Exotis ISSN 2398-2985

Reptiles

Amphotericin B

Contributor(s): Vetstream Ltd, David Perpinan

Introduction

Name

  • Amphotericin B.

Class of drug

  • Polyene antifungal antibiotic.

Description

Chemical name

  • (1R,3S,5R,6R,9R,11R,15S,16R,17R,18S,19E,21E,23E,25E,27E,29E,31E,33R,35S,36R,37S)- 33-[(3-amino- 3,6-dideoxy- β-D-mannopyranosyl)oxy]- 1,3,5,6,9,11,17,37-octahydroxy- 15,16,18-trimethyl- 13-oxo- 14,39-dioxabicyclo [33.3.1] nonatriaconta- 19,21,23,25,27,29,31-heptaene- 36-carboxylic acid.

Molecular formula

  • C47H73NO17.

Molecular weight

  • 942.

Physical properties

  • Yellow powder/tablets or solution.
  • Injectable: 50 mg/vial powder for reconstitution.
  • It occurs as a yellow to orange, odorless or practically odorless powder.
  • It is insoluble in water and anhydrous alcohol.

Storage requirements

  • Vials of powder for injection should be stored in the refrigerator, protected from light and moisture.
  • Reconstitution should be done with sterile water.
  • After reconstitution the preparation is stable for 1 week if refrigerated and stored in the dark.
  • Keep in the dark, however, the loss of drug activity is negligible for at least 8 h in room light.

Uses

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Indications

  • Advanced and/or severe systemic mycoses.
  • Fungal septicemia.
  • Candida is particularly susceptible to this medication.

Administration

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Pharmacokinetics

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Precautions

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Interactions

with other drugs

  • Amphotericin B may increase the toxic effects of cisplatin, fluorouracil, docorubicin and methotrexate.
  • Flucytocine (flucytosine) is synergistic with amphotericin B in vitro against Candida, Cryptococcus and Aspergillus.

Adverse Reactions

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Nogueira Brilhante R S, de Aragao Rodrigues P H, de Alencar L P et al (2015) Evidence of fluconazole-resistant Candida species in tortoises and sea turtles. Mycopathologia 180 (5-6), 421-426 PubMed.
  • Van Waeyenberghe L, Baert K, Pasmans F et al (2010) Vorizonazole, a safe alternative for treating infections caused by the Chrysosporium anamorph of Nannizziopsis vriesii in bearded dragons (Pogona vitticeps). Med Mycol 48 (6), 880-885 PubMed.
  • Hernandez-Divers S J (2001) Pulmonary candidiasis caused by Candida albicans in a Greek tortoise (Testudo graeca) and treatment with intrapulmonary amphotericin B. J Zoo Wildlife Med 32 (3), 352-359 PubMed.

Other sources of information

  • Meredith A (2015) Ed BSAVA Small Animal Formulary. Part B: Exotic Pets. 9th edn. BSAVA, UK. pp 20-21.
  • Plumb D C (2015) Plumb's Veterinary Drug Handbook. 8th edn. Blackwell Publishing, USA. pp 1296.
  • Carpenter J W & Marion C J (2013) Exotic Animal Formulary. 4th edn. Elsevier Saunders, USA. pp 564.
  • Mader D R (2006) Ed Reptile Medicine and Surgery. Saunders Elsevier, USA. pp 1242.
  • Girling S J & Raiti P (2004) BSAVA Manual of Reptiles. BSAVA, UK. pp 383.

Organisation(s)

  • National Office of Animal Health (NOAH) Compendium of Data Sheets for Animal Medicines. Website: www.noahcompendium.co.uk.

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