Adult:
Using conventional amphotericin B. 1 ml of a 100 mg/ml oral suspension 4 times daily retained in the mouth for a few minutes before swallowing or 10 mg lozenge dissolved in the mouth 4 times daily, increased to 8 lozenges daily if necessary or 100-200 mg tab/suspension 4 times daily. Continue for 48 hr after lesions have cleared.
Irrigation
CANDIDURIA
Adult:
Using conventional amphotericin B. 50 mg daily in 1000 ml of sterile water by continuous bladder irrigation.
Intrathecal
SEVERE MENINGITIS
Adult:
Using conventional amphotericin B. Initially, 25 mcg increased gradually to 0.25-1 mg 2-4 times a wk.
Intravenous
SEVERE SYSTEMIC FUNGAL INFECTIONS
Adult:
Using conventional amphotericin B. Test dose of 1 mg infused over 20-30 min, followed by an initial dose of 250 mcg/kg daily, increased gradually to a max of 1 mg/kg/day. For seriously ill patients, up to 1.5 mg/kg may be given daily or on alternate days. Daily dose is infused over 2-4 hr at a concentration of 100 mcg/ml in glucose 5%.
Precautions
Renal and hepatic impairment; pregnancy; monitor renal and liver function changes.
Potentially Life-threatening
Adverse Drug Reactions
Topical: Local irritation, pruritus and skin rash. IV infusion: Fever, chills, convulsions, malaise; nausea, vomiting, diarrhoea, anorexia; tinnitus, vertigo, hearing loss; hypotension, hypertension, cardiac arrhythmias; peripheral neuropathy; phloebitis, pain at Inj site, disturbances in renal function and renal toxicity.
Adverse Drug Reactions
Anaphylactic reaction; leucoencephalopathy. Overdosage can result in cardio-respiratory arrest.
Interactions
Increased toxicity with flucytosine. Drug induced renal toxicity enhanced in presence of other nephrotoxic medications. Antagonises effects of azole antifungals.
