Amphotericin-Associated Infusion-Related Reactions: A Narrative Review of Pre-Medications

Tonya Scardina*, Andrea J. Fawcett, Sameer J. Patel

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Purpose: Amphotericin B has been reported to cause infusion-related adverse effects (IRAEs). To prevent IRAEs, pre-medications may be administered prior to the administration of amphotericin B. The effects of different formulations of amphotericin B (amphotericin B deoxycholate and lipid formulations), duration of infusion, and utility of pre-medications in preventing IRAEs are reviewed. Methods: PubMed, Ovid Medline, Embase, Web of Science, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and the Scopus databases were searched with the following search terms: pre-medication, amphotericin B, and its related compounds. Upon review, a total of 39 publications were considered for inclusion. Findings: In vitro and in vivo studies have reported that amphotericin B deoxycholate stimulates pro-inflammatory cytokine genes causing IRAEs. Nonetheless, the clinical literature has reported that IRAEs occur among patients who received pre-medications. In comparison to amphotericin B deoxycholate, lipid-based formulations of amphotericin may result in a lower or similar risk for IRAEs. Implications: The routine use of pre-medications to prevent IRAEs after the administration of amphotericin B (amphotericin B deoxycholate or lipid formulations) would not be warranted.

Original languageEnglish (US)
Pages (from-to)1689-1704
Number of pages16
JournalClinical Therapeutics
Volume43
Issue number10
DOIs
StatePublished - Oct 2021

Keywords

  • adverse effects
  • amphotericin B
  • infusion-related reaction
  • pre-medication

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

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