Description overdue on 09/10/2013

Antibacterial drug with antifungal effect. Active ingredient - Amphotericin B . Principle effects based on binding to ergosterol That are located in the cell membrane of the fungus. Under the action of disturbed metabolism of the medicament and exits the cell contents into the extracellular space, causing lysis of the fungus. The main component of the drug is produced by Streptomyces nodosus. Depending on the concentration of active substance Ampholip can have both fungicidal and fungistatic action. The drug is not active against viruses, bacteria and rickettsiae. The medicament is discharged in the form of a suspension, a lyophilisate, in tablet dosage form. Buy Ampholip at any pharmacy networks (presentation of the prescription form the doctor is not required).

Indications:

Ampholip prescribed for fungal infections : North American blastomycosis, cryptococcal meningitis, musty mycosis , Disseminated forms of candidiasis, chronic mycetoma , Gialogifomikoz, disseminated sporotrichosis, histoplasmosis, chromomycosis, phycomycosis, disseminated aspergillosis, coccidioidomycosis,   intestinal kandidonositelstvo , Invasive aspergillosis, fungal sepsis , Endocarditis, infection of the abdominal organs (including peritonitis ) Gialogifomikoz, endophthalmitis. Drug Usage Ampholip recommends that prescribers in the US skin-visceral leishmaniasis. Immunocompromised patients with the diagnosis visceral leishmaniasis   drug administered as primary therapy.

Contraindications:

Ampholip not indicated in severe renal pathology system, with individual hypersensitivity to the active ingredient - amphotericin B. In patients with diabetes, cirrhosis , Breastfeeding, agranulocytosis, amyloidosis, glomerulonephritis , Hepatitis, pregnancy drug is prescribed with caution when evaluating the potential risk. Patients with concomitant diseases further examine others specialists.

Side effect:

Respiratory system:   rhinitis, cough, "tickle" in the throat (the appointment of inhaled forms). Nervous System: seizures, migraine headaches and pain, polyneuropathy. The digestive tract:   hepatotoxic manifestations in the form of increased levels of enzymes ALT and AST, dyspepsia (gastralgia, vomiting, diarrhea syndrome, nausea), appetite disorders. Cardiovascular system:   electrocardiographic changes, arrhythmias , Unstable blood pressure levels. Senses:   violation of visual perception in the form diplopia , Blurred vision, loss of hearing. Urinary Tract:   nephrotoxicity manifestations of azotemia , Hypercreatininemia, acidosis. Bodies of blood: hemolytic anemia , Leukopenia, thrombocytopenia. Allergic responses in the form of anaphylactic reactions, angioedema, febrile syndrome, itching, skin rash on the type of urticaria, bronchospasm, and dyspnea. The site of administration of amphotericin B may develop thrombophlebitis . Rarely observed during treatment with hypomagnesemia, myalgia, hypokalemia, arthralgia , Weight loss.

Mode of application:

Ampholip administered intravenous drip .  The recommended concentration is 0, 1 mg per 1 mL injection duration - 2-4 hours .  Before the treatment is carried out a test injection of the drug under control of body temperature and blood pressure levels: 1 mg of Amphotericin B diluted in 20-50 mils dextrose solution, the resulting solution was injected slowly over an hour .  In the absence of allergic reactions, side effects of the drug is administered in a daily dose, calculated according to the scheme: 0, 25-0, 30 mg per 1 kg body weight .  In severe renal pathology system, diseases of the cardiovascular system, hypersensitivity to the medicament treatment is recommended to start with the minimum dose - 5.10 mg progressive addition of 5-10 mg per day (maximum of 0, 7 mg / day) .  It is necessary to take into account the general condition of the patient, the severity of the underlying disease, comorbidities and tolerability of the drug in the selection of a dose of the drug .  If treatment is interrupted for more than 7 days, treatment should start with the lowest dose and then gradually increase .  To intracavitary instillation   A freshly prepared solution employed: 5-50 mg (basic substance) 10-20 ml of 5% dextrose. After instillation 8-12 hours recommended administration of 20 ml of N-acetylcysteine ​​5%, followed by gradual suction. For bladder irrigation solution is prepared according to the scheme of the basic substance of 5 mg per 1 liter of sterile water. Washing is carried out through a special three-channel catheter. Procedures are carried out for 5-10 days.   Treatment sporotrichosis:   treatment duration - 9 months course dose - 2, 5 grams. Treatment of aspergillosis:   The course lasts for 11 months, dose - 3, 6 g. Treatment rinotserebralnogo phycomycosis held exchange dose of 3-4 grams of amphotericin B inhalation solution before preparing the application of the scheme: 50 thousand. Units per 10 ml of sterile water. Inhalation conducted for 15-20 days, twice a day. A single dose was reduced to 25 thousand. Units using inhalers that work only on inspiration. The duration of therapy is designed for 10-14 days. Perhaps a refresher course in 7-10 days. Ampholip tablets administered twice a day for 200 thousand. Units. Perhaps the increase in unit dosage up to 500 thousand. Units. When localized forms candidiasis   treatment is carried out for 10-14 days. With deep and widespread mycosis Ampholip prescribed for 3-4 weeks.

Special instructions:

Ampholip price varies depending on the region and the form of (from 2,000 to 15,000 rubles). Long-term therapy leads to increased severity of toxic effects. During treatment with amphotericin B required to conduct a general analysis of blood and urine. It is recommended to control the weight of the patient, performance of hepatic and renal level of potassium ions in the blood. All patients underwent electrocardiography heart. Patients who are on dialysis, the medication may be administered only after completion of the procedure. The drug does not contain bacteriostatic agents and preservatives, so the medical staff requires full compliance with all the rules of aseptic and antiseptic. The system is recommended to wash the 5% glucose solution prior to reuse for intravenous infusions of amphotericin B. The treatment was stopped when diagnosing anemia .

Drug Interactions:

Ampholip incompatible with sodium chloride, heparin, and other solutions that contain electrolytes in the composition. The presence of benzyl alcohol and other bacteriostatic additives leads to precipitation of the active component. The drug is able to reduce the effectiveness of ethinyl estradiol   (increases the likelihood of bleeding "breakthrough"). Amphotericin B enhances the toxicity and improves the efficiency of flucytosine, sulfonylureas, theophylline (by extending the half-life). The synergy observed in the treatment of nitrofurans. Antidepressants, cimetidine, non-narcotic analgesics and other inhibitors of microsomal oxidation in liver are capable of increasing the concentration of active substance in the serum (enhanced toxicity), slow rate of metabolic processes. The opposite effect is observed when treating both inducers of microsomal oxidation in the liver (rifampicin, phenytoin, carbamazepine, barbiturates). At the same time there is a decrease the effectiveness of medication. Ampholip can increase the severity of toxic effects when taking cardiac glycosides , Curariform relaxants (with a deficiency of potassium ions in the body, this effect more pronounced). The risk of hypokalemia increased in the treatment of corticosteroids, adrenocorticotropic hormone, carbonic anhydrase inhibitors. It is unacceptable simultaneous treatment with antibiotics, which is expressed nephrotoxic effects. The risk of hematologic disorders and anemia increases with radiotherapy, while taking anticancer drugs and other drugs that have a depressing effect on bone marrow hematopoiesis.