23278539]

30. Hogg RJ, Arant BS Jr, Houser MT. Candida peritonitis in children on continuous ambulatory peritoneal dialysis. Int
J Pediatr Nephrol. 1982;3(4):287-291. [PubMed 6299987]

31. Imhof A, Walter RB, and Schaffner A, "Continuous Infusion of Escalated Doses of Amphotericin B Deoxycholate: An
Open-Label Observational Study," Clin Infect Dis, 2003, 36(8):943-51. [PubMed 12684904]

32. Jeffery GM, Beard ME, Ikram RB, et al, “Intranasal Amphotericin B Reduces the Frequency of Invasive Aspergillosis
in Neutropenic Patients,” Am J Med, 1991, 90(6):685-92. [PubMed 2042684]

33. Johnson RJ, Ramsey PG, Gallagher N, Ahmad S. Fungal peritonitis in patients on peritoneal dialysis: incidence,
clinical features and prognosis. Am J Nephrol. 1985;5(3):169-175. [PubMed 4014323]

34. Jones RS, Barman A, Suh B, et al, “Successful Treatment of Aspergillus vertebral Osteomyelitis With Amphotericin B
Lipid Complex,” Infect Dis Clin Pract, 1995, 4:237-9.

35. Kauffman CA, Bustamante B, Chapman SW, Pappas PG, Infectious Diseases Society of America. Clinical practice
guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America. Clin
Infect Dis. 2007;45(10):1255-1265. [PubMed 17968818]

36. Kaushik S, Ram J, Brar GS, Jain AK, Chakraborti A, Gupta A. Intracameral amphotericin B: initial experience in
severe keratomycosis. Cornea. 2001;20(7):715-719. [PubMed 11588423]

37. King CT, Rogers PD, Cleary JD, et al, "Antifungal Therapy During Pregnancy," Clin Infect Dis, 1998, 27(5):1151-60.
[PubMed 9827262]

38. Kintzel PE and Smith GH, “Practical Guidelines for Preparing and Administering Amphotericin B,” Am J Hosp
Pharm, 1992, 49(5):1156-64. [PubMed 1595747]

39. Klaus JR, Knodel LC, and Kavanagh RE, "Administration Guidelines for Parenteral Drug Therapy. Part I: Pediatric
Patients," J Pharm Technol, 1989, 5(3):101-28. [PubMed 10318297]

40. Koren G, Lau A, Klein J, et al, “Pharmacokinetics and Adverse Effects of Amphotericin B in Infants and Children,” J
Pediatr, 1988, 113(3):559-63. [PubMed 3411404]

41. Kravitz SP, Berry PL. Successful treatment of Aspergillus peritonitis in a child undergoing continuous cycling
peritoneal dialysis. Arch Intern Med. 1986;146(10):2061-2062. [PubMed 3767552]

42. Ku JH, Kim ME, Jeon YS, et al, "Urinary Ascites and Anuria Caused by Bilateral Fungal Balls in a Premature Infant,"
Arch Dis Child Fetal Neonatal Ed, 2004, 89(1):F92-3. [PubMed 14711869]

43. Lyman CA and Walsh TJ, “Systemically Administered Antifungal Agents. A Review of Their Clinical Pharmacology
and Therapeutic Applications,” Drugs, 1992, 44(1):9-35. [PubMed 1379913]

You might also like