{"id":270,"date":"2023-01-20T19:18:18","date_gmt":"2023-01-20T17:18:18","guid":{"rendered":"https:\/\/www.vetdrugslist.com\/?p=270"},"modified":"2025-05-17T01:45:34","modified_gmt":"2025-05-16T22:45:34","slug":"amphotericin-b-dose","status":"publish","type":"post","link":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/amphotericin-b-dose\/","title":{"rendered":"Amphotericin B"},"content":{"rendered":"<p style=\"text-align: center; font-size: 21px; font-family: sans-serif;\"><strong>Amphotericin B For Dogs, Cats and Other Animals: Uses, Dosage, and Side Effects Guide <\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-390 aligncenter\" src=\"https:\/\/www.vet-ebooks.com\/wp-content\/uploads\/2025\/01\/amphotericin-b-for-dogs-cats-and-other-animals-uses-dosage-and-side-effects-guide.jpg\" alt=\"Amphotericin B For Dogs, Cats and Other Animals: Uses, Dosage, and Side Effects Guide\" width=\"619\" height=\"372\" \/><\/p>\n\n<h2 id=\"cd-understanding\" class=\"cd-section-title\" style=\"border-bottom: 2px #fabd14 solid; font-size: 20px;\"><strong>Overview<\/strong><\/h2>\n<ul>\n<li>It binds to sterols in fungal cell membrane creating pores and allowing leakage of contents.<\/li>\n<li>50 mg\/vial powder for reconstitution.<\/li>\n<\/ul>\n<h2 id=\"cd-understanding\" class=\"cd-section-title\" style=\"border-bottom: 2px #fabd14 solid; font-size: 20px;\"><strong>Uses of Amphotericin B <\/strong><\/h2>\n<ul>\n<li><strong>Systemic fungal infections<\/strong> (e.g., Blastomycosis, Cryptococcosis, Coccidioidomycosis, Histoplasmosis).<\/li>\n<li><strong>Leishmaniasis<\/strong> (use is discouraged to prevent resistance in human treatments).<\/li>\n<li><strong>Bladder irrigation<\/strong> for fungal infections in dogs.<\/li>\n<li><strong>Intralesional treatment<\/strong> for localized infections.<\/li>\n<\/ul>\n<div class='code-block code-block-20' style='margin: 8px auto; text-align: center; display: block; clear: both;'>\n<a href=\"https:\/\/www.vet-ebooks.com\/premium-memberships\/\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-17003\" src=\"https:\/\/www.vet-ebooks.com\/wp-content\/uploads\/2024\/10\/veterinary-books-1.jpg\" width=\"480\" height=\"98\"  alt=\"Vet Books\"\/><\/a><\/div>\n\n<h2 style=\"border-bottom: 2px #fabd14 solid; font-size: 20px;\"><strong>Dose of Amphotericin B <\/strong><strong>\u00a0<\/strong><\/h2>\n<h4><strong>Dogs<\/strong><\/h4>\n<ol>\n<li><strong>Systemic Mycoses (Conventional Amphotericin):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 0.25\u20131 mg\/kg IV q48h, administered slowly over 4\u20136 hours.\n<ul>\n<li><strong>Reconstitution:<\/strong> Add 10 mL sterile water to the vial (5 mg\/mL solution); dilute 1:50 with 5% dextrose to achieve a 0.1 mg\/mL solution.<\/li>\n<li><strong>Alternative Administration:<\/strong> Dissolve 0.25\u20131 mg\/kg in 10\u201360 mL of 5% dextrose and administer over 10 minutes, 3 times weekly.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Duration:<\/strong> Several months of therapy are often necessary. Start at the lower end of the dose range and gradually increase as tolerated.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Cryptococcosis (Subcutaneous Alternative):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 0.5\u20130.8 mg\/kg added to 400\u2013500 mL of 0.45% saline\/2.5% dextrose.\n<ul>\n<li>Administer this total volume SC 2\u20133 times weekly to a cumulative dose of 8\u201326 mg\/kg.<\/li>\n<li><strong>Concentration Limit:<\/strong> Do not inject solutions more concentrated than 20 mg\/L to avoid subcutaneous abscesses.<\/li>\n<li><strong>Intralesional Treatment:<\/strong> 1 mg\/kg intralesional injection every 7 days, combined with oral itraconazole.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Bladder Irrigation (Conventional Amphotericin):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 30\u201350 mg in 50\u2013100 mL of sterile water, infused at 5\u201310 mL\/kg into the bladder daily for 5\u201315 days.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Systemic Mycoses (Lipid Formulations):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 1 mg\/kg IV q48h to a cumulative dose of 12 mg\/kg.<\/li>\n<li><strong>Higher Doses Tolerated:<\/strong> 1\u20132.5 mg\/kg IV q48h for 4 weeks or to a cumulative dose of 24\u201330 mg\/kg.<\/li>\n<li><strong>Reconstitution:<\/strong> Add sterile water (5 mg\/mL solution), dilute further to 1 mg\/mL with 5% dextrose.