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Pharmacology: Pharmacodynamics: Clinical activity of Amphotericin B has been shown against Candida species. Cryptococcus neoformans, Blastomyces dermatitidis, Histoplasma capsulatum, Torulopsis glabrata, Coccidioides immitis, Paracoccidioides braziliensis, Aspergillus species and species causing mucomycosis. Amphotericin B remains the antifungal of choice for progressive and potentially fatal infections with susceptible organisms. Depending on the concentration achieved in the body fluids and the susceptibility of the fungus, Amphotericin B acts as either fungicidal or fungistatic.
Pharmacokinetics: When administered intravenously, peak plasma concentrations of 0.5 to 4 micrograms/mL, have been reported. The average plasma concentration tends to reach 500 nanograms/mL with maintenance doses.
Amphotericin B is reported to be highly bound to plasma proteins and is widely distributed, but passes into the CSF only in small quantities.
The plasma half-life has been reported to be about 24 hours, with long term administration, the terminal half-life increases to 15 days.
Unchanged Amphotericin B is excreted in small amounts slowly in the urine. Traces have been reported to be present in the serum and urine several weeks after completion of treatment.
Amphotericin B is not removed by haemodialysis.
