Amphotericin B is complexed with deoxycholate (C-AMB) and marketed as a lyophilized powder (fungizone) containing 50 mg of amphotericin B that forms a colloid in water. Three lipid formulations of amphotericin B are marketed in the U.S. Amphotericin B colloidal dispersion (ABCD, amphotec, amphocil) contains equimolar amounts of amphotericin B and cholesteryl sulfate. ambisome is a small, unilamellar vesicle formulation that combines amphotericin B (50 mg) with 350 mg of lipid (phosphatidylcholine, cholesterol, and distearoylphosphatidylglycerol, in molar ratio of 10:5:4) in an ~10% molar ratio. Amphotericin B lipid complex (ABLC, abelcet) contains dimyristoylphosphatidylcholine and dimyristoylphosphatidylglycerol in a 7:3 mixture with ~35 mol% of amphotericin B.
The role of lipid formulations of amphotericin B in fungal infections remains to be determined. The risk of adverse effects such as nephrotoxicity is decreased by ~50% with lipid formulations, but they cost 20—50 times more and may be associated with a greater risk of febrile infusion reactions.
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