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Medicine (MD/DO)
Amphotericin B Side Effects & Toxicity

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Amphotericin B Side Effects & Toxicity

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Amphotericin B Side Effects & Toxicity

Amphibian-terminator (B) Bee with Toxic-green-glow
Amphotericin B is a polyene medication, which works by binding to ergosterol in fungal cell membranes. It forms membrane pores, causing electrolytes to leak, killing the fungal cell. It is used for serious, systemic mycoses. It can lead to the side effects of fever and chills, nephrotoxicity, hypotension, arrhythmias, anemia and IV phlebitis.
Fever/Chills "Shake and Bake"
Fever-beaver with Ice-cube and "Shake n' Bake"

Amphotericin B can acutely lead to high fever and shaking chills, which led to the "shake and bake" terminology.

Kidney with Toxic-green-glow

IV Amphotericin B administration has been linked to nephrotoxicity, which can be very severe, and is sometimes irreversible.

Milder with Liposomes
Lips-liposome removing Toxic-green-glow

The nephrotoxic symptoms seen with amphotericin B administration can be milder when the drug is co-administered with liposomes.


Patients who are initially given this drug may become hypotensive. This can subside with later application of the drug, which points to the idea that the hypotension occurs because of histamine release.


Several forms of anemia can occur, along with other blood dyscrasias. Patients can display hemolysis, along with leukopenia and thrombocytopenia.

IV Phlebitis
IV Flamingo

Acute reactions to injection can occur, and patients have been noted to display IV phlebitis.

Broken Arrhythmia-drum

Another side effect of using this medication is the development of arrhythmia. Due to renal tubular damage, potassium and magnesium levels can be altered. These should be closely monitored, as patients can develop serious arrhythmias, including ventricular fibrillation and cardiac failure.


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