When ATH:
J02AA01

Amphotericin B – Characteristic

Polyene antibiotics, producyruemy aktinomicetom Streptomyces nodosus. The powder is yellow or yellow-orange. Practically insoluble in water, ether, ethanol, xloroforme. Hygroscopic, sensitive to light and heat. Easy inactivated in acidic and alkaline media.

Amphotericin B – Pharmacological action

Systemic mikozy kandidomikoz —, aspergillosis, histoplasmosis, kryptokokkoz, coccidiomycosis, blastomycosis, pulmonary fungal infections (actinomycosis), cystitis, leishmaniasis.

Amphotericin B – Contraindications

Hypersensitivity, expressed human liver and kidneys, diseases of the hematopoietic system, diabetes.

Amphotericin B – Restrictions apply

Pregnancy, lactation.

Amphotericin B – Pregnancy and breast-feeding

Be wary of pregnancy (adequate and well-controlled studies of the safety of use in pregnant women were not conducted).

Category actions on the fetus by the FDA — B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

At the time of treatment should stop breastfeeding (unknown, whether the amphotericin b in breast milk).

Amphotericin B – Side effects

From the nervous system and sensory organs: headache, polyneuropathy, blurred vision, diplopia.

Cardio-vascular system and blood (hematopoiesis, hemostasis): arterïalnaya hypo- or giperteziya, arrhythmia, ECG changes, anemia, leukopenia, thrombocytopenia.

From the digestive tract: nausea, vomiting, diarrhea, epigastric pain, loss of appetite, increase in liver enzymes.

With the genitourinary system: impairment of renal function, incl. increased concentration of serum creatinine, proteinuria, azotemia, Acidosis.

Allergic reactions: skin rash, itch, angioedema, bronchospasm (inhalation).

Other: fever, chills, violation of the electrolyte composition of blood, incl. kaliopenia, gipomagniemiya; thrombophlebitis at the injection site; When the inhalation is a Tickle in the throat, cough, cold; the local application is possible allergic reactions.

Amphotericin B – Cooperation

Can enhance the effect of cardiac glycosides, and muscle relaxants curariform. Incompatible with nephrotoxic antibiotics and anticancer drugs.

Amphotericin B – Overdose

Symptoms: increased side effects, possible cardiac arrest and respiratory.

Treatment: symptomatic.

Amphotericin B – Dosing and Administration

B /, inhalation and locally (as an ointment). To determine the tolerability the initial dose for the on/in the introduction is 100 ug / kg body weight. The dose is determined individually, depending on the nature of the disease, efficacy and tolerability; the average dose is 250 mg / kg, if necessary (and good endurance) the increase in the daily dose of up to 1 mg / kg. Assign a day or 2 times a week. The duration of treatment depends on the severity and localization process, duration of the disease, etc.. and is not less than 4-8 weeks (to prevent recurrence).

Inhalation-solution prepared immediately before use, the rate of 50000 ED 10 ml of sterile water for injection. Inhalation out 1-2 times daily for a period of 15-20-min. When using inhalers, working only on inspiration, single dose to 5 ml (25000 ED). The course of treatment is 10-14 days, Refresh course — over 7-10 days.

Locally, Ointment applied thinly on the surface of the lesions 1-2 times a day (to 4 time). The course of treatment - at least 10 days.

Amphotericin B – Precautions

To reduce the severity of side effects appoint antipyretics and antihistamines, B vitamins, ascorbic acid, NSAIDs, iron supplements, potassium, etc.. During treatment requires systematic monitoring of renal function, liver, and the blood level of potassium in the blood. If you have symptoms of anemia treatment with amphotericin B should be discontinued. For better portability antibiotic solution for inhalation it is recommended to add 10-15 drops of glycerin health.

