Amphotericin B + Meglumine (Amphotericinum B + Methylglucaminum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
Read on
Clinical and pharmacological group: & nbsp

Antifungal means

Included in the formulation
АТХ:

J.02.A.A.01   Amphotericin B

Pharmacodynamics:

Depending on the sensitivity of the pathogen and the concentration of the drug in biological fluids is able to exert a fungicidal or fungistatic effect, binds to ergosterols in the cell membrane of sensitive fungi.

Active for most strains Histoplasma capsulatum, Coccidioides immitis, Paracoccidioides brasiliensis, Candida spp., Blastomyces dermatitidis, Rhodotorula spp., Cryptococcus neoformans, Sporothrix schenckii, Mucor mucedo, Rhizopus spp., Absidia spp., Basodiobolus ranarum, Aspergillus fumigatus. Moderately active against some protozoa: Leishmania braziliensis, Leishmania mexicana, Naegleria fowleri.

Pharmacokinetics:

It is distributed in most organs and tissues of the body, it penetrates the placenta. In the cerebrospinal fluid is not determined. 90% bound to plasma proteins. Very slowly excreted by the kidneys, can be found in the urine within 7 weeks after the end of treatment.

Indications:

- Candidiasis gastrointestinal tract;

- TOmuscular candidiasis;

- Fungal lesions internal organs;

- Chronic and granulomatous disseminated forms of candidiasis;

- Coccidiosis;

- Cryptococcosis;

- Histoplasmosis;

- North American blastomycosis;

- Chromomycosis,

- Fungal mycosis;

- Sporotrichosis.

ICD-10

I.B20-B24.B20.5   The disease caused by HIV, with manifestations of other mycoses

I.B20-B24.B20.4   The disease caused by HIV, with manifestations of candidiasis

I.B35-B49.B37.1   Pulmonary Candidiasis

I.B35-B49.B37   Candidiasis

I.B35-B49.B37.7   Candida septicemia

I.B35-B49.B38   Coccidioidomycosis

I.B35-B49.B39   Histoplasmosis

I.B35-B49.B40   Blastomycosis

I.B35-B49.B42   Sporotrichosis

I.B35-B49.B43   Chromomycosis and pheomycotic abscess

I.B35-B49.B44   Aspergillosis

I.B35-B49.B45   Cryptococcosis

I.B35-B49.B48.7   Opportunistic fungal infections

I.B50-B64.B55.9   Leishmaniasis, unspecified

II.C81-C96.C84.0   Mushroom mycosis

Contraindications:

- Chronic renal failure;

- Individual intolerance;

- Glomerulonephritis;

- Amyloidosis;

- Hepatitis and cirrhosis of the liver;

- Anemia and agranulocytosis;

- Diabetes;

- Pregnancy, breast-feeding.

Carefully:

In the process of treatment, systematic monitoring of the kidneys, liver, blood composition and potassium level in the blood is necessary. When symptoms of anemia appear, treatment should be discontinued.

Pregnancy and lactation:

Action category for the fetus by FDA - С. Not recommended during pregnancy and during breastfeeding.

Dosing and Administration:

Adults and children over 14 years of initial dose - 200,000 YE 2 times a day, if necessary, you can increase to 500,000 YE 2 times a day. The drug is taken orally after a meal. Duration of treatment with localized forms of candidiasis - 10-14 days, with common forms and deep mycoses - up to 3-4 weeks.

Children under two years of age are assigned to 25,000 YE 2 times a day, 2-6 years - 100,000 YE 2 times a day, 6-9 years - 150,000 YE 2 times a day, 9-14 years - 200,000 YE 2 times a day.

If necessary, in the absence of side symptoms, the course of treatment can be repeated in a week.

Side effects:

Nervous system: headache, polyneuropathy, double vision and blurred vision.

The cardiovascular system: arterial hypo- or hypertension, arrhythmia.

TOTo read: hemolytic anemia, leukopenia, thrombocytopenia.

Digestive system: nausea, vomiting, decreased appetite, diarrhea, pain in the stomach, increased activity of liver enzymes.

Genitourinary system: renal dysfunction, azotemia, acidosis.

Allergic reactions: skin rash, itching, angioedema.

Others: fever, chills, weight loss, hypokalemia, hypomagnesemia.

Overdose:No data.
Interaction:

With simultaneous use with diuretics, potentially nephrotoxic antibiotics, cyclosporine, the risk of developing nephrotoxic action is increased.

Simultaneous appointment with bone marrow suppressants, radiotherapy increases the risk of anemia and other blood problems.

The drug increases the toxicity of cardiac glycosides and antidepolarizing agents.

With simultaneous use increases the toxicity of flucytosine.

Joint application with glucocorticoids can lead to increased hypokalemia.

Special instructions:

During therapy, regular monitoring of the blood composition, in particular the level of potassium, kidney and liver function. If signs of anemia appear, treatment should be discontinued.

Instructions
Up