amphotericin B liposomal

Action and Spectrum

Actions and Spectrum: 

amphotericin B liposomal works by attaching to ergosterol, a component of fungal cell membranes, and disrupting its integrity. This causes the fungal cells to die. 

amphotericin B liposomal is effective against a variety of fungal species, including Aspergillus, Blastomyces, Coccidioides, Candida, Cryptococcus, Histoplasma, and many more, according to its spectrum of activity. 

Drug Interaction

Adverse Reaction

Frequency defined  

1-10% 

Alopecia 

Arthralgia 

Abnormal thinking 

Acidosis 

Mucositis 

Petechia 

Seizure 

Stomatitis 

Asthma 

Gastrointestinal haemorrhage 

Hallucinations 

Hyperventilation 

Fluid overload 

Coagulation disorder 

Depression 

Dizziness 

Electrolyte abnormalities 

Rash 

Renal function abnormalities 

Respiratory acidosis 

Agitation 

Bruising 

Injection site reaction 

Malaise 

Cellulitis 

Cardiovascular abnormalities 

Respiratory failure 

>10% 

Anemia (27-48%) 

Nephrotoxicity (14-47%) 

Hypokalemia (31-51%) 

Nausea (16-40%) 

Cough (2-18%) 

Rhinitis (11%) 

Phlebitis (9-11%) 

Bilirubinemia (<18%) 

Leukopenia (15-17%) 

ALT increased (15%) 

Vomiting (11-32%) 

Dyspnea (18-23%) 

Hyperglycemia (8-23%) 

Insomnia (17-22%) 

Hypertension (8-20%) 

Abdominal pain (7-20%) 

Edema (10-12%) 

Hyponatremia (9-12%) 

Chest pain (8-12%) 

Hypocalcemia (5-18%) 

Sepsis (7-14%) 

AST increased (13%) 

Constipation (15%) 

Peripheral edema (15%) 

Alkaline phosphatase increase (7-22%) 

Hypomagnesemia (15-50%) 

Chills (29-48%) 

Infusion reaction (4-21%) 

Headache (9-20%) 

Lung disorder (14-18%) 

Pain (14%) 

Hypervolemia (8-12%) 

Pruritus (11%) 

Tachycardia (9-19%) 

Anorexia (10-14%) 

Anxiety (7-14%) 

Hypotension (7-14%) 

Blood transfusion reaction (9-18%) 

Diarrhea (11-30%) 

Rash (5-25%) 

Pleural effusion (13%) 

Confusion (9-13%) 

Thrombocytopenia (6-13%) 

Weakness (6-13%) 

Back pain (12%) 

Black Box Warning

Black Box Warning 

The following is part of the amphotericin B liposomal black box warning: 

amphotericin B liposomal may result in severe infusion-related side effects, including fever, chills, rigours, hypotension, and dyspnoea. Healthcare professionals should closely monitor patients both during and for at least an hour after the infusion because these reactions can occasionally be fatal. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• amphotericin B liposomal is contraindicated in those who have a history of being allergic to any of its ingredients. 

Caution: 

• amphotericin B liposomal is nephrotoxic, those who already have renal impairment should take it with care. If there is indication that renal function is deteriorating, the drug should be stopped. 
• amphotericin B liposomal has the potential to produce electrolyte abnormalities, particularly hypokalaemia and hypomagnesemia. During therapy, electrolyte levels should be carefully monitored. 
• amphotericin B liposomal should be used cautiously in people who already have liver illness since it might induce hepatotoxicity. 
• amphotericin B liposomal should only be used in pregnant or nursing women if the risks are outweighed by the potential benefits. 
• It is best to avoid using amphotericin B liposomal concurrently with other nephrotoxic medications such aminoglycosides or cyclosporine. 
• The immune system can be suppressed, and infection risk increased by amphotericin B liposomal.

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excreted into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology 

amphotericin B liposomal is a polyene macrolide antifungal that functions by attaching to and rupturing the integrity of ergosterol, a component of fungal cell membranes. As a result, the fungal cell eventually dies, and intracellular contents flow out. 

A wide range of fungus species, including candida, histoplasma, blastomyces, aspergillus, cryptococcus, and many more, are susceptible to the broad-spectrum action of amphotericin B liposomal. 

Pharmacodynamics 

amphotericin B liposomal’s pharmacodynamics are associated with its mode of action as a polyene macrolide antifungal drug. Ergosterol, a substance found in fungal cell membranes, binds to amphotericin B liposomal, which causes holes to develop and compromise the membrane’s integrity. 

Pharmacokinetics 

Absorption   

amphotericin B liposomal is not absorbed orally and is taken intravenously. The medicine is covered from deterioration and assisted in reaching the intended infection location by the liposomes. 

Distribution 

amphotericin B liposomal is dispersed throughout the body after infusion, including to the infection site. The medication’s limited ability to treat fungal infections of the central nervous system is due to its difficulty in crossing the blood-brain barrier. 

Metabolism 

amphotericin B liposomal is excreted unchanged because it is not metabolized by the body. As a result, it doesn’t significantly interact with hepatic enzymes through drugs. 

Elimination and excretion 

amphotericin B liposomal is mostly removed by the kidneys, hence individuals with renal impairment require dosage changes. The medication has a lengthy half-life of elimination, allowing for less frequent administration. 

Adminstartion

Administration 

Before using, amphotericin B liposomal should be visually scrutinised for any indications of particle matter or discoloration. It is a sterile, liposomal suspension. If the drug seems hazy or discoloured, it should not be taken. 

The drug is provided in vials, and the proper diluent should be used to reconstitute it in accordance with the manufacturer’s instructions. In order to get the desired concentration, the regenerated solution should be further reduced in an infusion bag or container. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: amphotericin B liposomal 

Why do we use amphotericin B liposomal? 

amphotericin B liposomal is a medication that is often used to treat infections caused by Candida auris. Candida auris is a multidrug-resistant fungal pathogen that has emerged as a serious public health threat in recent years. This fungus is often resistant to commonly used antifungal medications, such as fluconazole and echinocandins, making it difficult to treat.

amphotericin B liposomal is an antifungal medication that is particularly effective against Candida auris because it is less susceptible to resistance than other antifungal agents. It works by binding to the fungal cell membrane and disrupting its integrity, ultimately leading to cell death.

Additionally, amphotericin B liposomal has the advantage of being delivered in a liposomal formulation, which can help to reduce its toxicity and side effects. This liposomal formulation allows the medication to be targeted specifically to the site of infection while minimizing its impact on healthy cells.