Oral amphotericin B (Fungilin) has been approved in most European countries for decades. It's used as a treatment and prophylaxis for a variety of oral and GI fungal infections, including oral thrush. In the United States, only an intravenous (IV) form of amphotericin B is available. The Health Group can help you import the low-dose oral form (in either a liquid or lozenge form) from England.
In the US, fluconazole (Diflucan) and ketaconazole (Nizoral) are the most common antifungal medications. While they are usually highly effective, we have had many requests from physicians for oral ampho B because some PWAs develop resistant strains of thrush (candida) that no longer respond to either of these drugs. The resistant strains can become very nasty--causing mouth pain and extreme difficulty in eating. Amphotericin B, in its IV form is standard therapy for a very serious brain infection called cryptococcal meningitits. Oral ampho cannot be used for cryptococcal meningitis. The oral form does not get absorbed into the body and cannot help fungal infections outside the GI tract. Oral amphotericin B should NOT be used as an alternative for non-GI tract disease.
Although the IV form of ampho B has long been dubbed ampho-terrible by PWAs due to its extreme side effects, the oral form is not toxic. No side effects have been noted at dosages under 3000 mg/day. Taking over 3000 mg/day can cause occasional stomach or intestinal discomfort, including diarrhea.
The standard dose to treat symptoms is 400 mg/day, which may be raised if necessary. If you're taking oral ampho B for oral thrush, continue taking it for 2-3 days after your symptoms disappear. If you're taking it for GI infection, keep taking it for 2-3 weeks after your symptoms disappear.
The standard therapy is 1 ml four times a day. One ml equals 100 mg. Each bottle has its own pipette, squirt it into your mouth and swish it around well. Coat the insides of your mouth and then swallow it. Swish four times a day. If you cannot swallow, oral ampho B can be administered through a nasal-gastric tube before eating.
Each lozenge is 100 mg. Take one tablet four times a day after eating, for two weeks. The dosage can be raised and/or taken for longer as necessary.
We import Fungilin brand oral ampho B made by Squibb in England. The liquid form comes in 12 ml bottles, at a concentration of 100 mg/ml. At the recommended dose, one bottle is a 3 day supply. The lozenges come in a box of 56 tablets of 100 mg each for a thirteen and 1/2 day supply.