The following graph shows the average serum creatinine concentrations in the compassionate use study and shows that there is a drop from pretreatment concentrations for all patients, especially those with elevated (greater than 1.7 mg/dL) pretreatment creatinine concentrations. official website and that any information you provide is encrypted Success rates at 2 weeks for Amphotericin B liposome for injection and Amphotericin B deoxycholate are summarized in the following table: Success at 10 weeks was defined as clinical success at week 10 plus CSF culture conversion at or prior to week 10. Study 94-0-002, a randomized, double-blind, comparative multi-center trial, evaluated the efficacy of Amphotericin B liposome for injection (1.5 to 6 mg/kg/day) compared with Amphotericin B deoxycholate (0.3 to 1.2 mg/kg/day) in the empirical treatment of 687 adult and pediatric neutropenic patients who were febrile despite having received at least 96 hours of broad spectrum antibacterial therapy. used in Beckman Coulter analyzers including the Synchron LX20). Packaged individually NDC 55150-365-01. Also to prevent kidney issues with dyes for cardiac caths, many times the patient will receive an IV for at least 12 hours before with bicarb and this is always ordered by the cardiologists in D5W as well. Single-Dose Vial, Rx only NDC 55150-365-01 An in-line membrane filter may be used for the intravenous infusion of Amphotericin B liposome for injection, provided THE MEAN PORE DIAMETER OF THE FILTER IS NOT LESS THAN 1.0 MICRON. The incidence of mycologically-confirmed, and clinically-diagnosed, emergent fungal infections are presented in the following table. [51][52][53] Ergosterol, the fungal sterol, is more sensitive to amphotericin B than cholesterol, the common mammalian sterol. Our members represent more than 60 professional nursing specialties. [17] Amphotericin B deoxycholate (ABD) is administered intravenously. The existence of an effective, safe and inexpensive oral formulation of amphotericin B would have significant applications for the treatment of disseminated fungal infections and would dramatically expand access to treatment of visceral leishmaniasis by introducing a readily available highly tolerated oral formulation . The violent chills and fevers have caused the drug to be nicknamed "shake and bake". In the empirical therapy study 97-0-034, on Day 1, where no premedication was administered, the overall incidence of infusion-related events of chills/rigors was significantly lower for patients administered Amphotericin B liposome for injection compared with Amphotericin B lipid complex. 5. Dosage form: injection, powder, lyophilized, for solution Success in patients with documented cryptococcal meningitis, 4 mg/kg/day, days 1 to 5, and 10, 17, 24, 31, 38. The pharmacokinetic profile of Amphotericin B was determined in febrile neutropenic cancer and bone marrow transplant patients who received 1 to 2 hour infusions of 1 to 5 mg/kg/day Amphotericin B liposome for injection for 3 to 20 days. Even after I double checked the info in the link that I provided above that states NAHCo3 is compatibile with NS, you still made me second guess myself, so I called the pharmacist at the hospital. Storage of Reconstituted Product Concentrate Pediatric patients appear to have more tolerance than older individuals for the nephrotoxic effects of Amphotericin B deoxycholate. Amphotericin B is a macrocyclic, polyene, antifungal antibiotic produced from a strain of Streptomyces nodosus. Careers. Treatment of Cryptococcal Meningitis in HIV-Infected Patients No formal clinical studies of drug interactions have been conducted with Amphotericin B liposome for injection; however, the following drugs are known to interact with Amphotericin B and may interact with Amphotericin B liposome for injection: National Library of Medicine http://www.vhpharmsci.com/PDTM/Monographs/sodium_bicarbonate.htm. 2019 Dec 15;572:118771. doi: 10.1016/j.ijpharm.2019.118771. Kidney damage is a frequently reported side effect, and can be severe and/or irreversible. It has not been necessary to alter the dose of Amphotericin B liposome for injection for this population. Only use D5W for their drips. Symptomatic supportive measures should be instituted. Ed.. In vitro and in vivo animal studies of the combination of Amphotericin B and imidazoles suggest that imidazoles may induce fungal resistance to Amphotericin B. No long-term studies in animals have been performed to evaluate carcinogenic potential of Amphotericin B liposome for injection. Eleven clinical studies supporting the efficacy and safety of Amphotericin B were conducted. Even after I double checked the info