What is the Difference Between Amphotericin B and Liposomal Amphotericin B?
🆚 Go to Comparative Table 🆚Amphotericin B and liposomal Amphotericin B are both antifungal agents used to treat various fungal infections. The difference between the two lies in their formulation and side effect profile.
Amphotericin B:
- Conventional formulation
- Deoxycholate salt
- Can cause kidney damage (nephrotoxicity)
- Known to cause infusion-related side effects
Liposomal Amphotericin B (AmBisome®):
- Unique lipid formulation
- Forms an ionic complex with the disteareoylphosphatidyl glycerol, promoting the retention of amphotericin B within the liposomes
- Less nephrotoxic compared to conventional amphotericin B
- Fewer infusion-related side effects
In a clinical trial comparing the two formulations, liposomal amphotericin B was found to have fewer proven fungal infections, fewer infusion-related side effects, and less nephrotoxicity, although the two drugs were equivalent in overall efficacy. Liposomal amphotericin B has been shown to provide an equally efficacious alternative to conventional amphotericin B deoxycholate in patients with AIDS and acute cryptococcal meningitis.
Comparative Table: Amphotericin B vs Liposomal Amphotericin B
Amphotericin B and Liposomal Amphotericin B are both antifungal medications, but they differ in their formulation and some of their properties. Here is a table highlighting the differences between the two:
Property | Amphotericin B | Liposomal Amphotericin B |
---|---|---|
Formulation | Conventional antifungal (deoxycholate) | Lipid-formulated antifungal |
Administration | Typically 0.5-1.0 mg/kg/day | 1-3 mg/kg/day, incrementally increased daily |
Tissue Concentration | Lower concentrations in primary reticuloendothelial organs (lungs, liver, spleen) | Higher concentrations in primary reticuloendothelial organs |
Renal Toxicity | Significant renal toxicity | Markedly reduced renal toxicity |
Hepatotoxicity | Significant hepatotoxicity | Significantly reduced hepatotoxicity |
Efficacy | Effective against various fungal infections | Comparable efficacy to conventional Amphotericin B |
Liposomal Amphotericin B (AmBisome®) has several advantages over conventional Amphotericin B, including an increased daily dosage of the parent drug (up to 10-fold), higher tissue concentrations in the primary reticuloendothelial organs (lungs, liver, spleen), a decrease in infusion-related side effects, and a marked decrease in renal and hepatotoxicity. Both formulations have been shown to be effective against various fungal infections.
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