Amphotericin B CAS No. 1397-89-3

Product Description

Amphotericin B (AmB) is a broad-spectrum, polyene antifungal that remains the gold-standard therapy for life-threatening systemic mycoses such as disseminated histoplasmosis, cryptococcal meningitis, aspergillosis and mucormycosis. By binding fungal membrane ergosterol it forms pores that rapidly kill Candida, Aspergillus, Cryptococcus, Histoplasma, Blastomyces, Coccidioides and Mucorales, and it is also used for visceral leishmaniasis and empirical coverage in febrile neutropenia. Two decades of formulation refinements have produced the conventional deoxycholate preparation (D-AmB) that is inexpensive but carries 60 % nephrotoxicity and a 23 % in-hospital mortality in severe histoplasmosis, versus lipid-based alternatives—liposomal AmB (L-AmB), ABLC and ABCD—that retain antifungal potency while markedly reducing renal and infusion-related adverse events. Recent findings, however, complicate its bedside use: cell-culture studies reveal that clinically achievable concentrations of AmB (and the related polyene nystatin) can enhance SARS-CoV-2 entry by up to 100-fold, apparently by antagonising the antiviral restriction factor IFITM3. Consequently, in COVID-19 patients with concurrent invasive pulmonary mucormycosis or CAPA, clinicians must balance AmB’s lifesaving antifungal activity against a potential pro-viral effect, and consider lipid formulations or alternative antifungals whenever feasible.

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Product Use & Characteristics

Chemical Identity

• Molecular Formula: C₄₇H₇₃NO₁₇

• Molecular Weight: 924.1 g/mol

• IUPAC Name:
  [(1R,3S,5R,6R,9R,11R,15S,16R,17R,18S,19E,21E,23E,25E,27E,29E,31E,33R,35S,36R,37S)-33-[(2R,3S,4S,5S,6R)-4-amino-3,5-dihydroxy-6-methyloxan-2-yl]oxy-1,3,5,6,9,11,17,37-octahydroxy-15,16,18-trimethyl-13-oxo-14,39-dioxabicyclo[33.3.1]nonatriaconta-19,21,23,25,27,29,31-heptaene-36-carboxylic acid]

Mechanism of Action

• Polyene antifungal that binds ergosterol in fungal cell membranes → forms trans-membrane pores → membrane disruption & cell death.

Spectrum of Activity (Broad)

Pathogen Group	Examples
Yeasts	Candida spp. (incl. C. albicans, C. glabrata), Cryptococcus neoformans
Molds	Aspergillus spp., Mucor spp. (zygomycetes)
Dimorphic fungi	Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis
Protozoa	Leishmania spp. (visceral leishmaniasis)

Formulations & Toxicity Profile

Formulation	Key Features	Toxicity	Cost
D-AmB (Deoxycholate)	Conventional	High nephrotoxicity, infusion reactions	Low
L-AmB (Liposomal, AmBisome)	Lipid encapsulation	Reduced nephrotoxicity	High
ABLC (Lipid Complex, Abelcet)	Lipid complex	Moderate infusion reactions vs. L-AmB	Mid-range
ABCD (Colloidal Dispersion)	Rarely used	High infusion reactions	Discontinued (2011)

Clinical Uses

• Invasive fungal infections

  • Candida bloodstream infections

  • Aspergillus pneumonia

  • Cryptococcal meningitis

• Empirical therapy in febrile neutropenia (unresponsive to antibiotics)

• Mucormycosis (adjunct to surgery)

• Visceral leishmaniasis (in endemic regions)

Adverse Effects & Risk Factors

Adverse Effect	Incidence (D-AmB)	Risk Factors
Nephrotoxicity	~60%	D-AmB, ICU stay, prolonged therapy
Infusion Reactions	20–35% (ABLC), ↓ with L-AmB	Neutropenia, rapid infusion, no premedication
Anemia	90% (severe cases)	Prolonged D-AmB use
Hypokalemia	55%	Renal losses
Mortality	23% (histoplasmosis cohort)	D-AmB use (OR 4.93), ICU admission (OR 9.46)

COVID-19 Considerations

• Potential SARS-CoV-2 enhancement (up to 100-fold in vitro) via IFITM3 pathway inhibition → increased viral entry.

• Implication: Avoid AmB in active COVID-19 with mucormycosis unless no alternatives; consider L-AmB if required.

Formulation Optimization

• Protein-mediated stabilization (e.g., hydrophobins, BSA) enhances AmB solubility → 4–32× dose reduction in vitro while maintaining efficacy.

• Lipid formulations (L-AmB, ABLC) reduce toxicity but remain cost-prohibitive in low-resource settings.

Practical Recommendations

• Premedication (antihistamines + corticosteroids) reduces infusion reactions (especially for ABLC).

• Hydration (saline) & slow infusion (≥2h) mitigate nephrotoxicity.

• L-AmB preferred in neutropenic/oncohematology patients.

Why us!

Qingdao Sigma Chemical Co., Ltd., established in January 2017 and headquartered in Qingdao, China, is a reliable chemical supplier. Specializing in pharmaceuticals, biochemical intermediates, and research chemicals, the company offers a diverse product portfolio, including peptides (e.g., Tirzepatide, Semaglutide), nootropics, veterinary products, and APIs, often marketed with ≥99% purity and COA certification. We provides R&D, custom synthesis, and contract manufacturing services at various scales, while claiming a global export presence across 100+ countries. With international warehouses in the USA, Europe, Australia, and Canada, Qingdao Sigma Chemical also facilitates drop-shipping and reshipments, positioning itself as a key supplier for laboratory and research applications.