in the link that I provided above that states NAHCo3 is compatibile with NS, you still made me second guess myself, so I called the pharmacist at the hospital. As with most other drugs, elderly patients receiving Amphotericin B liposome for injection should be carefully monitored. Exercise caution to prevent inadvertent overdosage, which can result in potentially fatal cardiac or cardiopulmonary arrest. While acute parasite clearance was achieved in most of the immunocompromised patients who received total doses of 30 to 40 mg/kg, the majority of these patients were observed to relapse in the 6 months following the completion of therapy. The symptoms do not occur with every dose and usually do not recur on subsequent administrations when the infusion rate is slowed. Not Interchangeable or Substitutable Clinical Laboratory Values [62], It is commercially known as Fungilin, Fungizone, Abelcet, AmBisome, Fungisome, Amphocil, Amphotec, and Halizon. Ambisome (Amphotericin B): Uses, Dosage, Side Effects, Interactions It was approved by the FDA in 1997. J Code (medical billing code): J0289 (10 mg, injection). Amphotericin B liposome for injection was evaluated in a compassionate use study in hospitalized patients with systemic fungal infections. [29] The amphipathic nature of amphotericin along with its low solubility and permeability has posed major hurdles for oral administration given its low bioavailability. Incidence of nephrotoxicity, mean peak serum creatinine concentration, mean change from baseline in serum creatinine, and incidence of hypokalemia in the double-blind, randomized study were lower in the Amphotericin B liposome for injection group as summarized in the following table: The effect of Amphotericin B liposome for injection (3 mg/kg/day) vs. Amphotericin B (0.6 mg/kg/day) on renal function in adult patients enrolled in this study is illustrated in the following figure: Amphotericin B - an overview | ScienceDirect Topics If the patient experiences discomfort during infusion, the duration of infusion may be increased. :selfbonk: Most patients that require Bicarb drips are usually those that have issues with acid-base balance and are many times renal patients, so you do not give them the extra sodium with the IV fluids. Irrigation with antibioticcontaining solutions for the prevention and Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research. Here, we studied the morphology of Delta virions from both paraformaldehyde (PFA) and electron beam inactivated samples and determined . and transmitted securely. The following adverse events are based on the experience of 244 patients (202 adult and 42 pediatric patients) of whom 85 patients were treated with Amphotericin B liposome for injection 3 mg/kg, 81 patients were treated with Amphotericin B liposome for injection 5 mg/kg and 78 patients were treated with Amphotericin B lipid complex 5 mg/kg in Study 97-0-034, a randomized, double-blind, multi-center study in febrile, neutropenic patients. Amphotericin B was fungicidal (MFC/MIC 4) against all A. fumigatus and A. flavus isolates but no A. terreus isolates, whereas voriconazole was fungicidal against 82% of A. These patients either had fungal infections refractory to Amphotericin B deoxycholate, were intolerant to the use of Amphotericin B deoxycholate, or had pre-existing renal insufficiency. Thanks. Amphotericin B is capable of forming channels in membranes. The following table presents a comparison of efficacy rates among immunocompetent and immunocompromised patients infected in the Mediterranean basin who had no prior treatment or remote prior treatment for visceral leishmaniasis. Musculoskeletal System Either "conventionally" complexed with sodium deoxycholate (ABD), as a cholesteryl sulfate complex (ABCD), as a lipid complex (ABLC), and as a liposomal formulation (LAMB). Bookshelf Acute kidney injury (AKI) is a relatively common complication of amphotericin B deoxycholate, as are other kidney manifestations, including urinary potassium wasting and hypokalemia, urinary magnesium wasting and hypomagnesemia, metabolic acidosis due to type 1 . Leukocyte Transfusions [45], In addition, electrolyte imbalances such as hypokalemia and hypomagnesemia are also common. Dilute immediately before use. Accessibility Amphotericin B injection comes as a solid powder cake to be made into a solution and then injected intravenously (into a vein) by a nurse or a doctor. It is not stable with any dextrose. Unrestricted Indications 1) Documented or suspected fungal pneumonia in a patient intolerant of or with contraindications to azoles 2) Prophylaxis . We comply with the HONcode standard for trustworthy health information. Amphotericin B liposome for injection is not interchangeable or substitutable on a mg per mg basis with other Amphotericin B products. The table also presents 10-week survival rates for patients treated in this study. Unopened vials of lyophilized material are to be stored at temperatures up to 25 C (77 F). The manufacturer recommends beginning intravenous therapy with a 1-mg test dose. