Salt loading provides some protection against toxicity, whereas potassium depletion and the concomitant use of such nephrotoxic drugs as cyclosporine and aminoglycosides promote nephrotoxicity. These new lipid formulations are significantly less nephrotoxic than the standard formulation, and their efficacy appears promising. At present, there is little choice among the different formulations that are licensed. The major deterrent to the use of the new preparations is cost. Many centers prefer to initiate therapy with conventional amphotericin and then switch to a lipid preparation once toxicity occurs.
Hematologic toxicity is only slightly less common than renal toxicity.
True allergic and hepatic reactions to amphotericin B probably do not occur.