Format

Send to

Choose Destination
  • Filters activated: Field: Title Word. Clear all
Drugs. 2016 Mar;76(4):485-500. doi: 10.1007/s40265-016-0538-7.

Liposomal Amphotericin B (AmBisome(®)): A Review of the Pharmacokinetics, Pharmacodynamics, Clinical Experience and Future Directions.

Author information

1
Institute for Infection and Immunity, St. George's University of London, London, UK. nstone@sgul.ac.uk.
2
Institute for Infection and Immunity, St. George's University of London, London, UK.
3
Department of Haematology, Royal Liverpool University Hospital, Liverpool, UK.
4
Antimicrobial Pharmacodynamics and Therapeutics, Department of Molecular and Clinical Pharmacology, 1.09 Sherrington Building, University of Liverpool, Liverpool, UK.

Abstract

Liposomal amphotericin B (AmBisome(®); LAmB) is a unique lipid formulation of amphotericin B. LAmB is a standard of care for a wide range of medically important opportunistic fungal pathogens. LAmB has a significantly improved toxicity profile compared with conventional amphotericin B deoxycholate (DAmB). Despite nearly 20 years of clinical use, the pharmacokinetics and pharmacodynamics of this agent, which differ considerably from DAmB, remain relatively poorly understood and underutilized in the clinical setting. The molecular pharmacology, preclinical and clinical pharmacokinetics, and clinical experience with LAmB for the most commonly encountered fungal pathogens are reviewed. In vitro, experimental animal models and human clinical trial data are summarized, and novel routes of administration and dosing schedules are discussed. LAmB is a formulation that results in reduced toxicity as compared with DAmB while retaining the antifungal effect of the active agent. Its long terminal half-life and retention in tissues suggest that single or intermittent dosing regimens are feasible, and these should be actively investigated in both preclinical models and in clinical trials. Significant gaps remain in knowledge of pharmacokinetics and pharmacodynamics in special populations such as neonates and children, pregnant women and obese patients.

PMID:
26818726
PMCID:
PMC4856207
DOI:
10.1007/s40265-016-0538-7
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center