Amphotericin B

How it works

It binds ergosterol in the fungal cell membrane, forming pores that increase permeability and cause leakage of intracellular contents and cell death.

Prescribing in practice

• Nephrotoxicity and electrolyte disturbance (notably hypokalaemia and hypomagnesaemia) are major risks, so renal function and electrolytes must be monitored closely.
• Different formulations are not interchangeable and prescriptions should specify the exact product to avoid serious dosing errors.
• Infusion-related reactions are common, and a test dose and supportive measures may be used as directed by the SPC.

Monitoring

Monitor renal function, serum electrolytes (particularly potassium and magnesium), full blood count and liver function during therapy.

Counselling the patient

• Tell the team if you develop fever, chills, breathlessness or other symptoms during the infusion.
• Regular blood tests are needed to check your kidneys and salts.
• Report reduced urine output or muscle weakness.

Evidence & guidelines

Amphotericin B remains a recommended option for many invasive fungal infections, with lipid formulations preferred where renal toxicity is a concern.