MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

Critical Care

Generic Name: Amphotericin B
Trade Name: Fungizone
Action: Fungistatic or Fungicidal Depending on Organism and concentration of drug
Indications: Treatment of Fungal Infections
Administration Guidelines:
Usual Dosage Range and Route: TEST DOSE: 1 mg in 50 ml OF Dextrose 5% in water over 20 minutes. Observe for 4 hours for possible adverse reactions

INITIAL DOSE: 0.25 - 1mg/kg to max of 1.5mg/kg/day IV daily over at least 4 TO 6 hours.

TOTAL DOSE: 1000 mg to 2500 mg over several weeks or months depending on type and severity of infection

Standard Concentration 50 mg / 500 ml D5W

Bladder irrigation 5mg/1000cc SWFI

Special Considerations: -Test dose not required for bladder irrigation

- Patients may be pre-medicated with acetaminophen, hydrocortisone, and/or meperidine to ameliorate fever, chills, rigors

- A second dose of acetaminophen and diphenhydramine may be administered halfway through infusion

- Amphotericin is not compatible in 0.9% sodium chloride and with other electrolytes and drugs

- Do not filter

Side Effects: - Arrhythmias and anaphylactic like reaction can occur

- Fever, chills, nausea, vomiting, diarrhea, headache, malaise

- Renal tubular acidosis, hypokalemia

- Hepatotoxicity, blood dyscrasia

 

 

revised 09/03