Amphotericin B (lipid complex)

Excreted Unchanged %
Half-Life (Normalesrd) Hours
Plasma Protein Binding %
Volume Of Distribution L/Kg
Dose For Normal Renal Function
5 mg/kg q24h
Adjustment For Renal Failure Method
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
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: None
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [A]
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] / Humphreys H, Oliver DA, Winter R, Warnock DW. Liposomal amphotericin B and continuous venous-venous haemofiltration [Letter]. J Antimicrob Chemother. 1994; 33: 1070-1. [PMID: 8089061] / Kan VL, Bennett JE, Amantea MA, Smolskis MC, McManus E, Grasela DM, et al. Comparative safety, tolerance, and pharmacokinetics of amphotericin B lipid complex and amphotericin B desoxycholate in healthy male volunteers. J Infect Dis. 1991; 164: 418-21. [PMID: 1856491] / Tomlin M, Priestley GS. Elimination of liposomal amphotericin by hemodiafiltration [Letter]. Intensive Care Med. 1995; 21: 699-700. [PMID: 8522680]
Toxicity Notes
There are 630 mg NaCl in a 350 mg dose (9 mg NaCl/mL). Thought to be less nephrotoxicity than standard amphotericin B formulation; may have larger Vd and longer T1/2 than standard amphotericin B preparation. No data on pharmacokinetics 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.).