Amphotericin B is nefrotoksichyym drug that causes a lot of great and small unwanted reactions. Therefore, its parenteral application is limited only to potentially fatal fungal infection. Before using amphotericin B physician must see the annotation attached producer of special precautions, adverse reactions and information on how the introduction.
Amphotericin B initially applied intravenously in a single test dose of 0.1 mg / kg (maximum 1 mg) for 3-4 hours to detect feverish and hemodynamic response in a patient. During the introduction of carefully recorded temperature, pulse, respiration and blood pressure. The first therapeutic dose – 0.25 mg / kg / day given on the same day as a test. Patients with severe reactions to a test dose of the drug should be appointed to a lesser dose. In a subsequent dose increases by 0,1-0,25 mg / kg for 4 days to reach the common dose 0,5-1 mg / kg. If the situation threatens the lives, increasing doses of 0.25 mg / kg in consecutive 3-4-hour introductions to within 12-24 hours was achieved maximum total daily dose of 1 mg / kg. Low-dose amphotericin B (for example, 0,1-0,3 mg / kg / day) are used to good effect when kandidoznyh ezofagitah.
In patients with impaired kidney function of the concentration of drug in serum increased slightly. In hemodialysis and peritoneal dialysis is not udayutsya significant quantities of the drug.
In some cases, may be needed dose 1,25-1,5 mg / kg. For premature infants exact dose is not installed, but the above were applied with success.
Amphotericin B should be applied in 5% dextrose solution nomvodnom. The drug is not if the solution becomes cloudy when you add amphotericin B.
Adequate serum concentrations of the drug after one week of daily introduction usually supported the use of doses in a day or sometimes twice a week.