What dose is used for liposomal amphotericin B?

L-AmB (AmBisome): Candida/Aspergillus invasive: 3-5 mg/kg/day IV; cryptococcal meningitis (HIV): 3 mg/kg/day for 2 weeks induction; empirical/prophylaxis in febrile neutropenia: 3 mg/kg/day; ABLC (Abelcet): 5 mg/kg/day for refractory or resistant fungal infections.

What nephrotoxicity monitoring is required for amphotericin?

Baseline creatinine, electrolytes (K, Mg), CBC; daily creatinine and electrolytes during therapy; creatinine doubling warrants dose reduction or lipid formulation substitution; hypokalemia and hypomagnesemia are universal with conventional amphotericin (supplement aggressively).

What pre-medication reduces infusion-related reactions?

Pre-medicate with paracetamol/NSAIDs, diphenhydramine, and hydrocortisone 25-50 mg IV; hydration with 500-1000 mL NS before infusion reduces nephrotoxicity; infuse over 2 hours for L-AmB; test dose (1 mg over 20 min) recommended before first dose of conventional AmB.

When is lipid formulation preferred over conventional amphotericin?

Lipid formulations preferred for: impaired renal function (creatinine >2.5 mg/dL), nephrotoxic co-medications, prior conventional AmB nephrotoxicity, or infections requiring high-dose/prolonged therapy; lipid formulations 10x less nephrotoxic than conventional.

What is the role of amphotericin in Cryptococcal meningitis?

L-AmB 3-4 mg/kg/day or deoxycholate 0.7-1 mg/kg/day + flucytosine 100 mg/kg/day for 2 weeks induction (WHO/IDSA); flucytosine adds 30% mortality benefit; consolidation with fluconazole 400 mg/day for 8 weeks; maintenance 200 mg/day lifelong in HIV.

Amphotericin B Lipid Complex Dosing and Nephrotoxicity Monitor

Calculates liposomal amphotericin B (L-AmB) and amphotericin B lipid complex (ABLC) dosing for invasive fungal infections, pre-medication protocol, infusion-related reaction management, and nephrotoxicity threshold.

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Amphotericin B Lipid Complex Dosing and Nephrotoxicity Monitor

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Frequently Asked Questions

What dose is used for liposomal amphotericin B?

What nephrotoxicity monitoring is required for amphotericin?

What pre-medication reduces infusion-related reactions?

When is lipid formulation preferred over conventional amphotericin?

What is the role of amphotericin in Cryptococcal meningitis?