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Amphotericin b Side Effects: Common, Severe, Long Term - Drugs.com Amphotericin B liposome for injection is pale yellow to yellow lyophilized product, available as single cartons. Several molecular mechanisms have been proposed to explain exceptionally high effectiveness of amphotericin B in combating fungi. Stability of amphotericin B in four concentrations of dextrose injection. Safety and effectiveness in pediatric patients below the age of one month have not been established (See DESCRIPTION OF CLINICAL STUDIES - Empirical Therapy in Febrile Neutropenic Patients and DOSAGE AND ADMINISTRATION). Flucytosine Eugia US LLC 279 Princeton-Hightstown Rd. [19], Mammalian and fungal membranes both contain sterols, a primary membrane target for amphotericin B. 25 In 2009, the FDA approved a surgical lavage system containing a low concentration (ie, 0.05%) of chlorhexidine gluconate in sterile . If a severe anaphylactic reaction occurs, the infusion should be immediately discontinued and the patient should not receive further infusions of Amphotericin B liposome for injection. Optimization, stabilization, and characterization of amphotericin B loaded nanostructured lipid carriers for ocular drug delivery. The most common regimens included diphenhydramine, a corticosteroid, acetaminophen, and heparin, administered alone or in combination with these or other drugs. If this is not feasible, Amphotericin B liposome for injection must be administered through a separate line. The novel lipid delivery system of amphotericin B: drug profile and relevance to clinical practice. Amphotericin B alone is insoluble in normal saline at a pH of 7. Two molecules of each form a tetramer that aggregate into spiral arms on a disk-like complex. Abnormal renal function, acute kidney failure, acute renal failure, dysuria, kidney failure, toxic nephropathy, urinary incontinence, and vaginal hemorrhage. Metabolic & Nutritional Disorders [17][26] It was developed by NeXstar Pharmaceuticals (acquired by Gilead Sciences in 1999). Has 30 years experience. PDF UMC Health System Patient Label Here AMPHOTERICIN B PLAN Distribution In a review of studies from 1960 to 1991 , bladder irrigation with amphotericin B appeared to be the most effective treatment for uncomplicated funguria, while ketoconazole was least effective. tubocurarine) due to hypokalemia. Available for Android and iOS devices. An official website of the United States government. Such differences may affect the functional properties of these drug products. The long terminal elimination half-life is probably a slow redistribution from tissues. This drug should be used primarily for treatment of patients with progressive and potentially life-threatening fungal infections; it should not be used to treat noninvasive forms of fungal disease such as oral thrush, vaginal candidiasis, and esophageal candidiasis in patients with normal neutrophil counts. Kulkarni R, Misra UK, Meshram C, Kochar D, Modi M, Vishnu VY, Garg RK, Surya N. Ann Indian Acad Neurol. Skin reactions, including serious forms, are also possible. Serious side effects of Amphotericin b Concurrent use of corticosteroids and ACTH may potentiate hypokalemia, which could predispose the patient to cardiac dysfunction. Amphotericin B, the active ingredient of Amphotericin B liposome for injection, acts by binding to the sterol component, ergosterol, of the cell membrane of susceptible fungi. CAUTION: DO NOT RECONSTITUTE WITH SALINE OR ADD SALINE TO THE RECONSTITUTED CONCENTRATION, OR MIX WITH OTHER DRUGS. Two supportive, prospective, randomized, open-label, comparative multi-center studies examined the efficacy of two dosages of Amphotericin B liposome for injection (1 and 3 mg/kg/day) compared to Amphotericin B deoxycholate (1 mg/kg/day) in the treatment of neutropenic patients with presumed fungal infections. Thus, patients treated with amphotericin B should have daily monitoring of serum creatinine and electrolytes. Intravenous admixtures of amphotericin B 0.25 and 1.4 mg/mL in 5% dextrose injection have an expiration date of 35 days and 36 hours, respectively. [13], Amphotericin B is used for life-threatening protozoan infections such as visceral leishmaniasis[14] and primary amoebic meningoencephalitis.