Neonatal Drug Therapy Manual

Amphotericin B Liposome

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Updated March 5, 2024 - 2:32pm

Alternate Name(s): 
AmBisome
Classification: 
Antifungal
Original Date: 
April 2012
Revised Date: 
Indications: 
  • Treatment of severe fungal infections and/or deep mycoses in patients:
    • who fail to respond to conventional amphotericin B
    • who develop nephrotoxicity after conventional amphotericin B
    • in whom conventional amphotericin B is contraindicated because of renal impairment
Administration: 
  • IV intermittent infusion: over 2 hours
Dosage: 
  • 3 - 5 mg/kg/day once daily
Side Effects: 
  • CNS: fever
  • CVS: hypotension, arrhythmias, vasodilatation, hypertension, tachycardia, edema, bradycardia
  • Endocrine and metabolic: hypokalemia, hypomagnesemia, hyperglycemia, hypocalcemia, hyperphosphatemia, hyponatremia
  • Hematologic: anemia, thrombocytopenia, leukopenia
  • Hepatic: ALT increased, AST increased, alkaline phosphatase increased, bilirubinemia
  • Local: phlebitis, injection site inflammation
  • Renal: renal tubular acidosis, serum creatinine increased, BUN increased, oliguria, hematuria
  • Miscellaneous: anaphylactoid and other allergic reactions
Parameters to Monitor: 
  • serum creatinine, BUN, urine output
  • serum electrolytes (particularly magnesium and potassium)
  • liver function tests
  • CBC
Reconstitution and Stability: 
  • Amphotericin B Liposome 50 mg
    • Add 12 mL SWFI.  Shake vigorously for 30 seconds.
    • Take 10 mL (40 mg) and using a 5 microns filter on the syringe add to 10 mL of D5W
    • Final concentration: 2 mg/mL
Compatibility: 

- Solutions Compatible: Dextrose solutions up to D25W

- Incompatible:  Saline solutions.  Do not mix with other drugs

Notes: 
References: 

- Taketomo CK, Hodding JH, Kraus DM.  Pediatric Dosage Handbook 17th Edition.  Hudson: Lexi-Comp Inc; 2010

- Lau E. (Editor). Drug Handbook and Formulary- The Hospital for Sick Children.  Toronto: 2011- 2012

- Juster-Reicher A, Flidel-Rimon O, Amitay M, Even-Tov S, Shinwell E, Leibovitz E.  High-dose liposomal amphotericin B in the therapy of systemic candidiasis in neonates.  Eur J Clin Microb Dis 2003 Oct; 22(10): 603-7

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