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Leishmaniasis (Lipid Formulations):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 1\u20132.5 mg\/kg IV twice weekly for 8 injections.<\/li>\n<li><strong>Cumulative Dose:<\/strong> At least 10 mg\/kg is required but may continue long-term depending on clinical response. Gradually increase the dose.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<hr \/>\n<h4><strong>Cats<\/strong><\/h4>\n<ol>\n<li><strong>Systemic Mycoses (Conventional Amphotericin):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 0.1\u20130.25 mg\/kg IV q48h.\n<ul>\n<li><strong>Details:<\/strong> Follow the same reconstitution and dilution procedures as for dogs.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Duration:<\/strong> Several months of therapy, depending on clinical response.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Cryptococcosis (Subcutaneous Alternative):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 0.5\u20130.8 mg\/kg added to 400\u2013500 mL of 0.45% saline\/2.5% dextrose.\n<ul>\n<li>Administer SC 2\u20133 times weekly to a cumulative dose of 10\u201315 mg\/kg.<\/li>\n<li><strong>Intralesional Treatment:<\/strong> 1 mg\/kg intralesional injection every 7 days, combined with oral itraconazole.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Systemic Mycoses (Lipid Formulations):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 1 mg\/kg IV q48h to a cumulative dose of 12 mg\/kg.<\/li>\n<li><strong>Higher Doses Tolerated:<\/strong> 1\u20132.5 mg\/kg IV q48h for 4 weeks or to a cumulative dose of 24\u201330 mg\/kg.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<hr \/>\n<h4><strong>Horses<\/strong><\/h4>\n<ol>\n<li><strong>Systemic Mycoses (Conventional Amphotericin):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> Start with 0.3 mg\/kg IV in 1 L of 5% dextrose over 1 hour.\n<ul>\n<li>Gradually increase the dose by 0.1\u20130.15 mg\/kg daily for the next 2 days.<\/li>\n<li><strong>Maintenance Dose:<\/strong> 0.5\u20130.6 mg\/kg IV every 2\u20133 days for up to 1 month or until a cumulative dose of 6.75 mg\/kg is reached.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Limb Pythiosis (Regional Limb Perfusion):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 50 mg diluted in 50 mL LRS, administered into the affected limb via IV regional limb perfusion.\n<ul>\n<li>Apply a tourniquet above the injection site and remove after 45 minutes.<\/li>\n<li>Repeat after 14 days if necessary.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Fungal Endometritis:<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 200\u2013250 mg (NOT mg\/kg) intrauterine infusion daily or every other day for 3\u20137 days.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<hr \/>\n<h4><strong>Birds<\/strong><\/h4>\n<ol>\n<li><strong>Systemic Mycoses (Conventional Amphotericin):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 1.5 mg\/kg IV q12h for 3\u20135 days.\n<ul>\n<li><strong>Alternative Routes:<\/strong> 1 mg\/kg intratracheally q12h or 0.3\u20131 mg\/mL nebulized for 15 minutes 2\u20134 times daily.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Aspergillosis (Psittacines and Raptors):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 1.5 mg\/kg IV q8h for 3 days, followed by flucytosine.\n<ul>\n<li>Intratracheal alternative: 1 mg\/kg diluted in sterile water q8\u201324h for 3 days.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Macrorhabdiasis:<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 100\u2013150 mg\/kg PO q12h for 30 days.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<hr \/>\n<h4><strong>Rabbits<\/strong><\/h4>\n<ul>\n<li><strong>Systemic Mycoses (Conventional Amphotericin):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 1 mg\/kg\/day IV.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<hr \/>\n<h4><strong>Reptiles<\/strong><\/h4>\n<ul>\n<li><strong>Fungal Respiratory Infections (Conventional Amphotericin):<\/strong>\n<ul>\n<li><strong>Dose:<\/strong> 1 mg\/kg diluted in saline, given intratracheally q24h for 14\u201328 treatments.