Ambisome

— THERAPEUTIC CATEGORIES —
  • Fungal infections

Ambisome Generic Name & Formulations

General Description

Amphotericin B (as liposome) 50mg/vial; pwd for IV infusion after reconstitution, filtration, and dilution.

Pharmacological Class

Polyene antifungal.

How Supplied

Vials—10

Ambisome Indications

Indications

Empiric treatment of presumed fungal infections in febrile, neutropenic patients. Treatment of cryptococcal meningitis in HIV-infected patients. Aspergillus, Candida, or Cryptococcus infections in patients who are refractory to or intolerant of amphotericin B deoxycholate. Treatment of visceral leishmaniasis.

Ambisome Dosage and Administration

Adults and Children

Give by IV infusion over 2hrs; may reduce duration to 1 hr if well-tolerated or increase if discomfort occurs. Stop infusion immediately if severe anaphylactic reaction occurs. <1 month: consult manufacturer. ≥1 month: Empiric therapy in febrile neutropenia: 3mg/kg per day. Cryptococcal meningitis: 6mg/kg per day. Aspergillus, Candida or Cryptococcus: 3–5mg/kg per day. Visceral leishmaniasis: immunocompetent: 3mg/kg per day on days 1–5, and 14, 21 (may repeat if parasites remain); immunocompromised: 4mg/kg per day on days 1–5, and 10, 17, 24, 31, 38 (obtain consult if parasites remain or relapse occurs).

Ambisome Contraindications

Not Applicable

Ambisome Boxed Warnings

Not Applicable

Ambisome Warnings/Precautions

Warnings/Precautions

Administer only by appropriately trained personnel. Be fully familiar with this drug's toxicity before use. Monitor renal and hepatic function, CBCs, and electrolytes (esp. K+, Mg++). Elderly. Pregnancy (Cat.B). Nursing mothers: not recommended.

Ambisome Pharmacokinetics

See Literature

Ambisome Interactions

Interactions

Caution with antineoplastics (renal toxicity, bronchospasm, hypotension), corticosteroids and ACTH (monitor electrolytes, cardiac function), azole antifungals (resistance), leukocyte transfusions (acute pulmonary toxicity), other nephrotoxic agents. May potentiate skeletal muscle relaxants, digitalis (monitor K+). May increase flucytosine toxicity. Azoles may increase fungal resistance. May cause false elevations of serum phosphate with the PHOSm assay analyzer.

Ambisome Adverse Reactions

Adverse Reactions

Infusion reactions, chills, bronchospasm, hypotension, GI disturbances, electrolyte disturbances; cardiovascular, respiratory, and dermatological effects; renal dysfunction, edema, increased liver enzymes, anaphylaxis, others.

Ambisome Clinical Trials

See Literature

Ambisome Note

Not Applicable

Ambisome Patient Counseling

See Literature