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 journalArticlepeer-review

35 Scopus citations


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
Issue number6
StatePublished - Nov 2013


  • Amphotericin B
  • Antifungal
  • Mechanisms
  • Toxicokinetics

ASJC Scopus subject areas

  • Pharmacology (medical)


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