Fixed Dosing Versus Weight-Based Dosing of Liposomal Amphotericin B for Morbidly Obese Persons

In a model system, a daily infusion of 300 mg was potentially safer than dosing at 3 mg/kg.

Little is known about the pharmacokinetics of liposomal amphotericin B (LAMB) in morbidly obese patients. The standard dose of 3 mg/kg is assumed to be both safe and therapeutic. To examine this specifically, Dutch investigators gave single doses of LAMB at 1 mg/kg and 2 mg/kg to 16 patients with body-mass indices (BMIs) >40 (median total body weight [TBW], 137 kg) who were awaiting bariatric surgery. Total blood concentrations of amphotericin B were determined at various time points up to 48 hours after infusion. The investigators then created a Monte Carlo pharmacokinetic simulation model and compared the effects of a fixed dose of 300 mg daily with daily infusions of 3 mg/kg.

Among the 16 patients, there was no association between TBW and…

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Fixed Dosing Versus Weight-Based Dosing of Liposomal Amphotericin B for Morbidly Obese Persons

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Reviewing Author