{"id":1626,"date":"2023-06-25T17:28:42","date_gmt":"2023-06-25T17:28:42","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/ambisomex\/"},"modified":"2023-06-25T19:59:18","modified_gmt":"2023-06-25T19:59:18","slug":"ambisomex","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/ambisomex\/","title":{"rendered":"Ambisomex"},"content":{"rendered":"

<\/p>\n

Ambisome<\/h1>\n

CLINICAL USE<\/h3>\n

Antifungal agent:
\nSystemic fungal infections (yeasts and<\/p>\n

yeast-like fungi including Candida
\nalbicans)
\nTreatment of visceral leishmaniasis<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

1\u20133 mg\/kg\/day, maximum 5 mg\/kg
\n(unlicensed dose)
\nVisceral leishmaniasis: total dose of
\n21\u201330 mg\/kg given over 10\u201321 days<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           :
    \n924.1<\/li>\n
  • %Protein binding                           :
    \n90<\/li>\n
  • %Excreted unchanged in urine     :
    \n2\u20135<\/li>\n
  • Volume of distribution (L\/kg)       :
    \n0.1\u20130.44<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :
    \n6.3\u201310.7\/Unchanged<\/p>\n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function<\/li>\n
  • <10           :
    \nDose as in normal renal function<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :
    \nNot dialysed. Dose as in normal renal function<\/li>\n
  • HD                     :
    \nNot dialysed. Dose as in normal renal function<\/li>\n
  • HDF\/high flux   :
    \nUnknown dialysability. Dose as in
    \nnormal renal function<\/li>\n
  • CAV\/VVHD      :
    \nNot dialysed. Dose as in normal renal function<\/p>\n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs
    \nCiclosporin: increased nephrotoxicity<\/p>\n

    Tacrolimus: increased nephrotoxicity<\/p>\n

    Increased risk of nephrotoxicity with<\/p>\n

    aminoglycosides and other nephrotoxic
    \nagents and cytotoxics
    \nCardiac glycosides: increased toxicity if<\/p>\n

    hypokalaemia occurs
    \nCorticosteroids: increased risk of<\/p>\n

    hypokalaemia (avoid concomitant use
    \nunless corticosteroids are required to
    \ncontrol reactions)
    \nFlucytosine: enhanced toxicity in<\/p>\n

    combination with amphotericin<\/p>\n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    See SPC. Prepare intermittent infusion<\/p>\n

    in glucose 5% (incompatible with sodium
    \nchloride 0.9%, electrolytes or other drugs).
    \nReconstitute vial contents with water for
    \ninjection
    \nDilute to a concentration of 0.2\u20132 mg\/mL<\/p>\n

    Route<\/h4>\n

    IV infusion<\/h4>\n

    Rate of Administration<\/h4>\n

    30\u201360 minutes<\/p>\n

    Comments<\/h4>\n

    Paracetamol and parenteral pethidine<\/p>\n

    may alleviate rigors associated
    \nwith amphotericin administration.
    \nAntihistamines can also be administered
    \nto control reactions
    \nFlush existing IV line with glucose 5%<\/p>\n

    before and after infusion administration
    \nFor patients on CAV\/VVHD, amphotericin<\/p>\n

    should be given into the venous return of
    \nthe dialysis circuit
    \nShould be given post dialysis<\/p>\n

    OTHER INFORMATION<\/h4>\n

    *** AMPHOTERICIN IS HIGHLY
    \nNEPHROTOXIC ***
    \nCan cause distal tubular acidosis<\/p>\n

    May cause polyurea, hypovolaemia,<\/p>\n

    hypokalaemia and acidosis.
    \nAmphotericin and flucytosine act<\/p>\n

    synergistically when co-administered
    \nenabling lower doses to be used effectively
    \nA test dose of amphotericin is<\/p>\n

    recommended at the beginning of a new
    \ncourse (1 mg over 10 minutes then stop
    \nand observe for next 30 minutes)
    \nMonitor renal function, full blood count,<\/p>\n

    potassium, magnesium and calcium levels
    \nLiposomal amphotericin is considerably<\/p>\n

    less nephrotoxic compared with
    \namphotericin, but is considerably more
    \nexpensive<\/li>\n","protected":false},"excerpt":{"rendered":"

    Ambisome CLINICAL USE Antifungal agent: Systemic fungal infections (yeasts and<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1626","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1626","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1626"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1626\/revisions"}],"predecessor-version":[{"id":2943,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1626\/revisions\/2943"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1626"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1626"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1626"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}