Amphotericin B (Amphotericin B)

Intravenously drip for 2-4 hours, the recommended concentration is 0.1 mg / ml.

Trial dose - 1 mg (base) is diluted in 20 ml of 5% dextrose solution and administered intravenously for at least 20-30 minutes under the control of blood pressure, pulse, body temperature every 30 minutes for 2-4 hours.

With good tolerability, the recommended daily dose is 0.25-0.3 mg / kg, depending on the severity of the disease.

With increased sensitivity to the drug, diseases of the cardiovascular system, kidney failure, treatment starts with low doses of 5-10 mg and, gradually increasing by 5-10 mg / day, adjusted to the recommended daily dose of 0.5-0.7 mg / kg.

Selection of therapeutic doses is carried out individually, depending on the type and severity of the infection. When using the drug every other day, the dose should not exceed 1.5 mg / kg (to avoid the development of cardiopulmonary insufficiency).

The maximum daily dose is 1.5 mg / kg.

Sporotrichosis: course dose 2.5 g, duration of therapy - 9 months.

Aspergillosis: course dose - 3.6 g, treatment duration - 11 months.

Rhinocerebral fikomycosis: the course dose is 3-4 g.

In the event of discontinuation of therapy for more than 7 days, it should be resumed at the lowest dose (0.25 mg / kg), gradually increasing to the desired level.

Children: intravenously, first 0.25 mg / kg (base) per day in a 5% dextrose solution for 6 hours; taking into account tolerability, the dose is gradually increased (usually 0.125 - 0.25 mg / kg every day or every other day) to a maximum dose of 1 mg / kg or 30 mg per 1 m^2.

Children are given minimal effective doses.

To prepare a solution for intravenous administration, a solution with an initial concentration of 5 mg / ml is used. To do this, sterile syringe (needle no. 20) -contain 10 ml of sterile water for injection without bacteriostatic additives directly into the vial with the drug. The contents of the vial are shaken to form a clear colloidal solution. To obtain a solution with a concentration of 0.1 mg / ml it is diluted with 5% dextrose solution with pH not lower than 4.2 in a ratio of 1:50. Before dilution it is necessary to check the acidity of the available dextrose solution. The pH of the dextrose solution generally exceeds 4.2, otherwise 1-2 ml of the buffer solution should be added to the dilution.

The following buffer solution is recommended: sodium hydrophosphate (anhydrous) - 1.59 g, sodium dihydrogen phosphate (anhydrous) - 0.96 g, water for injection - up to 100 ml.

Before addition to the dextrose solution, the buffer solution is sterilized by filtration through a bacterial ceramic ormembrane filter or by autoclaving for 30 minutes at a pressure of 1 atm and 121 ° C.