-
Views
-
Cite
Cite
Romuald Bellmann, Petra Egger, Christian J. Wiedermann, Differences in Pharmacokinetics of Amphotericin B Lipid Formulations Despite Clinical Equivalence, Clinical Infectious Diseases, Volume 36, Issue 11, 1 June 2003, Pages 1500–1501, https://doi.org/10.1086/374876
Close - Share Icon Share
Extract
SIR—Because of their lower toxicity, lipid formulations of amphotericin B (AmB) are frequently administered to critically ill patients who require treatment of suspected or proven systemic mycosis. Three lipid formulations that are used in clinical practice—liposomal AmB (AmBisome; NeXstar Pharmaceuticals), AmB colloidal dispersion (Amphotec; Sequus Pharmaceuticals) and AmB lipid complex (Abelcet; The Liposome Company)—appear to have impressive differences in their pharmacokinetics. For example, the volume of distribution for AmB lipid complex is reported to exceed that for liposomal AmB by a factor of 1000 [1]. The differences have been observed in numerous studies investigating time-concentration profiles of lipid formulations of AmB and have been ascribed to the different particle sizes and shapes of the 3 lipid formulations [2–6]. In contrast to these findings, the clinical efficacy of the 3 formulations has turned out to be approximately identical [7–17]. Thus, none of the 3 drugs is preferred in a recent Infectious Diseases Society of America guideline [18]. The striking contradiction between clinical equivalence and pharmacokinetic diversity has stimulated an engaged discussion in a previous issue of this journal [1, 19, 20].
