What is Fungizone used for?

• Severe potentially life-threatening fungal infections affecting the body as a whole (systemic infection), for example cryptococcosis, North American blastomycosis, invasive candidiasis, coccidioidomycosis and histoplasmosis, mucormycosis, aspergillosis.
• Protozoal infection called American mucocutaneous leishmaniasis.

How does Fungizone work?

• Fungizone infusion contains the active ingredient amphotericin, which is a type of medicine called an antifungal. It is used to treat infections caused by fungi and yeasts.
• Amphotericin kills fungi and yeasts by interfering with their cell membranes. It works by binding to a substance called ergosterol, which is an essential component of fungal cell membranes. This disrupts the fungal cell membrane, causing holes to appear in it.
• The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. As amphotericin causes holes to appear in the cell membranes, essential constituents of the fungal cells can leak out. This kills the fungi and treats the infection.

How is Fungizone given?

• Fungizone infusion is given via a drip into a vein (intravenous infusion) over two to four hours.
• The number of infusions given and the length of treatment will depend on the severity of the infection and how well it responds to the treatment.
• Fungizone solution may also be made into a bladder irrigation to treat candidal infections of the bladder, or lung inhalations to treat aspergillosis affecting the lungs. It may also be given by injection into the spinal column (intrathecal injection) to treat coccidiodal meningitis. The solution has also been used to bathe the ear, eye, peritoneum, lung cavities and joint spaces to treat fungal infections in these areas.

Fungizone should be used with caution in

• People with decreased kidney function.
• People with decreased liver function.

Pregnancy and breastfeeding

• This medicine is not known to be harmful when used during pregnancy. However, the manufacturer states that it should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the developing baby. For life-threatening disease, the benefit of treatment is likely to outweigh any risks. Seek further medical advice from your doctor.
• It is not known if this medicine passes into breast milk. However, due to the properties of the medicine only low levels would be anticipated in milk. If the medicine does pass into breast milk, it is unlikely to be absorbed into the baby's bloodstream as it is not absorbed when taken by mouth. Seek further medical advice from your doctor.

Possible side effects of Fungizone

• Low blood pressure (hypotension).
• Nausea and vomiting.
• Shivering.
• Fever (high temperature).
• Low blood potassium level (hypokalaemia).
• Shortness of breath (dyspnoea).
• Elevated level of creatinine (a marker of kidney function) in the blood.
• Abnormal kidney function.
• Decreased numbers of red blood cells in the blood (anaemia).
• Abnormal liver function.
• Low blood magnesium levels (hypomagnesemia).
• Rash.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can Fungizone affect other medicines?

There may be an increased risk of side effects on the kidneys if this medicine is used in combination with other medicines that can have side effects on the kidneys. Some of these are listed below and they should be avoided if at all possible. People receiving treatment with any of these in combination with amphotericin should have their kidney function regularly monitored:

• aminoglycoside antibiotics, eg gentamicin
• ciclosporin
• pentamidine
• polymixin
• tacrolimus
• vancomycin
• zidovudine

There may be an increased risk of a drop in the amount of potassium in the blood (hypokalaemia) if this medicine is used in combination with any of the following:

• corticosteroids, eg hydrocortisone, fludrocortisone, prednisolone, dexamethasone
• corticotropin (ACTH)
• diuretics, eg bendroflumethiazide, furosemide.

If hypokalaemia occurs due to amphotericin treatment, this may increase the risk of side effects from digoxin.

Amphotericin may increase the blood level of flucytosine, which could increase the risk of its side effects.

Amphotericin may be less effective at treating infection if it is used in combination with azole-type antifungals such as ketoconazole, itraconazole or miconazole.

References:

https://www.medicines.org.uk/emc/product/10716/smpc

https://www.hpra.ie/img/uploaded/swedocuments/551887af-84d4-42cd-8a97-3adc7428f8f1.pdf

https://www.netdoctor.co.uk/medicines/infection/a6780/fungizone-amphotericin/

https://www.rxlist.com/fungizone-drug.htm

https://www.drugs.com/mtm/fungizone.html

https://www.webmd.com/drugs/2/drug-6038/fungizone-injection/details