Amphotericin B (colloidal dispersion)

Half-Life (Normalesrd) Hours
24-30/Unchanged
Plasma Protein Binding %
90
Volume Of Distribution L/Kg
4.0
Dose For Normal Renal Function
3-4 mg/kg q24h
Adjustment For Renal Failure Method
I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
q24h[A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
q24h[A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
q24h[A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None
Supplement For Dialysis [Recommendation Level]: Pd
PD: None
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [A]
References
Amantea MA, Bowden RA, Forrest A, Working PK, Newman MS, Mamelok RD. Population pharmacokinetics and renal function-sparing effects of amphotericin B colloidal dispersion in patients receiving bone marrow transplants. Antimicrob Agents Chemother. 1995; 39: 2042-7. [PMID: 8540713] / 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] / Bellmann R, Egger P, Gritsch W, Bellmann-Weiler R, Joannidis M, Kaneider N, et al. Amphotericin B lipid formulations in critically ill patients on continuous veno-venous haemofiltration. J Antimicrob Chemother. 2003; 51: 671-81. [PMID: 12615870] / Heinemann V, Bosse D, Jehn U, K&#246; hny B, Wachholz K, Debus A, et al. Pharmaco-kinetics of liposomal amphotericin B (Ambisome) in critically ill patients. Antimicrob Agents Chemother. 1997; 41: 1275-80. [PMID: 9174183] / Sanders SW, Buchi KN, Goddard MS, Lang JK, Tolman KG. Single-dose pharmacokinetics and tolerance of a cholesteryl sulfate complex of amphotericin B administered to healthy volunteers. Antimicrob Agents Chemother. 1991; 35: 1029-34. [PMID: 1929241]
Toxicity Notes
Thought to have less nephrotoxicity than standard amphotericin B; T1/2, plasma protein binding, and Vd appear to be the same as for standard amphotericin B. No data on pharmocokinetics in renal failure. Infusion-related reactions may occur. For patients on dialysis, it may be more cost-effective to use standard formulation of amphotericin B (q.v.).