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Did your doctor tell you?...
Amphotericin
B is well-known for its severe and potentially lethal side effects. Very often a serious acute reaction after the infusion
(1 to 3 hours later) is noted consisting of high fever, shaking chills, hypotension, anorexia, nausea, vomiting, headache,
dyspnea, and tachypnea, drowsiness, generalised weakness. This reaction sometimes subsides with later applications of the
drug and may in part be due to histamine liberation. An increase in prostaglandin-synthesis may also play a role. This nearly
universal febrile response necessitates a critical (and diagnostically difficult) professional determination as to whether
the onset of high fever is a novel symptom of a fast-progressing disease, or merely the induced effect of the drug. In order
to decrease the likelihood and severity of the symptoms, initial doses should be low and increased slowly.
Intravenously administered Amphotericin B has also been associated with multiple
organ damage in therapeutic doses. Nephrotoxicity (kidney damage) is a frequently reported side-effect, and can be severe
and/or irreversible. It is much milder when delivered via liposomes (AmBisome) if possible. Electrolyte imbalances (e.g. hypokalemia
and hypomagnesemia) may also result. In the liver, increased liver enzymes and hepatotoxicity (up to and including fulminant
liver failure) are common. In the circulatory system, several forms of anemia and other blood dyscrasias (leukopenia, thrombopenia),
serious cardiac arrhythmias (including ventricular fibrillation), and even frank cardiac failure have been reported. Skin
reactions, including serious forms, are also possible.
