Amphotericin B (Injection, Intravenous)

The Amphotericin B injection is administered to patients suffering from serious and possibly fatal fungal infections.

Overview

As an antifungal, the Amphotericin B injection slows the rate of growth of fungi, which are responsible for infecting the patient. The medicine is fast acting because it's injected directly into the vein. The speed of delivery is vital because it's typically given to patients with life-threatening infections.

Conditions Treated

  • Fungal infections

Type of Medicine

  • Antifungal

Side Effects

There are a number of common side effects associated with Amphotericin B. If the patient experiences any of the following symptoms in a severe or frequent degree, he or she should contact their physician promptly. While not every patient will experience every side effect, there is the chance of reacting strongly to Amphotericin B and that should be reported immediately.

One of the most commonly reported side effects of the Amphotericin B treatment has been stomach pain and cramping, which may be accompanied by heartburn or diarrhea. Unexplained weight loss is another side effect patients should note and report to their healthcare provider.

There's also the possibility of experiencing pain throughout the body, particularly in the muscles, bones, and in the joints. A lack of energy may accompany these symptoms, or may manifest on its own. The patient may also observe redness or swelling at the site of the Amphotericin B injection.

Additionally, the patient may be presented with the following:

  • pale skin
  • shortness of breath
  • headaches
  • lightheadedness

They may also feel unusually cold about the hands and feet.

Less common but still possible side effects of taking the antifungal treatment include flushing of the skin or an unexplained outbreak, such as hives or a rash. Patients have also reported manifesting blisters in relation to skin reactions to the Amphotericin B injection. Itching may accompany any of these conditions.

More serious, but still less frequently reported side effects include:

  • difficulty in breathing
  • yellowing of the eyes
  • yellowing of skin pigmentation
  • decreased ability to urinate

While these are the most commonly reported side effects of the Amphotericin B treatment, that doesn't mean the patient can't experience other side effects. Any abnormal condition should be reported to the patient's doctor, particularly when it's a severe or frequent manifestation.

For patients who do experience severe or frequent side effects, a consultation with their doctor may help. He may be able to prescribe additional medications that will either reduce or eliminate the side effects altogether. Such medications may include acetaminophen, diphenhydramine, or a corticosteroid, such as hydrocortisone. As it is important to continue Amphotericin B for the prescribed treatment regiment, the patient's doctor will likely do what he can to ease the patient's discomfort or pain. The important thing is to resolve the infection as quickly as possible.

Dosage

When Amphotericin B is manufactured, it comes in a solid powder cake form that must be broken down, developed into a liquid solution, and injected intravenously. The solution, which is administered by a doctor or nurse, is delivered slowly over a period of 2 to 6 hours once per day.

Typically, the patient first receives a sample dose over a 20 to 30 minute period to see how his or her body tolerates the medication. Once the doctor can evaluate the patient's response, full treatment can begin. The duration of the treatment depends on how well the patient responds to the medication, how severe the infection is, and the individual's general health.

It is likely that patients will experience a reaction shortly upon receiving their first treatment. The reaction typically occurs within one to three hours after starting the Amphotericin B infusion and is more severe with the first few doses. Common reactive symptoms include the onset of a fever, and the sudden chills. Other symptoms include a loss of appetite, nausea, vomiting, dizziness, difficulty breathing, and severe or frequent headaches.

In some instances, patients may be able to administer their own doses at home. Another possibility is to have a home healthcare aide assist with the treatments. In either scenario, the doctor will instruct the patient on proper storage techniques and the correct method for administering the dosages. The doctor will also ensure the patient is fully stocked with all of the necessitated equipment. An inadequate storage device or a mistake in administering the infusion can result in an ineffective treatment and make the entire drug therapy fail. That's not something either the patient or the doctor wants, as that would further jeopardize the patient's life.

Interactions

The reason the doctor asks each of his patients about their medical and medication histories is because many factors can affect how the body handles certain drugs. An adverse reaction between Amphotericin B and another substance, for example, may mean the difference between curing the patient or worsening his condition.

In speaking specifically of Amphotericin B, there are a number of medications with which it interacts negatively. The antifungal treatment reacts badly with anti-cancer drugs, such as mechlorethamine and nitrogen mustard, for instance.
Amphotericin B also creates adverse symptoms, when combined with:

  • ketoconazole
  • itraconazole
  • cidofovir
  • digoxin
  • flucytosine

Patients taking kidney medications, similar to and including pentamidine and tacrolimus, should talk to their doctors, prior to starting treatment. Aminoglycosides, such as gentamicin, and the muscle relaxants tubocurarine and zidovudine can also affect the way Amphotericin B works on the body.

Patients taking any of the aforementioned medications in particular should speak with their doctor ahead of starting the drug therapy. While other drugs, both prescription and over the counter, may interact harshly with Amphotericin B, the drugs mentioned here are known to cause harmful reactions.

Warnings

The primary warning in administering or taking Amphotericin B is that it's intended to treat serious, life a threatening fungal infections. Therefore, it shouldn't be used as a less urgent treatment for fungal infections of the mouth, throat, or vagina. Also, Amphotericin B should never be administered in cases where the patient has a normal, healthy immune system, as the body's natural defenses should be given the chance to fight of the infection.

Additionally, patients should be forthright in telling their doctors about other medications and drugs they are taking. Over the counter medicines, vitamins, herbal remedies, and even alcohol can have a powerful impact on how the body handles Amphotericin B. Any reaction can cause the medicine to be ineffective or, even worse, create a more perilous situation for the patient.

If the patient is receiving leukocyte (white blood cell) transfusions or has ever been diagnosed with kidney disease, he or she should tell their doctor. As a result, they may have to discuss other treatment options for their fungal infection.

Women should tell their doctor if they're planning to get pregnant or have already conceived a child. A pregnancy may be affected by Amphotericin B, so women should also notify their doctor if they become pregnant during the course of the drug therapy. Breastfeeding should also be avoided, until treatment has case included and the patient has discussed the risks with her doctor.

Individuals should notify their surgeon or dentist, if they require surgery while on the Amphotericin B drug therapy. The surgeon or dentist may be able to delay the procedure or implement extra safeguards to protect the patient's health and safety.

Although allergic reactions to Amphotericin B are rare, they do happen. If the patient does begin exhibiting symptoms of a serious allergic reaction, their physician should be contacted immediately. Signs that an individual is allergic to Amphotericin B include the manifestation of a rash, accompanied by itching and/or swelling. Watch for swelling of the face, tongue, and throat in particular. An allergic reaction in the patient may also produce severe dizziness or trouble breathing.

In the event of an overdose, the patient or a loved one should call 9-1-1 immediately. If emergency personnel cannot be contacted for some reason, the Poison Control Center should be contacted. They may be able to help get the reaction under control, until rescue personnel can be dispatched.

Storage

When Amphotericin B is shipped, it's stored in dry ice for the transport. Once received at its destination, the antifungal medicine should be stored at a consistent temperature of -5°C to -20°C, until it's ready to be used. The medication can be maintained in this manner for up to 12 months, before it must be discarded.

A fungal infection can become a serious and sometimes deadly matter, if treatment isn't pursued in a timely manner. When the body's natural defenses fail, it may be necessary to seek additional help. Amphotericin B can provide that help, fighting off the infection and saving the patient's life. While it's important to ensure the doctor has all of the necessary medical background and drug history, Amphotericin B can be the answer to the patient's deadly fungal infection and failing immune response.

Resources
Last Reviewed:
December 25, 2017
Last Updated:
April 04, 2018