[15]. [28], An oral preparation exists but is not widely available. The typical daily dose of amphotericin B deoxycholate in the treatment of disseminated aspergillosis is 1-1.5 mg/kg every 24 hours. Dismiss. Language links are at the top of the page across from the title. World Health Organization's List of Essential Medicines, "Updates to the Prescribing Medicines in Pregnancy database", "Ambisome- amphotericin b injection, powder, lyophilized, for solution", "Understanding the evolution of drug resistance points to novel strategy for developing better antimicrobials", "Naegleria fowleri: pathogenesis, diagnosis, and treatment options", "Antifungal Agents, Breakpoint tables for interpretation of MICs", "Index | The Antimicrobial Index Knowledgebase - TOKU-E", "History of the development of azole derivatives", "Comparison of fungizone, Amphotec, AmBisome, and Abelcet for treatment of systemic murine cryptococcosis", "Does lipid emulsion reduce amphotericin B nephrotoxicity? Lipid formulations of amphotericin B are extremely expensive. Immediately after the addition of water, SHAKE THE VIAL VIGOROUSLY, TTY Biopharm Company Limited LiouDu Factory. Patients received study drug once daily for an induction period of 11 to 21 days. Which Is More Stable Thiophene Or Pyridine? In addition, different liposomal or lipid-complex products with a common active ingredient may vary from one another in the chemical composition and physical form of the lipid component. [4] There is a lipid formulation that has a lower risk of side effects. In empirical therapy study 97-0-034, a greater proportion of patients in the Amphotericin B lipid complex group discontinued the study drug due to an adverse event than in the Amphotericin B liposome for injection groups. Because mammalian and fungal membranes are similar in structure and composition, this is one mechanism by which amphotericin B causes cellular toxicity. Amphotericin B is a polyene antifungal antibiotic produced by Streptomyces nodosus, with antifungal activity. It is used to treat fungal infections. It is considered first line therapy for invasive mucormycosis infections, cryptococcal meningitis, and certain aspergillus and candidal infections. He confirmed Sodium Bicarb is compatible with normal saline. Dosage is based on your medical condition, weight, and response to therapy. It forms transmembrane channels leading to alterations in cell permeability through which monovalent ions (NA+, K+, H+, and Cl-) leak out of the cell resulting in cell death. Particular attention should be given to monitoring renal function. The effect of Amphotericin B liposome for injection on renal and hepatic function and on serum electrolytes was assessed from laboratory values measured repeatedly in Study 94-0-002. Elderly Patients The pharmacokinetic profile of Amphotericin B after administration of Amphotericin B liposome for injection is based upon total serum concentrations of Amphotericin B. The metabolic pathways of Amphotericin B after administration of Amphotericin B liposome for injection are not known. Amphotericin B liposome for injection and Amphotericin B were infused over two hours. The growing chain is constructed by a series of Claisen reactions. [54] Bacteria are not affected as their cell membranes do not usually contain sterols. The following infrequent adverse experiences have been reported in post-marketing surveillance, in addition to those mentioned above: angioedema, erythema, urticaria, bronchospasm, cyanosis/hypoventilation, pulmonary edema, agranulocytosis, hemorrhagic cystitis, and rhabdomyolysis. Amphotericin B liposome for injection and Amphotericin B were found to be equivalent with respect to the total number of emergent fungal infections. Must be reconstituted and Different Amphotericin B products are not equivalent in terms of pharmacodynamics, pharmacokinetics and dosing. Specializes in onc, M/S, hospice, nursing informatics. sharing sensitive information, make sure youre on a federal This medication is usually given by injection into a vein as directed by your doctor, usually given once a day or every other day. Has 28 years experience. I was pondering what normal saline is not compatible with. :smilecoffeeIlovecof, 6 Articles; . Basic with other Amphotericin B If this is not feasible, Amphotericin B liposome for injection must be administered through a separate line. It is used to treat fungal infections. Mycologically-confirmed fungal infections at study entry were cured in 8 of 11 patients in the Amphotericin B liposome for injection group and 7 of 10 in the Amphotericin B group. Sodium Bicarbonate-always mix that with D5W. [40] Reactions sometimes