An antifungal drip (polyene)
Amphotericin
A powerful hospital antifungal drip for severe systemic fungal infections; newer forms are gentler on the kidneys.
What is Amphotericin?
Amphotericin is a powerful antifungal given by a drip into a vein in hospital to treat severe, life-threatening systemic fungal infections. The older form can be hard on the kidneys and often causes fever and chills while the drip is running, whereas the modern liposomal forms (such as AmBisome) are gentler on the kidneys and better tolerated. Because of these effects, the team closely monitors the kidneys and minerals such as potassium and magnesium throughout treatment. It is always given and monitored by specialists.
Education and reference only. This is a plain-language guide to Amphotericin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Amphotericin is a polyene antifungal used in hospital for severe, deep-seated fungal infections, such as serious candida, aspergillus and cryptococcal infections, often in people who are very unwell or have a weakened immune system. It is given as a drip into a vein. It comes in an older conventional form and in newer fat-based (liposomal and lipid) forms, such as AmBisome, which are designed to be gentler on the kidneys. It is reserved for serious infections rather than minor fungal problems.
How it works
Amphotericin attaches to a substance in the fungal cell membrane and pokes holes in it, so the contents leak out and the fungal cells die. This makes it a powerful treatment, but the same substance is also found in small amounts in human cells, especially in the kidneys, which is why the older form can harm the kidneys and disturb minerals. The modern liposomal forms wrap the medicine in tiny fat bubbles that release it more selectively at the infection, which is why they are gentler on the kidneys.
Company & origin
Originated / developed by: Generic (several manufacturers).
A powerful polyene antifungal given as a drip in hospital for severe, life-threatening fungal infections.
Practical use
How to take Amphotericin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given only as a slow drip into a vein in hospital by trained staff; it is not available as a tablet for systemic infection.
- The specialist team chooses the right form (older or modern liposomal) and sets and adjusts your treatment.
- You may be given fluids or other medicines before the drip to reduce fever, chills and kidney effects.
- Tell the staff if you get fever, chills, shivering or feel unwell while the drip is running.
- Regular blood tests check your kidneys and minerals, so attend these as arranged.
Weighing it up
Advantages & disadvantages of Amphotericin
Advantages
- A powerful and broad treatment for severe, life-threatening fungal infections.
- Modern liposomal forms (such as AmBisome) are much gentler on the kidneys than the older form.
- Works against a wide range of serious fungi, including those resistant to some other antifungals.
Disadvantages
- The older form can harm the kidneys and disturb minerals such as potassium and magnesium.
- Often causes fever, chills and shivering during the infusion, especially the older form.
- Can only be given as a drip in hospital and needs close monitoring.
Practical use
Good to know
Amphotericin is a strong, specialist hospital medicine reserved for serious fungal infections, so the team manages everything closely. The key point is that the older conventional form often causes fever, chills and shivering during the infusion and can harm the kidneys, while the modern liposomal forms (such as AmBisome) are gentler on the kidneys and better tolerated. Whichever form is used, the team monitors kidney function and minerals such as potassium and magnesium, and may give fluids or other medicines before the drip to reduce reactions. It is given alongside treatment of the underlying illness, and how long it is needed depends on the infection.
Who should not take it / use with caution
- People who have had a serious allergic reaction to amphotericin should not be given it unless there is no alternative.
- It is used with great caution, and a kidney-friendly form chosen, in people with existing kidney problems.
- In pregnancy and breastfeeding it is used only when a severe infection makes the benefit outweigh the risk.
Monitoring
- Kidney blood tests before and during treatment.
- Minerals such as potassium and magnesium, which may need replacing.
- Watching for fever and chills during the infusion and reviewing how the infection responds.
Side effects
- Fever, chills and shivering during the infusion, especially with the older form.
- Kidney effects and low potassium or magnesium, which are monitored with blood tests.
- Nausea, headache, and rarely more serious allergic or heart-rhythm effects.
Key interactions
- Combining it with other medicines that affect the kidneys can increase the risk of kidney harm.
- Low potassium it causes can increase the effects of digoxin and some other medicines, so levels are monitored.
- The specialist team reviews all your medicines and may adjust them during treatment.
Available as: A drip (infusion) into a vein, given in hospital, in older and modern liposomal forms.
Answers
Amphotericin: frequently asked questions
Why is amphotericin so closely monitored?
It is a powerful antifungal that can affect the kidneys and minerals, so the team checks your kidney function and potassium and magnesium throughout treatment.
What is the difference between the old form and AmBisome?
The older conventional form is harder on the kidneys and often causes fever and chills, while the modern liposomal forms such as AmBisome are gentler on the kidneys and better tolerated.
Why do I get fever and chills during the drip?
Reactions such as fever, chills and shivering are common with amphotericin, especially the older form; the team can give medicines beforehand to reduce them.
Will it damage my kidneys permanently?
Kidney effects are often reversible and are watched closely with blood tests; using a liposomal form and giving fluids helps protect the kidneys.
What infections is it used for?
It is reserved for severe, life-threatening systemic fungal infections, such as serious candida, aspergillus and cryptococcal infections, not minor fungal problems.
The wider class
About Antifungal (polyene)
Amphotericin belongs to the antifungal (polyene) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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