Amphotericin B Liposomal

Amphotericin B Liposomal is a prescription medication used to treat fungal infections in neutropenic patients, systemic fungal infections, Cryptococcal Meningitis in HIV-infected patients, and Visceral Leishmaniasis. 

• Amphotericin B Liposomal is available under the following different brand names: AmBisome.

Common side effects of Amphotericin B Liposomal include:

• fever, 
• shaking, 
• chills, 
• flushing (warmth, redness, or tingly feeling), 
• loss of appetite, 
• dizziness, 
• nausea, 
• vomiting, 
• stomach pain, 
• diarrhea, 
• headache, 
• shortness of breath, 
• fast breathing 1 to 2 hours after the infusion is started, 
• sleep problems (insomnia), and 
• skin rash

Serious side effects of Amphotericin B Liposomal include:

• swelling or pain at the injection site, 
• muscle or joint pain, 
• unusual tiredness, 
• weakness, 
• muscle cramping, 
• changes in the amount of urine, 
• painful urination, 
• numbness or tingling of arms or legs, 
• vision changes, 
• hearing changes, 
• ringing in the ears, 
• dark urine, 
• severe stomach pain, 
• yellowing of the eyes or skin (jaundice), 
• swelling ankles or feet, 
• fast, slow, or irregular heartbeat,
• cold sweats, 
• blue lips, 
• easy bruising or bleeding, 
• fever, 
• persistent sore throat, 
• mental or mood changes, 
• seizures, 
• black stools, and
• vomit that looks like coffee grounds

Rare side effects of Amphotericin B Liposomal include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Powder for injection

• 50mg/vial

Fungal Infection, Empiric Therapy

• 3 mg/kg IV once daily

Systemic Fungal Infection

• 3-5 mg/kg IV once daily

Cryptococcal Meningitis

• 6 mg/kg IV once daily

Visceral Leishmaniasis

• Immunocompetent patients: 3 mg/kg IV once daily on days 1-5,14, and 21 (course may be repeated if parasitic clearance is not achieved)
• Immunocompromised patients: 4 mg/kg IV once daily on days 1-5, 10, 17, 24, 31, and 38 (If parasitic clearance is not achieved, consult infectious disease specialists for further treatment)

Oral suspension, extended-release

• 47.31g/473mL per bottle (Riomet ER)
• reconstituted suspension is 500mg/5mL 

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• No formal clinical studies of drug interactions have been conducted with Amphotericin B Liposomal. 

This information does not contain all possible interactions or adverse effects.  Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use.  Keep a list of all your medications with you, and share this information with your doctor and pharmacist.  Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Amphotericin B Liposomal?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Amphotericin B Liposomal?”

Cautions

• Indicated for patients with progressive and potentially fatal fungal infections
• Do not use for noninvasive fungal infections (eg, oral thrush, vaginal candidiasis, esophageal candidiasis) in patients with normal neutrophil counts
• Use caution when coadministration with other drugs that cause hypokalemia (eg, corticosteroids, digoxin)
• Acute pulmonary toxicity reported with simultaneously leukocyte transfusions
• Use caution with other nephrotoxic medications

Pregnancy and Lactation

• May be acceptable. Either animal studies show no risk but human studies are not available or animal studies showed minor risks and human studies were done and showed no risks.  
• It is unknown whether distributed in breast milk, caution is advised.