amphotericin B deoxycholate

Adult Dosing .

Dosage forms:  INJ

Special Note

[formulation clarification]

Info: amphotericin B salts, liposomal, and lipid-complex products not bioequivalent; reassess dose if switching between products

infections, systemic fungal

[0.3-1 mg/kg/dose IV q24h]

Start: 0.25 mg/kg/dose IV q24h, incr. 5-10 mg/24h; for severe infections, start w/ maint. dose; Max: 1.5 mg/kg/day; Alt: may give double dose IV q48h, max 1.5 mg/kg/dose

candidal cystitis (off-label)

[50 mg/24h irrigation x1-2 days]

Info: continuous bladder irrigation

endocarditis, fungal (off-label)

[0.3-1 mg/kg/dose IV q24h]

Info: cont. for >6wk; refer to AHA guidelines

endophthalmitis, fungal (off-label)

[5-10 mcg in 0.1 mL sterile water intravitreally x1]

Info: part of multi-drug regimen; refer to institution protocol; may repeat in 4-7 days

renal dosing

[irrigation or intravitreal route]

renal impairment: not defined

HD/PD: not defined

[all other routes]

CrCl <10: consider giving usual dose q48h or decr. usual dose by 50%; Info: consider lipid formulations

HD: no adjustment; no supplement; PD: not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  INJ

Special Note

[formulation clarification]

Info: amphotericin B salts, liposomal, and lipid-complex products not bioequivalent; reassess dose if switching between products

infections, systemic fungal

[0.25-1 mg/kg/dose IV q24h]

Start: 0.1 mg/kg IV test dose over 20min, then remainder of 1st dose; Max: 1.5 mg/kg/day; Alt: 1.5 mg/kg/dose IV q48h; Info: incr. 0.25-0.5 mg/kg/dose q24-48h

endocarditis, fungal (off-label)

[0.25-1 mg/kg/dose IV q24h]

Info: cont. for >6wk; refer to AHA guidelines

renal dosing

[see below]

renal impairment: no adjustment; Info: consider giving usual dose q48h or decr. usual dose by 50% if renal impairment due to amphotericin B; consider lipid formulations

HD/PD: no adjustment; no supplement

hepatic dosing

[not defined]