Amphotericin B Lipid Complex: Uses, IV Dosing, Side Effects
Last updated September 7, 2026.
**Amphotericin B lipid complex injection (brand name Abelcet) is a polyene antifungal medicine given through a vein to treat severe, invasive fungal infections.** Amphotericin B binds to ergosterol in the fungal cell membrane, punches holes in it, and causes the fungal cell to leak and die. Packaging the drug in lipid ribbons lets a higher dose be given with less kidney injury than conventional amphotericin B deoxycholate. The most important safety point is that this drug is given only by a trained clinician in a hospital or infusion center, because infusion reactions, kidney damage, and low potassium need monitoring with blood tests and vital signs during and after each dose.
What does it treat?
Amphotericin B lipid complex is approved for invasive fungal infections in people whose infection has not responded to conventional amphotericin B or who cannot tolerate it because of kidney damage. In practice that means deep infections such as invasive aspergillosis, disseminated or severe candidiasis, cryptococcal infection including meningitis, and endemic mold and yeast infections such as blastomycosis, coccidioidomycosis, and histoplasmosis, often in people with cancer, transplants, HIV, or long stays in intensive care. Typical patterns that lead to it are persistent fever with neutropenia despite antibiotics, fungus growing in blood cultures, pneumonia with nodules on CT, or fungal elements seen on tissue biopsy. It is not used for thrush, vaginal yeast infections, or nail fungus. There are no combination products; other lipid forms such as liposomal amphotericin B (AmBisome) and plain amphotericin B deoxycholate are different products with different doses and cannot be swapped milligram for milligram.
How do you take it?
Amphotericin B lipid complex comes only as a 5 mg/mL sterile suspension in 20 mL vials, diluted in 5% dextrose and given as an intravenous infusion; there is no pill, and it is not given by mouth. The labeled adult and pediatric dose is 5 mg/kg once daily, infused at a rate of 2.5 mg/kg per hour, which makes 5 mg/kg per day the usual daily ceiling. The vial is shaken until the yellow settled layer disappears, and an inline filter is not used; it is never mixed with saline or with other drugs or electrolytes in the same line. If the infusion runs longer than two hours, the bag is shaken every two hours. Total treatment length depends on the infection and can run days to many weeks. Food and drink do not change absorption because the drug goes straight into the vein, though many people are given acetaminophen, diphenhydramine, or hydrocortisone before the infusion to blunt fever and chills. There is no self-administered missed dose; if you miss an infusion appointment, call your infusion center or treating team the same day to reschedule rather than doubling up later. Call your team before the next dose if you notice much less urine, swelling in the legs, muscle cramps, an irregular heartbeat, or worsening fever, since these can mean the dose or schedule needs to change.
Side effects to know
- Common: Most people get some infusion-related effects, especially fever, shaking chills, nausea, vomiting, and headache during or shortly after the drug runs in, and blood tests often show a rising creatinine, low potassium, low magnesium, or mild anemia.
- Serious: Stop the infusion and get help right away for anaphylaxis with hives, swelling of the lips or throat, wheezing, or a drop in blood pressure, and for chest pain, a racing or irregular heartbeat, severe shortness of breath, or seizures. Also call your team urgently for very low urine output, severe muscle weakness or cramping from low potassium, unusual bruising or bleeding, or new confusion, since these can mean kidney failure, dangerous electrolyte loss, or low platelets.
Who should not take it?
You should not receive amphotericin B lipid complex if you have had a serious allergic reaction to amphotericin B in any form, unless your specialist decides the infection is life threatening and no other option exists. Tell the team first if you have kidney disease, are on dialysis, have low potassium or magnesium, have heart rhythm problems, or are pregnant or breastfeeding. Systemic fungal infections have been treated in pregnant women with amphotericin B without reported harm to the newborn, and the FDA label notes animal reproduction studies with the lipid complex have not been done, so it is given in pregnancy when clearly needed. It is not known whether the drug passes into human milk, so your clinician will weigh continuing to nurse against the importance of treatment. Drugs that matter most are other kidney-stressing medicines such as aminoglycosides, cyclosporine, tacrolimus, and pentamidine; digoxin and corticosteroids, which become riskier when potassium falls; flucytosine, whose toxicity can rise; skeletal muscle relaxants, whose effect is exaggerated by low potassium; azole antifungals, which may work against each other with amphotericin B; and leukocyte transfusions, which have been linked to lung reactions. There is no direct alcohol interaction, but alcohol adds to dehydration, nausea, and liver strain during treatment, so skip it while you are on this drug.
