Tericin Injection
Amphotericin B (Liposomal)
50mg/vial
Beacon Pharmaceuticals Ltd.
| Pack size | 1's pack |
|---|---|
| Unite Price | 15045.10 BDT |
Indications
Tericin Injection is used for:
Systemic fungal infections, Visceral leishmaniasis, Cryptococcal meningitis
Adult Dose
Adult:
Intravenous
Systemic fungal infections
Indicated for treatment of Aspergillus species, Candida species, and/or Cryptococcus species infections
As liposomal amphotericin B:
Test dose 1 mg infused over 10 minutes, then 3 mg/kg once daily given via infusion over 30-60 minutes.
Max: 5 mg/kg daily.
Duration of treatment: At least 14 days.
Cryptococcal Meningitis
Indicated for treatment of Cryptococcal meningitis in HIV-infected patients
6 mg/kg IV qDay
Visceral Leishmaniasis
Indicated for treatment of visceral leishmaniasis
Immunocompetent patients
3 mg/kg IV qDay on days 1-5, 14, and 21
May repeat course of therapy if parasitic clearance not achieved
Immunocompromised patients
4 mg/kg IV qDay on days 1-5, 10, 17, 24, 31, and 38
Child Dose
Systemic Fungal Infections
Test dose: 0.1 mg/kg IV, not to exceed 1 mg; administer over 20-60 min
Initial dose: 0.25 mg/kg/dose IV qDay/qOD
Maintenance: Increase by 0.25 mg/day increments as tolerated to 1-1.5 mg/kg/day
Renal Dose
Renal Impairment
CrCl <10 mL/min: 0.5-0.7 mg/kg IV q24-48hr
Consider other antifungal agents that may be less nephrotoxic
Intermittent hemodialysis: 0.5-1 mg/kg IV q24hr after dialysis session
Continuous renal replacement therapy: 0.5-1 mg/kg IV q24hr
Administration
IV Preparation
Reconstitute by adding 12 mL sterile water for injection to 50 mg-vial (resulting concentration 4 mg/mL); do not use fluids containing NaCl or bacteriostatic agent
Do not admix with other drugs or electrolytes
Shake vial vigorously for 30 seconds
Dilute further by withdrawing appropriate amount of reconstituted solution and adding to D5W to provide a final concentration of 1-2 mg/mL; lower concentrations (0.2-0.5 mg/mL) may be appropriate for infants and small children
IV Administration
May be infused through in-line filter provided pore diameter >1 micron
May be administered through existing IV line; if doing so, flush line with D5W prior to infusion, otherwise use separate line
Infuse over at least 2 hr using controlled infusion device; if well tolerated, infusion time may be reduced to 1 hr
Infusion time may need to be increase if discomfort during infusion occurs
Withdraw dosage amount into a syringe and inject through a 5-micron filter into appropriate amount of D5W
Use a controlled infusion device and an inline filter (with a mean pore diameter >1 micron)
Contra Indications
Hypersensitivity; lactation; do not give to patients receiving antineoplastics.
Precautions
Renal and hepatic impairment; pregnancy; monitor renal and liver function changes.
Lactation: Excretion in milk is unknown; due to the potential for serious adverse reactions in breast-fed infants, a decision should be made whether to discontinue nursing or whether to discontinue the drug, taking into account the importance of the drug to the mother
Pregnancy-Lactation
Pregnancy Category: B
Lactation: Excretion in milk is unknown; due to the potential for serious adverse reactions in breast-fed infants, a decision should be made whether to discontinue nursing or whether to discontinue the drug, taking into account the importance of the drug to the mother
Interactions
Increased toxicity with flucytosine. Drug induced renal toxicity enhanced in presence of other nephrotoxic medications. Antagonises effects of azole antifungals.
Potentially Fatal: Potentiates K loss by corticosteroids. Avoid diuretics. Enhances digitalis toxicity and neuromuscular blocker effects.
Side Effects
Side effects of Amphotericin B (Liposomal) :
>10%
Anorexia, Chills, Diarrhea, Fever, Headache, Hypokalemia, Hypomagnesemia, Hypotension, Malaise, Nausea, Pain (generalized), Pain at injection site, Renal function abnormalities, Tachypnea, Vomiting
1-10%
Arachnoiditis, Delerium, Flushing, Hypertension, Leukocytosis, Lumbar nerve pain, Paresthesia, Urinary retention
<1%
Agranulocytosis, Anuria, Bone marrow suppression, Cardiac arrest, Coagulation defects, Convulsions, Dyspnea, Hearing loss, Leukopenia, Maculopapular rash, Renal failure, Thrombocytopenia, Vision changes
Potentially Fatal: Anaphylactic reaction; leucoencephalopathy. Overdosage can result in cardio-respiratory arrest.
Mode of Action
Amphotericin B is a polyene antifungal antibiotic which alters cell membrane permeability by binding to ergosterol, thus causing leakage of cell components and subsequent cell death. It is active against Absidia spp, Aspergillus spp, Basidiobolus spp, B. dermatitidis, Candida spp, C. immitis, Conidobolus spp, C. neoformans, H. capsulatum, Mucor spp, P. brasiliensis, Rhizopus spp, Rodotorula spp. and S. schenckii.
Note
Tericin 50mg/vial Injection generic name is Amphotericin B (Liposomal). Tericin 50mg/vial Injection is manufactured by Beacon Pharmaceuticals Ltd.Tericin is availble in all over Bangladesh.
Mes BD drug index information on Tericin Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.