Toxicokinetic and mechanistic basis for the safety and tolerability of liposomal amphotericin B

Angela S. Loo, Saif A. Muhsin, Thomas J. Walsh

Research output: Contribution to journalArticle

Abstract

Introduction: Amphotericin B (AmB) was first approved by the US Food and Drug Administration in 1959 with sodium deoxycholate (DAmB, Fungizone®). Extensive toxicities associated with the drug led to the development of lipid formulations of AmB, including liposomal amphotericin B (L-AmB, AmBisome®). Phase I studies as well as comparative Phase III clinical trials indicate that L-AmB is associated with less nephrotoxicity and reduced infusion-related toxicity. There is, however, no recent comprehensive review of the safety and tolerability of L-AmB. Areas covered: This article reviews the safety, tolerability and the mechanisms of the major toxicities associated with L-AmB, including nephrotoxicity, infusion-related reactions (IRRs), anemia and thrombocytopenia, and hepatic abnormalities. The article further discusses the mechanism of action and pharmacokinetics of L-AmB. Expert opinion: L-AmB is a broad-spectrum antifungal agent that has significantly reduced toxicities compared to its predecessor, DAmB.

Original languageEnglish (US)
Pages (from-to)881-895
Number of pages15
JournalExpert Opinion on Drug Safety
Volume12
Issue number6
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Amphotericin B
Safety
liposomal amphotericin B
Toxicokinetics
Phase III Clinical Trials
Deoxycholic Acid
Antifungal Agents
Expert Testimony
United States Food and Drug Administration
Thrombocytopenia
Anemia
Pharmacokinetics
Lipids
Liver

Keywords

  • Amphotericin B
  • Antifungal
  • Mechanisms
  • Toxicokinetics

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Toxicokinetic and mechanistic basis for the safety and tolerability of liposomal amphotericin B. / Loo, Angela S.; Muhsin, Saif A.; Walsh, Thomas J.

In: Expert Opinion on Drug Safety, Vol. 12, No. 6, 11.2013, p. 881-895.

Research output: Contribution to journalArticle

Loo, Angela S. ; Muhsin, Saif A. ; Walsh, Thomas J. / Toxicokinetic and mechanistic basis for the safety and tolerability of liposomal amphotericin B. In: Expert Opinion on Drug Safety. 2013 ; Vol. 12, No. 6. pp. 881-895.
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