When is it an emergency?
Call 911 in the US for collapse, fainting, trouble breathing, chest pain, swelling of the face or throat, or a seizure during or after an infusion, since anaphylaxis and severe infusion reactions happen with this drug. Overdose is a medical emergency: amphotericin B overdose has caused cardiac and respiratory arrest, and warning signs include a very slow, fast, or irregular pulse, severe weakness, confusion, and collapse. If a wrong dose or wrong amphotericin B product is given, stop the infusion, call 911, and call Poison Control at 1-800-222-1222 for guidance. Go to an emergency department the same day for near-total loss of urine over 12 hours, vomiting you cannot keep ahead of, black or bloody stools, or a fever above 103 F with rigors that do not settle after the infusion ends.
What a Pymander AI doctor consult looks like
Illustrative example, not a real member's messages.
Common questions
What is the maximum dose of amphotericin B lipid complex?
The labeled dose is 5 mg/kg given once a day, so 5 mg/kg per day is the usual ceiling. It is infused at a rate of 2.5 mg/kg per hour, which means a 70 kg person receives 350 mg over roughly two hours. Doses are calculated on body weight each time and are not increased beyond the label without a specialist decision. Never assume the dose carries over from another amphotericin B product: conventional amphotericin B deoxycholate is dosed around 0.25 to 1.5 mg/kg per day, so mixing the products up can cause a several-fold overdose.
Can I drink alcohol while getting this drug?
There is no listed interaction between alcohol and amphotericin B lipid complex, but drinking is still a bad idea during treatment. Alcohol dehydrates you, and dehydration is the main thing that makes the kidney effects of this drug worse. It also adds to nausea and vomiting, which are already common after infusions, and it can hide early signs of infection worsening. Skip alcohol until your treatment course is finished and your kidney tests are back to your baseline.
Is amphotericin B lipid complex safe in pregnancy or while breastfeeding?
Systemic fungal infections have been treated in pregnant women with conventional amphotericin B without reported effects on the newborn, and the FDA label states that animal reproduction studies with the lipid complex have not been conducted. It is used in pregnancy when the fungal infection is serious enough that not treating is the bigger risk, which is usually the case for the infections this drug is approved for. Tell your obstetrician and your infectious disease team you are pregnant so they can monitor kidney function and potassium closely. For breastfeeding, it is not known whether the drug appears in human milk, so your clinician will decide with you whether to keep nursing or pause during treatment.
Do I need to eat before an infusion, and can food change how it works?
Food does not affect the drug itself because it goes directly into a vein and never passes through your stomach. A light meal or snack before the infusion is still helpful because nausea and chills are common as the drug runs in. Drink fluids on infusion days unless your team has restricted them, since staying hydrated protects your kidneys. If nausea keeps you from eating or drinking for a day or more, tell your team, because dehydration is what turns mild kidney changes into serious ones.
What are the signs of an overdose or a bad reaction?
Amphotericin B overdose has caused cardiac and respiratory arrest, so the red flags are a very slow, very fast, or irregular pulse, severe weakness, confusion, fainting, and trouble breathing. A severe infusion reaction looks like hives, swelling of the lips or throat, wheezing, chest tightness, or a sudden drop in blood pressure, sometimes with violent shaking chills. If any of these happen, the infusion is stopped immediately and emergency care is started. Call 911 for collapse or breathing trouble, and call Poison Control at 1-800-222-1222 if a wrong dose or the wrong amphotericin B product was given.
Which medicines interact with amphotericin B lipid complex?
The biggest group is other drugs that stress the kidneys, including aminoglycoside antibiotics, cyclosporine, tacrolimus, and pentamidine, since the combined effect on kidney function is worse than either alone. Because this drug drives potassium down, digoxin toxicity becomes more likely, corticosteroids and corticotropin deepen the potassium loss, and skeletal muscle relaxants can have an exaggerated effect. Flucytosine toxicity may increase when the two are given together, and azole antifungals such as fluconazole and voriconazole may work against amphotericin B. Leukocyte transfusions given near an infusion have been linked to lung reactions, so they are usually separated in time. Give your team a full list of your medicines and supplements before the first dose.