Safety analysis of liposomal amphotericin B in adult patients: Anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia

Akari Shigemi, Kazuaki Matsumoto, Kazuro Ikawa, Keiko Yaji, Yoshihiro Shimodozono, Norifumi Morikawa, Yasuo Takeda, Katsushi Yamada

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Liposomal amphotericin B (L-AmB), which was developed to reduce side effects, has been shown to have a better safety profile than both the deoxycholate and lipid complex forms of amphotericin B; however, the frequency of major side effects is still unclear. Thus, the aim of the present study was to assess retrospectively the frequency of L-AmB-induced anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia as well as the relationship between daily dose of L-AmB and these side effects. A low red blood cell (RBC) count (post-/pre-treatment) and anaemia were observed in 7 and 10 of 21 adult patients, respectively. Thrombocytopenia was observed in 11 of 19 adult patients. Doses of L-AmB that are estimated to cause side effects of a low RBC count, anaemia and thrombocytopenia with 50% probability are 4.0, 3.3 and 3.0 mg/kg/day, respectively. Nephrotoxicity was observed in 6 of 22 patients. Variations of total bilirubin, γ-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase used as indices of hepatotoxicity were observed in 6, 7, 8 and 8 of 22 patients, respectively. Hypokalaemia was observed in 4 of 9 patients; however, nephrotoxicity, hepatotoxicity and hypokalaemia were not caused in a dose-dependent manner. In conclusion, the present analyses showed that L-AmB dose-dependently induced anaemia and thrombocytopenia in adult patients. It is important to pay attention to causing anaemia and thrombocytopenia when patients are receiving L-AmB at doses of >3.3 mg/kg/day and >3.0 mg/kg/day, respectively.

Original languageEnglish
Pages (from-to)417-420
Number of pages4
JournalInternational journal of antimicrobial agents
Volume38
Issue number5
DOIs
Publication statusPublished - 2011 Nov 1
Externally publishedYes

Keywords

  • Anaemia
  • Hepatotoxicity
  • Hypokalaemia
  • Liposomal amphotericin B
  • Nephrotoxicity
  • Thrombocytopenia

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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