S. Kline et al., LIMITED TOXICITY OF PROLONGED THERAPY WITH HIGH-DOSES OF AMPHOTERICIN-B LIPID COMPLEX, Clinical infectious diseases, 21(5), 1995, pp. 1154-1158
We describe six patients with invasive fungal infections who received
large cumulative doses (22.3-73.6 g) of amphotericin B lipid complex (
ABLC) over 21-121 weeks. The drug was well tolerated at these very lar
ge doses, and there was limited toxicity, Collectively, these patients
received ABLC therapy for a mean of 53.8 weeks (range, 21-121 weeks).
The mean serum creatinine level at the start of ABLC therapy was 1 mg
/dL (range, 0.4-1.9 mg/dL), and at the end of therapy this level was 1
.5 mg/dL (range, 1.0-2.0 mg/dL). Over the course of therapy, only two
patients had serum creatinine levels of greater than or equal to 2 mg/
dL, with transient peak serum creatinine levels of 3.5 and 2.8 mg/dL,
respectively. Several patients required replacement therapy with oral
or intravenous potassium, None of the patients had ABLC-associated tox
ic effects necessitating discontinuation of the treatment. ABLC may be
given in substantially larger doses than conventional amphotericin B,
and very high doses of ABLC that are administered over several months
appear to be relatively less toxic than those of conventional amphote
ricin B.