Liposomal Amphotericin B Injectable: Dosing and Safety
Liposomal amphotericin B guidance for selected severe fungal disease and leishmaniasis, with reduced nephrotoxicity compared with conventional amphotericin.
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Source reviewed
March 2024
Guide category
Injectable drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Antifungal.
Indications
- Cryptococcal meningitis, when conventional amphotericin B is contra-indicated.
- Mucocutaneous or visceral leishmaniasis.
- Severe histoplasmosis.
Forms and strengths, route of administration
- Powder for injection, in 50 mg vial, dissolved in 12 ml water for injection to obtain a concentrated suspension containing 4 mg/ml.
- Withdraw the required dose, pass it through the provided filter, and inject into 5% glucose to obtain a final concentration between 0.2 and 2 mg/ml for IV perfusion.
Dose and duration
| Weight | Liposomal amphotericin B, 50 mg-vial in 12 ml | G5% | ||
|---|---|---|---|---|
| Daily dose in mg | Nb of vials | Volume of suspension (4 mg/ml) to be withdrawn | Volume required for administration | |
| 4 kg | 12 | 1 | 3 ml | 50 ml |
| 5 kg | 15 | 4 ml | ||
| 6 kg | 18 | 4.5 ml | ||
| 7 kg | 21 | 5 ml | ||
| 8 kg | 24 | 6 ml | ||
| 9 kg | 27 | 7 ml | ||
| 10 kg | 30 | 7.5 ml | ||
| 15 kg | 45 | 11 ml | ||
| 20 kg | 60 | 2 | 15 ml | 250 ml |
| 25 kg | 75 | 19 ml | ||
| 30 kg | 90 | 23 ml | ||
| 35 kg | 105 | 3 | 26 ml | 500 ml |
| 40 kg | 120 | 30 ml | ||
| 45 kg | 135 | 34 ml | ||
| 50 kg | 150 | 38 ml | ||
| 55 kg | 165 | 41 ml | ||
| 60 kg | 180 | 45 ml |
Cryptococcal meningitis, severe histoplasmosis
- Child over 1 month and adult: 3 mg/kg once daily over 30 to 60 minutes for 2 weeks.
Mucocutaneous or visceral leishmaniasis
Follow the recommended regional protocol. For information, the total dose in children over 1 month and adults is 15 to 30 mg/kg.
Contra-indications, adverse effects, precautions
- Due to numerous and potentially severe adverse effects, patients should be kept under close surveillance.
- May cause infusion intolerance reactions, local thrombophlebitis, allergic reactions, gastrointestinal disturbances, renal-function disturbances, hypokalaemia, hypomagnesiemia, elevated liver enzymes, and rarely thrombocytopenia or anaemia.
- Avoid combination with drugs causing hypokalaemia, nephrotoxic drugs, digoxin, and zidovudine.
- The infusion may be administered over 2 hours if necessary to prevent or minimize adverse effects.
- Monitor serum creatinine and, if possible, serum potassium throughout treatment and adapt supplementation according to results.
- If renal function deteriorates, reduce the dose by half for a few days.
- Pregnancy: check for renal dysfunction in the neonate if administered during the last month of pregnancy.
- Breast-feeding: avoid, except if vital.
- Liposomal amphotericin B is better tolerated and less nephrotoxic than conventional amphotericin B.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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