It is advisable to give a test dose and then to observe the patient carefully for about 30 minutes before starting treatment. Patients experiencing acute toxic reactions in whom treatment is essential may be given prophylactic treatment to ameliorate the reactions. To reduce the risk of vein irritation and infusion related adverse effects, the rate of intravenous infusion of conventional amphotericin B should be slow. Patients given any parenteral form of amphotericin B should be monitored for changes in renal function, liver function, serum electrolytes, and hematological status. If the Blood Urea Nitrogen or creatinine concentrations increase to clinically significant levels amphotericin B therapy should be interrupted or the dose reduced until renal function improves. Alternatively, a lipid amphotericin B preparation may be substituted. Treatment should be stopped if liver function tests are abnormal. Acute pulmonary, reactions have been noted in patients given amphotericin B during or shortly after leucocyte transfusions. Care should be taken not to confuse the dosage regimens for individual preparations, and in particular those of conventional and lipid formulations.
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