4.6 Review

The reformulation of Amphotericin B for oral administration to treat systemic fungal infections and visceral leishmaniasis

Journal

EXPERT OPINION ON DRUG DELIVERY
Volume 6, Issue 3, Pages 271-284

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1517/17425240902802861

Keywords

amphotericin B; antifungal; leishmaniasis; oral formulation

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Amphotericin B (AmB) is a parenterally administered broad-spectrum antifungal and leishmanicidal drug that has been on the market for over sixty years. Unfortunately, significant infusion-related side effects and renal toxicity often accompany treatment, limiting its clinical applications. Lipid-based formulations have somewhat ameliorated the associated toxicity, but the increased cost of formulations restricts widespread use. AmB is amphipathic and exhibits low solubility and permeability, resulting in negligible absorption when administered orally. Advances in drug delivery systems have overcome some of the solubility issues that prevent oral bioavailability and new formulations are currently in development. The existence of an effective, safe and inexpensive oral formulation of amphotericin B would have significant applications for the treatment of disseminated fungal infections and would dramatically expand access to treatment of visceral leishmaniasis by introducing a readily available highly tolerated oral formulation of a drug with known efficacy.

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