Amphotret Special Precautions

Amphotret (Amphotericin B for Injection U.S.P.) therapy is required to be initiated under close clinical observation by a qualified medical personnel. Acute reactions which are common include fever, chills, headache, nausea and vomiting. A variety of ancillary medications, most often including acetaminophen, nonsteroidal anti-inflammatory drugs, antihistamines, antiemetics, and corticosteroids, are used for the prophylaxis and treatment of adverse effects associated with administration of Amphotret (Amphotericin B for Injection U.S.P.). Meperidine (25 to 50 mg IV) has been shown in some patients to decrease the duration of shaking chills, and fever that may accompany the infusion of amphotericin B. Addition of heparin (1000 units per infusion) and the use of pediatric scalp vein needle may lessen the incidence of thrombophlebitis. Extravasation may cause chemical irritation. Patients who experience a pronounced reaction to a test dose of Amphotret (Amphotericin B for Injection U.S.P.) should receive premedication before subsequent doses, otherwise the use of ancillary medications should be reserved for the treatment of symptoms.
Renal function should be monitored frequently during amphotericin B therapy. It is also advisable to monitor on a regular basis liver function, serum electrolytes (particularly magnesium and potassium), blood counts and hemoglobin concentrations. laboratory test results should be used as a guide to subsequent dosage adjustments.