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<div class='code-block code-block-30' style='margin: 8px 0; clear: both;'>\n <html>\n  <head>\n    <style>\n    \n \n      #calculator {\n        width: 100%;\n        margin: auto;\n      }\n      \n      @media (max-width: 600px) {\n        #calculator {\n          width: 90%;\n        }\n      }\n      \n      #calculator23 {\n        display: block;\n        margin-bottom: 8px;\n        font-size: 14px;\nfont-family: sans-serif;font-weight:600;\n      }\n      \n      #calculator24{\n        width: 100%;\n        padding: 12px 20px;\n        margin: 8px 0;\n        box-sizing: border-box;\n        border: 2px solid #ccc;\n        border-radius: 4px;\n      }\n      \n      #calculator25 {\n        width: 100%;\n    background-color: #fabd14;\n    color: white;\n    padding: 11px 18px;\n    margin: 5px 0;\n    border: none;\n    border-radius: 4px;\n    cursor: pointer;\n    font-size: 15px;\n    font-family: sans-serif;\n    font-weight: 600;\n}\n      }\n      \n      #result {\n        font-size: 18px;\n        font-weight: bold;\n      }\n    <\/style>\n  <\/head>\n  <body>\n  \n \n\n  <h2 style=\"border-bottom: 2px #fabd14 solid;font-size: 20px;\" id=\"cd-understanding\" class=\"cd-section-title\"><span><strong>Drug Dosage Calculator<\/strong><\/span><\/h2>\n    <form id=\"calculator\">\n      <label id=\"calculator23\" for=\"weight\">Animal Weight (kg):<\/label>\n      <input type=\"text\" id=\"weight\" name=\"weight\" id=\"calculator24\">\n      <label for=\"dose\" id=\"calculator23\">Drug Dose (mg\/kg):<\/label>\n      <input type=\"text\" id=\"dose\" name=\"dose\" id=\"calculator24\">\n      <label for=\"concentration\" id=\"calculator23\">Drug Concentration (mg\/mL or mg\/tablet):<\/label>\n      <input type=\"text\" id=\"concentration\" name=\"concentration\" id=\"calculator24\">\n      <button type=\"button\" onclick=\"calculate()\" id=\"calculator25\">Calculate<\/button>\n    <\/form> \n    \n    <p style=\"\n    font-size: 13px;\n    font-weight: 600;\n    font-family: sans-serif;\n    background: #444;\n    padding: 5px;\n    border-radius: 5px;\n    color: #fff;\n\">You Should Give: <span id=\"result\"><\/span><\/p>\n\n\n    \n    <script>\n      function calculateDose(weight, dose, concentration) {\n        return (weight * dose \/ concentration).toFixed(2);\n      }\n      \n      function calculate() {\n        let weight = document.getElementById(\"weight\").value;\n        let dose = document.getElementById(\"dose\").value;\n        let concentration = document.getElementById(\"concentration\").value;\n        let result = calculateDose(weight, dose, concentration);\n        document.getElementById(\"result\").innerHTML = result + \" mL or tablet \";\n      }\n    <\/script>\n  <\/body>\n<\/html>\n<\/div>\n\n<h2 id=\"cd-understanding\" class=\"cd-section-title\" style=\"border-bottom: 2px #fabd14 solid; font-size: 20px;\"><strong>Side Effects of Amphotericin B in Dogs and Cats<\/strong><\/h2>\n<ul>\n<li><strong>Common:<\/strong> Vomiting, diarrhea, pyrexia (fever), hypokalemia, phlebitis, and renal failure.<\/li>\n<li><strong>Rare:<\/strong> Hepatic failure, anaphylactic reactions, tachycardia, and arrhythmias.<\/li>\n<li><strong>Specific:<\/strong> Subcutaneous abscesses (if concentration &gt;20 mg\/L).<\/li>\n<\/ul>\n<h2 id=\"cd-understanding\" class=\"cd-section-title\" style=\"border-bottom: 2px #fabd14 solid; font-size: 20px;\"><strong>Contraindications of Amphotericin B\u00a0<\/strong><\/h2>\n<ul>\n<li>Avoid in patients with severe renal or hepatic failure.<\/li>\n<li>Use cautiously with nephrotoxic medications.<\/li>\n<\/ul>\n<h2 id=\"cd-understanding\" class=\"cd-section-title\" style=\"border-bottom: 2px #fabd14 solid; font-size: 20px;\"><strong>Some Notes:<\/strong><\/h2>\n<ul>\n<li><strong>Nephrotoxicity Management:<\/strong>\n<ul>\n<li>Administer pre- and post-infusion fluids, such as <strong>saline or lactated Ringer&#8217;s (5 mL\/kg\/hr)<\/strong>, 30 minutes before and 120 minutes after amphotericin B administration to mitigate nephrotoxicity.<\/li>\n<li>Ensure IV lines are thoroughly flushed with <strong>5% dextrose water<\/strong> before and after amphotericin B administration.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Gradual Dose Adjustment:<\/strong>\n<ul>\n<li>Start with the <strong>lowest recommended dose<\/strong> and increase gradually based on the patient&#8217;s tolerance to minimize adverse effects.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Monitoring Requirements:<\/strong>\n<ul>\n<li>Conduct regular renal function tests (serum creatinine, BUN) and monitor electrolytes (potassium, magnesium). Discontinue treatment if <strong>BUN &gt; 30\u201340 mg\/dL<\/strong> or <strong>serum creatinine &gt; 3 mg\/dL<\/strong>.