subside with later applications of the drug. [36][37] The precise etiology of the reaction is unclear, although it may involve increased prostaglandin synthesis and the release of cytokines from macrophages. [57] The first synthesis of the compound's naturally occurring enantiomeric form was achieved in 1987 by K. C. Amphotericin B liposome for injection did not affect fertility or days to copulation. Janjua OS, Shaikh MS, Fareed MA, Qureshi SM, Khan MI, Hashem D, Zafar MS. J Fungi (Basel). : An existing intravenous line must be flushed with 5% Dextrose Injection prior to infusion of Amphotericin B liposome for injection. Mean Creatinine Concentrations Over Time How do you give liposomal amphotericin B injection? Amphotericin B liposome for injection has been shown to be significantly less toxic than Amphotericin B deoxycholate; however, adverse events may still occur. Verify the product name and dosage pre-administration, especially if dose exceeds 1.5 mg/kg. Nicolaou. It is active against clinically relevant yeasts and moulds, including Candida spp., Aspergillus spp. If DISCARD PARTIALLY USED VIALS. [25], AmBisome (LAMB) is a liposomal formulation of amphotericin B for injection and consists of a mixture of phosphatidylcholine, cholesterol and distearoyl phosphatidylglycerol that in aqueous media spontaneously arrange into unilamellar vesicles that contain amphotericin B. Amphotericin B is an antifungal medication that fights infections caused by fungus. Immediately after the addition of water, SHAKE THE VIAL VIGOROUSLY for 30 seconds to completely disperse the AmBisome. Renal Impairment The .gov means its official. Within each module, the extender units are loaded onto the current ACP domain by acetyl transferase (AT). There were no effects on male reproductive function. Reactivity with the membrane is also sterol concentration dependent. Study 97-0-034, a randomized, double-blind, comparative multi-center trial, evaluated the safety of Amphotericin B liposome for injection (3 and 5 mg/kg/day) compared with Amphotericin B lipid complex (5 mg/kg/day) in the empirical treatment of 202 adult and 42 pediatric neutropenic patients. Amphotericin Toxicity | PSNet - Agency for Healthcare Research and Quality In India, efficacy and safety of liposomal amphotericin B have been studied at a range of total dosage. It acts by binding to sterols (primarily ergosterol) in the cell membrane and alters the permeability of the membrane allowing intracellular potassium and other cellular constituents to "leak out". Azoles (e.g., ketoconazole, miconazole, clotrimazole, fluconazole, etc.) Amphotericin B has been the mainstay of antifungal therapy for invasive and serious mycoses, but other antifungals (eg, fluconazole, voriconazole, posaconazole, the echinocandins) are now considered first-line drugs for many of these infections. "Efficacy and safety of amphotericin B lipidbased formulationsA systematic review and metaanalysis." However, adverse effects are common, with nephrotoxicity being the most serious, occurring early in the course of treatment, and usually being reversible in most patients. [26] It was approved by the FDA in 1996. A systematic review and meta-analysis", "Editorial response: choosing amphotericin B formulations-between a rock and a hard place", "Highly effective oral amphotericin B formulation against murine visceral leishmaniasis", "Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America", "Stealth Amphotericin B nanoparticles for oral drug delivery: In vitro optimization", "Oral amphotericin B: challenges and avenues", "The antifungal drug amphotericin B promotes inflammatory cytokine release by a Toll-like receptor- and CD14-dependent mechanism", "Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america", "It only takes one to do many jobs: Amphotericin B as antifungal and immunomodulatory drug", "Exposure of the yeast Candida albicans to the anti-neoplastic agent adriamycin increases the tolerance to amphotericin B", "Amphocin, amphotericin B for injection, USP", "Amphotericin biosynthesis in Streptomyces nodosus: deductions from analysis of polyketide synthase and late genes", AmBisome Summaries of Product Characteristics (United Kingdom), https://en.wikipedia.org/w/index.php?title=Amphotericin_B&oldid=1147358684, World Health Organization essential medicines, Short description is different from Wikidata, Drugboxes which contain changes to watched fields, Articles with unsourced statements from June 2022, Articles with unsourced statements from May 2016, Articles with unsourced statements from December 2022, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License 3.0, Fungizone, Mysteclin-F, AmBisome