Amphotericin B

Excreted Unchanged %
Half-Life (Normalesrd) Hours
24 hr to 15 days/Unchanged
Plasma Protein Binding %
Volume Of Distribution L/Kg
Dose For Normal Renal Function
0.25-1.5 mg/kg q24h
Adjustment For Renal Failure Method
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
q24h [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [B]
Bekersky I, Fielding RM, Dressler DE, Lee JW, Buell DN, Walsh TJ. Plasma protein binding of amphotericin B and pharmacokinetics of bound versus unbound amphotericin B after administration of intravenous liposomal amphotericin B (AmBisome) and amphotericin B deoxycholate. Antimicrob Agents Chemother. 2002; 46: 834-40. [PMID: 11850269] / Block ER, Bennett JE, Livoti LG, Klein WJ Jr, MacGregor RR, Henderson L. Flucytosine and amphotericin B: hemodialysis effects on the plasma concentration and clearance. Studies in man. Ann Intern Med. 1974; 80: 613-7. [PMID: 4823813] / Morgan DJ, Ching MS, Raymond K, Bury RW, Mashford ML, Kong B, et al. Elimination of amphotericin B in impaired renal function. Clin Pharmacol Ther. 1983; 34: 248-53. [PMID: 6872420] / Muther RS, Bennett WM. Peritoneal clearance of amphotericin B and 5-fluorocytosine. West J Med. 1980; 133: 157-60. [PMID: 7015695]
Toxicity Notes
Nephrotoxic. Renal tubular acidosis; potassium wasting. Infusion-related reactions. Toxicity lessened by sodium loading. If nephrotoxicity occurs, increase dosing interval or preferably change to a lipid-amphotericin product.