If infusion-related immediate reactions occur (e.g. fever, hypotension), duration of infusion may be increased to 3–4 hours.
Amphotericin B Liposomal is considered to be at a lower risk of causing harm if extravasated (as compared to amphotericin B – conventional).17
If total parenteral nutrition (TPN) or IV fluids are turned off during the infusion, consider monitoring of blood glucose level.
Cerebrospinal fluid (CSF) penetration of lipid formulations of amphotericin B is poor.8,9 Therefore, in cases of fungal meningitis, additional antifungal therapy is required.
Even though a neonatal pharmacokinetic study8 using amphotericin B - lipid complex showed substantial drug concentration in urine, a recent review2 suggests that the liposomal preparation of amphotericin B is a poor candidate for the treatment of neonatal candiduria as it has lesser renal tissue penetration. This reduced penetration is considered to be responsible for its reduced nephrotoxicity as compared to conventional amphotericin B.
Although amphotericin B formulations are known to cause nephrotoxicity and may cause hepatotoxicity, reducing the dose in these disease states is not currently recommended.19 If nephrotoxicity or hepatotoxicity is a significant concern, consider other antifungals.
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