and other, 40% found in urine after single cumulated over several days, Other nephrotoxic drugs (such as aminoglycosides): Increased risk of serious renal damage, Cytostatic drugs: Increased risk of kidney damage, hypotension, and bronchospasms, Transfusion of leukocytes: Risk of pulmonal (lung) damage occurs, space the intervals between the application of amphotericin B and the transfusion, and monitor pulmonary function, This page was last edited on 30 March 2023, at 12:39. What is the difference between liposomal amphotericin B and amphotericin B? Double check that one. Amphotericin B liposome for injection and Amphotericin B lipid complex were infused over two hours. Amphotericin B is designated chemically as: [1R-(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--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 (CAS No.1397-89-3). Amphotericin B for injection should not be given at doses greater than 1.5 mg/kg. Amphotericin B Products. Amphotericin B liposome for injection should only be used during pregnancy if the possible benefits to be derived outweigh the potential risks involved. Amphotericin B has a molecular formula of C47H73NO17 and a molecular weight of 924.08 g/mol. Amphotericin B nephrotoxicity - UpToDate Unauthorized use of these marks is strictly prohibited. When administered concomitantly, serum potassium levels should be closely monitored. Attach the 5 micron filter provided to the syringe. [3][4], Amphotericin B was isolated from Streptomyces nodosus in 1955 at the Squibb For Medical Research Institute from cultures isolated from the streptomycete obtained from the river bed of Orinoco in that region of Venezuela[6] and came into medical use in 1958. Why must amphotericin B be given intravenously? Amphotericin B liposome for injection is not interchangeable or substitutable on a mg per mg basis with other Amphotericin B products. Amphotericin B was studied in patients with visceral leishmaniasis who were infected in the Mediterranean basin with documented or presumed Leishmania infantum. What is NS NOT compatible with? - General Nursing Talk - allnurses 6. [17] They are more expensive than amphotericin B deoxycholate. Amphotericin B molecules can form pores in the host membrane as well as the fungal membrane. [citation needed], Two amphotericins, amphotericin A and amphotericin B, are known, but only B is used clinically, because it is significantly more active in vivo. Other Nephrotoxic Medications [21] As the original formulation of amphotericin, it is often referred to as "conventional" amphotericin. Amphotericin B liposome for injection may contain hydrochloric acid and/or sodium hydroxide as pH adjusters. Empirical Therapy in Febrile Neutropenic Patients Epidemic of Mucormycosis in COVID-19 Pandemic: A Position Paper. Has 11 years experience. The incidence of adverse events occurring in more than 10% of subjects in one or more arms regardless of relationship to study drug are summarized in the following table: Infusion-Related Reactions Injection is Not Interchangeable Due to the nature and quantity of amphophilic substances used, and the lipophilic moiety in the Amphotericin B molecule, the drug is an integral part of the overall structure of the Amphotericin B liposome for injection liposomes. Amphotericin B is used in the treatment of often life-threatening fungal infections. Revised: September 2022, Rx only NDC 55150-365-01 Amphotericin B liposome for injection is a true single bilayer liposomal drug delivery system. However, in situ structural characterization of Delta is missing. Amphotericin B liposome for injection forms a yellow translucent suspension. This is amphotericin B's primary effect as an antifungal agent. Specializes in Hospice. How to use Amphotericin B Liposome Suspension For Reconstitution. Maybe it just depends on the facility's policy. Open archive. This medication is usually given by injection into a vein as directed by your doctor, usually once a day. Drug class: Polyenes Amphotericin B liposome for injection-treated patients had a lower incidence of infusion-related fever (17% versus 44%), chills/rigors (18% versus 54%) and vomiting (6% versus 8%) on Day 1 as compared to Amphotericin B deoxycholate-treated patients. * 97.5% Confidence Interval for the difference between Amphotericin B liposome for injection and Amphotericin B rates. No. In addition, nearly three times as many patients administered Amphotericin B required a reduction in dose due to toxicity or discontinuation of study drug due to an infusion-related reaction compared with those administered Amphotericin B liposome for injection.
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