Amphotericin B Injection (patient information)

IMPORTANT WARNING
Amphotericin B can cause serious side effects. This medication should only be used for the treatment of potentially life-threatening fungal infections and not to treat less serious fungal infections of the mouth, throat, or vagina in patients with a normal immune system (body's natural protection against infection).

About your treatment
Your doctor has ordered amphotericin B, an antifungal medication, to help treat your infection. It will be added to an intravenous fluid that will drip for about 2-6 hours through a needle or catheter placed in your vein once a day or once every other day.

Amphotericin B is used to kill fungus that can cause serious or life-threatening infections. Amphotericin B is not effective against bacterial infections or viruses. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.

Precautions
Before administering amphotericin B:


 * tell your doctor and pharmacist if you are allergic to amphotericin B, any other medications, or any of the ingredients in amphotericin B. Ask your health care provider for a list of the ingredients.
 * tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aminoglycoside antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Nes-RX, Neo-Fradin), paramomycin (Humatin), streptomycin, and tobramycin (Tobi, Nebcin); certain antifungals such as clotrimazole, fluconazole, itraconazole (Sporanox), ketoconazole, and miconazole; corticotropin (ACTH, H.P., Acthar Gel); cyclosporine (Neoral, Sandimmune); digoxin (Digitek, Lanoxicaps, Lanoxin); flucytosine (Ancobon); medications for the treatment of cancer, such as nitrogen mustard; oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); and pentamidine (NebuPent, Pentam 300).
 * tell your doctor if you are receiving transfusions or having radiation treatments. Also tell your doctor if you have or have ever had diabetes, or heart or kidney disease.
 * tell your doctor if you are pregnant, or plan to become pregnant. If you become pregnant while taking amphotericin B, call your doctor.Do not breastfeed if you are taking amphotericin B.
 * if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking amphotericin B.

Administering your medication
Before you administer amphotericin B, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider. Protect the solution from light during administration.

It is important that you use amphotericin B exactly as directed. Do not stop your therapy on your own for any reason because your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health care provider. If your therapy is stopped for longer than one week for any reason, call your health care provider. If your infusion is restarted, it probably will be restarted at a lower dose. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

Minor Side Effects
Amphotericin B may cause side effects. Some side effects are more severe and more common with the first few doses of amphotericin B. Your health care provider may prescribe other medications to decrease these side effects, or tell you to administer amphotericin B every other day. If you have never experienced any of the following side effects from previous doses and suddenly have symptoms, stop your infusion and call your health care provider immediately.


 * fever
 * chills
 * fast breathing
 * headache
 * changes in heart beat
 * dizziness
 * fainting
 * blurred vision
 * nausea
 * vomiting
 * loss of appetite

Tell your health care provider if any of these symptoms are severe or do not go away:


 * pale skin
 * flushing
 * tiredness
 * diarrhea
 * stomach cramping
 * heartburn
 * muscle or joint pain
 * weight loss
 * ringing in the ears
 * hearing loss
 * pain, burning, numbness, or tingling in the hands or feet

Severe Side Effects
If you experience any of the following symptoms, call your health care provider immediately:


 * rash
 * itching
 * hives
 * difficulty breathing or swallowing
 * wheezing
 * confusion
 * loss of responsiveness or consciousness
 * seizures
 * decreased urination
 * change in heartbeat
 * pain in the upper right part of the stomach
 * extreme tiredness
 * unusual bleeding or bruising
 * black and tarry stools
 * red blood in stools
 * bloody vomit
 * vomiting material that looks like coffee grounds
 * lack of energy
 * yellowing of the skin or eyes
 * changes in vision
 * flu-like symptoms
 * sore throat, chills, cough, and other signs of infection

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storing your medication
Talk to your health care provider about how you should store your medication. Your health care provider will probably tell you to store your medication in the refrigerator and to protect this solution from light. Your health care provider will tell you when and how you should throw away any unused medication and will probably mark this date on the medication container. Ask your health care provider if you do not understand the directions or you have any questions.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury and to properly dispose of medical waste.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Signs of infection
If you are receiving amphotericin B in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:


 * tenderness
 * warmth
 * irritation
 * drainage
 * redness
 * swelling
 * pain

Brand names

 * Amphocin®
 * Fungizone® Intravenous