Amphotericin B – Cooperation

Active substance	Description of interaction
Altretamïn	FMR. If concomitant use increases the risk of kidney damage and the likelihood of hypotension and bronchospasm.
Amikacin	FMR: synergism. Strengthens (mutually) The risk of developing nephrotoxicity.
Anastrozol	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Asparaginase	FMR. If concomitant use increases the risk of kidney damage and the likelihood of hypotension and bronchospasm.
Atrakuriya besilate	FMR: synergism. Against the background of amphotericin B and the resulting effect is enhanced by hypokalemia.
Bikalutamid	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Bleomycin	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Busulfan	FMR. Against the background of amphotericin B increases the risk of bronchospasm and hypotension; may affect the kidneys.
Vancomycin	FMR. Strengthens (mutually) The risk of developing neurons, th- and nephrotoxicity.
Vekuroniya bromide	FMR: synergism. Against the background of amphotericin B and the resulting effect is enhanced by hypokalemia.
Vynorelbyn	FMR. In a joint application increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Ganciclovir	FMR. In a joint application increases the risk of kidney damage, increases in serum creatinine.
Gemcitabine	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Gentamicin	FMR. Strengthens (mutually) The risk of developing nephrotoxicity.
Gidrokortizon	FMR. It increases the likelihood of hypokalemia, aritmii, dilatation of myocardial injury and heart failure.
Dakarʙazin	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Daunorubicin	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Digoxin	FMR. Increases (mutually) the risk of toxicity (possibly as a consequence of increasing hypokalemia).
Doxorubicin	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Docetaxel	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Zidovudine	FMR: synergism. Strengthens (mutually) the risk of bone marrow, It increases the likelihood of renal impairment.
Idaruʙiцin	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Interferon alfa-2a	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Interferon alfa-2b, recombinant human	FMR. If concomitant use increases the risk of kidney damage and the likelihood of hypotension and bronchospasm.
Irinotecan	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Ifosfamid	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Kanamycin	FMR: synergism. Strengthens (mutually) The risk of developing nephrotoxicity.
Carboplatin	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Karmustin	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Kortizon	FMR. It increases the likelihood of hypokalemia and arrhythmia.
Levamisole	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Lomustin	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Megestrol	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Melfalane	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Merkaptopurin	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Methylprednisolone	FMR. It increases the likelihood of hypokalemia and arrhythmia.
Methotrexate	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Mikonazol	FMR: antagonizm. Weakens effect: It inhibits the synthesis of sterols and membranes of the cytoplasmic membrane of fungi, depriving, thereby, amphotericin B binding sites.
Mytoksantron	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Mitomycin	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Paclitaxel	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Prednisolone	FMR: synergism. It increases the likelihood of hypokalemia and arrhythmia.
Procarbazine	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Rokuroniya bromide	FMR: synergism. Against the background of amphotericin B and the resulting effect is enhanced by hypokalemia.
Streptomycin	FMR. Strengthens (mutually) The risk of developing nephrotoxicity.
Tamoxifen	FMR: synergism. Combined use increases the risk of kidney damage and the likelihood of hypotension and bronchospasm.
Tobramycin	FMR: synergism. Strengthens (mutually) The risk of developing nephrotoxicity.
Topotecan	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Toremifene	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Triamcinolone	FMR: synergism. It increases the likelihood of hypokalemia and arrhythmia.
Fludrokortizon	FMR. It increases the likelihood of hypokalemia and associated side effects (Arrhythmia).
Fluconazole	FMR: antagonizm. Weakens effect: It inhibits the synthesis of sterols and membranes of the cytoplasmic membrane of fungi, depriving, thereby, amphotericin B binding sites.
Flutamid	FMR: synergism. If concomitant use increases the risk of kidney damage and the likelihood of hypotension and bronchospasm.
Khlorambutsil	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Cyclosporine	FMR. If concomitant use increases the risk of kidney damage.
Cyclophosphamide	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Cisplatin	FMR. When combined with the use of amphotericin B increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Exemestane	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Epirubicin	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Estramustine	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.
Etoposide	FMR. If concomitant use increases the risk of kidney damage and increases the likelihood of developing bronchospasm and hypotension.