amphotericin

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(amphotericin B)

An antifungal drug that is active against a wide range of organisms and can be used to treat most fungal infections; it is especially effective in treating systemic (generalized) infections. When taken orally or applied topically, for treating superficial infections, side effects are rare. For systemic infections amphotericin is given by intravenous infusion, which must be under medical supervision because side effects can be severe. A prescription only medicine, amphotericin is available as lozenges to be dissolved in the mouth and as solutions or lipid formulations for intravenous infusion.

Side effects:
when injected, amphotericin can cause nausea, vomiting, loss of appetite, diarrhoea, stomach pains, fever, headache, muscle and joint pains, anaemia, allergic reactions, kidney damage, and (less frequently) changes in blood pressure, abnormal heart rhythms, blood disorders, liver damage, hearing loss, double vision, and convulsions.

Precautions (with injections):
since severe allergic reactions can occur, a test dose of amphotericin should be given before the full dose. Tests for liver and kidney function during treatment are necessary. Amphotericin should be used with caution in people taking corticosteroids or anti-cancer drugs and in women who are pregnant or breastfeeding.

Interactions with other drugs:

Aminoglycoside antibiotics: increase the risk of toxic effects on the kidney.
Ciclosporin: increases the risk of toxic effects on the kidney.
Corticosteroids increase the risk of low concentrations of potassium in the blood.
Digoxin and digitoxin: the toxic effects of these drugs are increased if amphotericin causes potassium concentrations in the blood to fall.
Diuretics amphotericin increases the risk of loop and thiazide diuretics causing low potassium concentrations in the blood.
Tacrolimus increases the risk of toxic effects on the kidney.

Proprietary preparations:
Abelcet; AmBisome; Fungilin; Fungizone.