<\/li>\n<li>Assess for infusion-related reactions, including phlebitis, tachycardia, and hypotension.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Drug Interactions:<\/strong>\n<ul>\n<li>Avoid co-administration with <strong>nephrotoxic drugs<\/strong> (e.g., aminoglycosides, NSAIDs, cisplatin) to prevent compounded renal damage.<\/li>\n<li>Use caution with <strong>potassium-depleting drugs<\/strong> (e.g., loop or thiazide diuretics), as they may exacerbate amphotericin B-induced hypokalemia.<\/li>\n<li>Monitor closely for <strong>digoxin toxicity<\/strong> when co-administered, as hypokalemia can increase its risk.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Pre-Treatment for Side Effects:<\/strong>\n<ul>\n<li>Use <strong>aspirin, diphenhydramine<\/strong>, or an antiemetic to reduce fever, vomiting, and infusion-related adverse effects.<\/li>\n<li>Opt for <strong>slow infusion rates<\/strong> or lipid formulations to lower nephrotoxicity risk.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Compatibility Notes:<\/strong>\n<ul>\n<li>Do not mix amphotericin B with <strong>sodium chloride<\/strong> or electrolyte-containing solutions to avoid precipitation.<\/li>\n<li>Always use <strong>5% dextrose water<\/strong> for dilution and administration. Lipid formulations are also incompatible with saline solutions.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Special Precautions:<\/strong>\n<ul>\n<li>Amphotericin B should be used cautiously in patients with pre-existing <strong>renal or hepatic disease<\/strong>, and only when necessary in <strong>pregnant or nursing animals<\/strong>.<\/li>\n<li>Regular weight monitoring and hydration checks are essential in <strong>exotic species<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Resistance Considerations:<\/strong>\n<ul>\n<li>Avoid amphotericin B for <strong>leishmaniasis in dogs<\/strong>, as it may contribute to resistance in human treatment protocols, per <strong>WHO recommendations<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Long-Term Therapy:<\/strong>\n<ul>\n<li>Therapy duration for systemic fungal infections may extend over several months. Adjust cumulative doses based on clinical response and toxicity thresholds.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Storage Guidelines:<\/strong>\n<ul>\n<li>Store conventional amphotericin B powder at <strong>2\u00b0C\u20138\u00b0C (36\u00b0F\u201346\u00b0F)<\/strong>, protected from light and moisture. Use reconstituted solutions within <strong>7 days<\/strong>.<\/li>\n<li>Follow specific storage and stability recommendations for lipid formulations per the manufacturer\u2019s guidelines.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Exotics and Amphotericin B:<\/strong>\n<ul>\n<li>In <strong>birds<\/strong>, amphotericin B shows reduced nephrotoxicity but may cause myelosuppression. Intratracheal and nebulized routes are common for respiratory infections.<\/li>\n<li><strong>Reptiles<\/strong> tolerate intratracheal doses well; sterile preparation is critical for these routes.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Amphotericin B For Dogs, Cats and Other Animals: Uses, Dosage, and Side Effects Guide Overview It binds to sterols in fungal cell membrane creating pores and allowing leakage of contents. 50 mg\/vial powder for reconstitution. Uses of Amphotericin B Systemic fungal infections (e.g., Blastomycosis, Cryptococcosis, Coccidioidomycosis, Histoplasmosis). Leishmaniasis (use is discouraged to prevent resistance in [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1052,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[37,6],"tags":[],"class_list":["post-270","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-antifungal","category-antimicrobials"],"_links":{"self":[{"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/posts\/270","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/comments?post=270"}],"version-history":[{"count":0,"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/posts\/270\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/media\/1052"}],"wp:attachment":[{"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/media?parent=270"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/categories?post=270"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.vet-ebooks.com\/vetdrugslist\/wp-json\/wp\/v2\/tags?post=270"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}