مركب ينتمي لمجموعة البولين وغالباً ما يستخدم لعلاج العدوى الجهازية الفطرية عن طريق الحقن بالوريد.
مركب ينتمي لمجموعة البولين وغالباً ما يستخدم لعلاج العدوى الجهازية الفطرية عن طريق الحقن بالوريد
الجرعة هى 5 مج لكل كجم من الوزن تعطى كمرة واحدة بالوريد بمعدل 2.5 لكل كجم بالساعة
.
Preparation of Admixture for Infusion: Shake the vial gently until there is no evidence of any yellow sediment at the bottom. Withdraw the appropriate dose of ABELCET® (amphotericin b) from the required number of vials into one or more sterile syringes using an 18-gauge needle. Remove the needle from each syringe filled with ABELCET® (amphotericin b) and replace with the 5-micron filter needle supplied with each vial. Each filter needle may be used to filter the contents of up to four 100 mg vials. Insert the filter needle of the syringe into an IV bag containing 5% Dextrose Injection USP, and empty the contents of the syringe into the bag. The final infusion concentration should be 1 mg/mL. For pediatric patients and patients with cardiovascular disease the drug may be diluted with 5% Dextrose Injection to a final infusion concentration of 2 mg/mL. Before infusion, shake the bag until the contents are thoroughly mixed. Do not use the admixture after dilution with 5% Dextrose Injection if there is any evidence of foreign matter. Vials are for single use. Unused material should be discarded. Aseptic technique must be strictly observed throughout handling of ABELCET® (amphotericin b) , since no bacteriostatic agent or preservative is present.
DO NOT DILUTE WITH SALINE SOLUTIONS OR MIX WITH OTHER DRUGS OR ELECTROLYTES as the compatibility of ABELCET® (amphotericin b) with these materials has not been established. An existing intravenous line should be flushed with 5% Dextrose Injection before infusion of ABELCET® (amphotericin b) , or a separate infusion line should be used. DO NOT USE AN IN-LINE FILTER.
The diluted ready-for-use admixture is stable for up to 48 hours at 2° to 8°C (36° to 46°F) and an additional 6 hours at room temperature.
Dose
Systemic fungal infection
. By intravenous infusion
Neonate initial test dose of 100 micrograms/kg
included as part of first dose of 1 mg/kg, then 1 mg/
kg once daily (after 7 days, may be reduced to 1 mg/kg
on alternate days)
Child 1 month–18 years initial test dose of 100 micrograms/kg (max. 1 mg) included as part of first dose of
250 micrograms/kg daily; increased over 2–4 days, if
tolerated, to 1 mg/kg daily; in severe infection max.
1.5 mg/kg daily or on alternate days
Note prolonged treatment usually necessary; if interrupted for longer than 7 days, recommence at
250 micrograms/kg daily and increase gradually
Abelcet Cephalon
Lipid formulations
Abelcet (Cephalon) A
Intravenous infusion, amphotericin 5 mg/mL as
lipid complex with L-a-dimyristoylphosphatidylcholine and L-a-dimyristoylphosphatidylglycerol,
net price 20-mL vial = £82.13 (hosp. only)
Dose
Severe invasive candidiasis; severe systemic fungal
infections in children not responding to conventional
amphotericin or to other antifungal drugs or where
toxicity or renal impairment precludes conventional
amphotericin, including invasive aspergillosis,
cryptococcal meningitis and disseminated cryptococcosis in children with HIV
. By intravenous infusion
Child 1 month–18 years initial test dose of 100 mic
AmBisome امبيسوم (Gilead)
Intravenous infusion, powder for reconstitution,
amphotericin 50 mg encapsulated in liposomes, net
price 50-mg vial = £96.69
Electrolytes Na+< 0.5 mmol/vial
Excipients include sucrose 900 mg/vial
Dose
Severe systemic or deep mycoses where toxicity
(particularly nephrotoxicity) precludes use of conventional amphotericin
. By intravenous infusion
Neonate initial test dose 100 micrograms/kg then
1 mg/kg once daily, increased if necessary to 3 mg/
kg once daily; max. 5 mg/kg once daily
Child 1 month–18 years initial test dose 100 micrograms/kg (max. 1 mg) then 1 mg/kg once daily,
increased if necessary in steps of 1 mg/kg daily to
3 mg/kg once daily; max. 5 mg/kg once daily
Suspected or proven infection in febrile neutropenic
patients unresponsive to broad-spectrum antibacterials
. By intravenous infusion
Child 1 month–18 years initial test dose 100 micrograms/kg (max. 1 mg) then 3 mg/kg once daily until
afebrile for 3 consecutive days; max. period of treatment 42 days; max. 5 mg/kg once daily
Visceral leishmaniasis see section 5.4.5 and product
literature
Amphocil امفوسيل (Beacon)
Intravenous infusion, powder for reconstitution,
amphotericin as a complex with sodium cholesteryl sulphate, net price 50-mg vial = £104.10, 100-
mg vial = £190.05
Electrolytes Na+< 0.5 mmol/vial
Dose
Severe systemic or deep mycoses where toxicity or
renal failure precludes use of conventional amphotericin
. By intravenous infusion
Child 1 month–18 years initial test dose 100 micrograms/kg (max. 2 mg) then 30 minutes later 1 mg/kg
once daily, increased gradually if necessary to 3–
4 mg/kg once daily; max. 6 mg/kg daily
