No formal clinical studies of drug interactions have been conducted with AmBisome. However, the following drugs are known to interact
with amphotericin B and may interact with AmBisome:
Antineoplastic agents: Concurrent use of antineoplastic agents may enhance the potential for renal toxicity, bronchospasm, and hypotension. Antineoplastic
agents should be given concomitantly with caution.
Corticosteroids and corticotropin (ACTH): Concurrent use of corticosteroids and ACTH may potentiate hypokalemia which could predispose the patient to
cardiac dysfunction. If used concomitantly, serum electrolytes and cardiac function should be closely monitored.
Digitalis glycosides: Concurrent use may induce hypokalemia and may potentiate digitalis toxicity. When administered concomitantly, serum potassium levels
should be closely monitored.
Flucytosine: Concurrent use of flucytosine may increase the toxicity of flucytosine by possibly increasing its cellular uptake and/or impairing its
renal excretion.
Azoles (e.g. ketoconazole, miconazole, clotrimazole, fluconazole, etc.): In vitro and in vivo animal studies of the combination of amphotericin B and
imidazoles suggest that imidazoles may induce fungal resistance to amphotericin B. Combination therapy should be administered with caution, especially in
immunocompromised patients.
Leukocyte transfusions: Acute pulmonary toxicity has been reported in patients simultaneously receiving intravenous amphotericin B and leukocyte transfusions.
Other nephrotoxic medications: Concurrent use of amphotericin B and other nephrotoxic medications may enhance the potential for drug-induced renal toxicity.
Intensive monitoring of renal function is recommended in patients requiring any combination of nephrotoxic medications.
Skeletal muscle relaxants: Amphotericin B-induced hypokalemia may enhance the curariform effect of skeletal muscle relaxants (e.g. tubocurarine) due to
hypokalemia. When administered concomitantly, serum potassium levels should be closely monitored.
|