Cited by 538Antifungal resistance and susceptibilityFungal Infections and StudiesAntibiotics Pharmacokinetics and Efficacy

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Liposomal Amphotericin B (AmBisome®): A Review of the Pharmacokinetics, Pharmacodynamics, Clinical Experience and Future Directions

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Stone, Neil R. H., Bicanic, Tihana, Salim, Rahuman, Hope, William·2016·Drugs

DOI 10.1007/s40265-016-0538-7PMC PMC4856207

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Abstract

Liposomal amphotericin B (AmBisome(®); LAmB) is a unique lipid formulation of amphotericin B. LAmB is a standard of care for a wide range of medically important opportunistic fungal pathogens. LAmB has a significantly improved toxicity profile compared with conventional amphotericin B deoxycholate (DAmB). Despite nearly 20 years of clinical use, the pharmacokinetics and pharmacodynamics of this agent, which differ considerably from DAmB, remain relatively poorly understood and underutilized in the clinical setting. The molecular pharmacology, preclinical and clinical pharmacokinetics, and clinical experience with LAmB for the most commonly encountered fungal pathogens are reviewed. In vitro, experimental animal models and human clinical trial data are summarized, and novel routes of administration and dosing schedules are discussed. LAmB is a formulation that results in reduced toxicity as compared with DAmB while retaining the antifungal effect of the active agent. Its long terminal half-life and retention in tissues suggest that single or intermittent dosing regimens are feasible, and these should be actively investigated in both preclinical models and in clinical trials. Significant gaps remain in knowledge of pharmacokinetics and pharmacodynamics in special populations such as neonates and children, pregnant women and obese patients.

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Authors: Stone, N. R. H., Bicanic, T., Salim, R., & Hope, W.
Affiliations: St George's, University of London (GB)
Royal Liverpool University Hospital (GB)
University of Liverpool (GB)
Corresponding author: Stone, Neil R. H.
ORCID: Stone, Neil R. H.
Bicanic, Tihana
Hope, William
Venue: Drugs
Publisher: Springer Science and Business Media LLC
Published: 2016-01-27
Volume: 76
Issue: 4
Pages: 485-500
ISSN: 0012-6667 (ISSN-L)
1179-1950
DOI: 10.1007/s40265-016-0538-7
PMC: PMC4856207
OpenAlex: W2298912458
Cited by: 537
References: 119
Citations by year: 2026: 52 · 2025: 81 · 2024: 73 · 2023: 61 · 2022: 73 · 2021: 60 · 2020: 55 · 2019: 40 · 2018: 16 · 2017: 23 · 2016: 1
FWCI: 4.10
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Drugs (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: Wellcome Trust Strategic Award (Medical Mycology and Fungal Immunology) (RG12848-10)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Infectious Diseases › Fungal Infections and Studies
Health Sciences › Medicine › Pharmacology (medical) › Antibiotics Pharmacokinetics and Efficacy
Keywords: liposomal amphotericin B, amphotericin B deoxycholate, pharmacokinetics, pharmacodynamics, antifungal agents, opportunistic fungal infection, drug toxicity, dosing regimen, intermittent dosing, neonates, pregnancy, obesity, molecular pharmacology
MeSH terms: Amphotericin B, Animals, Chemistry, Pharmaceutical, Clinical Trials as Topic, Deoxycholic Acid, Drug Combinations, Half-Life, Humans, Tissue Distribution

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Liposomal Amphotericin B (AmBisome®): A Review of the Pharmacokinetics, Pharmacodynamics, Clinical Experience and Future Directions

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