High Alert
Amphotericin B liposome
Spectrum:
Absorption: IV administration results in complete bioavailability.
Distribution: Extensively distributed to body tissues and fluids. Poor penetration into CSF.
Half-Life: Biphasicinitial phase, 2448 hr; terminal phase, 15 days. Lipid complex: 174 hr. Liposomal: 100153 hr.
Contraindicated in:
Use Cautiously in:
CV: chest pain, hypotension, edema, hypertension, tachycardia
Derm: pruritus, rashes
F and E: hyperglycemia, hypocalcemia, hypokalemia, hypomagnesemia
GI: ↑liver enzymes, diarrhea, hyperbilirubinemia, nausea, vomiting, abdominal pain
GU: nephrotoxicity, hematuria
Hemat: anemia, leukopenia, thrombocytopenia
Local: phlebitis
MS: arthralgia, myalgia
Neuro: anxiety, confusion, headache, insomnia
Resp: dyspnea, hypoxia, wheezing
Misc: chills, fever, acute infusion reactions, HYPERSENSITIVITY REACTIONS
Drug-drug:
Amphotericin Deoxycholate
Amphotericin B Lipid Complex (Abelcet)
Amphotericin B Liposome (AmBisome)
Amphotericin Deoxycholate
Amphotericin B Lipid Complex
Amphotericin B Liposome
Lab Test Considerations:
Shake vial gently until yellow sediment at bottom has dissolved. Withdraw dose from required number of vials with 18-gauge needle. Replace needle from syringe filled with amphotericin B lipid complex with 5-micron filter needle. Each filter needle may be used to filter the contents of no more than 4 vials. Insert filter needle of syringe into IV bag of D5W and empty contents of syringe into bag. Protect from light. Infusion is stable for 6 hr at room temperature or 48 hr if refrigerated.Final concentration of infusion should be 1 mg/mL; a concentration of 2 mg/mL can be used for pediatric patients or patients who cannot tolerate large volumes of fluid.
Do not use an in-line filter. Infuse at a rate of 2.5 mg/kg/hr via infusion pump. If infusion exceeds 2 hr, mix contents by shaking infusion bag every 2 hr. If administering through an existing line, flush line with D5W before infusion or use a separate line.
Reconstitute each 50mg vial with 12 mL of sterile water for injection to achieve concentration of 4 mg/mL. Immediately shake vial vigorously for at least 30 sec until all particulate matter is completely dispersed. Reconstituted vials are stable for 24 hr if refrigerated. Withdraw appropriate volume for dilution into a syringe. Attach the 5-micron filter to the syringe and inject syringe contents into an appropriate volume of D5W. Infusion should be administered within 6 hr of dilution.Final concentration of infusion should be 12 mg/mL; a lower concentration (0.20.5 mg/mL) may be used for infants and small children.
Infuse over 2 hr. Infusion time may be shortened to 1 hr if patient tolerates infusion without any adverse reactions. If discomfort occurs during infusion, duration of infusion may be increased. May be administered through an in-line filter with pore diameter of at least 1 micron. If administering through an existing line, flush line with D5W before infusion or use a separate line.
Do not dilute or admix with saline solutions, other medications, or solutions containing a bacteriostatic agent.
Amphotericin B Deoxycholate
Amphotericin B Lipid Complex
Amphotericin B Liposome
IV Administration: