| Drugs |
Dosage |
Adverse Effects |
Remarks |
| Amphotericin B |
0.7-1.5 mg/kg/day IV OD for acute therapy (2 weeks of induction phase) |
Nephrotoxicity, fever, nausea, vomiting, hepatotoxicity, anemia, neurotoxicity, hyperkalemia |
Nephrotoxicity is related to cumulative dose |
| Flucytosine |
100 mg/kg/day PO in 4 divided doses (2 weeks of induction phase) |
Bone marrow suppression, Hepatotoxicity, GI upset, Renal and skin toxicity |
Should be avoided in children with severe renal involvement. TDM levels should be between 40-60 µg/ml. |
| Fluconazole |
10-12 mg/kg/day PO/IV BD (max: 800 mg/day) [8-10 weeks of consolidation phase]. 3-6 mg/kg/day PO (max:200 mg) [Secondary prophylaxis]. |
Skin rash, pruritis, Stevens Johnson syndrome, Hepatitis, alopecia in scalp & public area |
Inhibits P-450 cytochrome and thus adjustment with antiretroviral therapy is required. |
| Itraconazole |
2-5 mg/kg/day PO BD [Consolidation phase – 8 weeks] |
Skin rash, pruritis, Thrombocytopenia, Leukopenia, hepatitis, GI upset |
Inhibits P450 cytochrome enzyme and thus has drug interactions with antiretroviral agents. |
| Liposomal Amphotericin B |
3-5 mg/kg/day IV OD [Induction phase – 2 weeks] |
Acute infusion related reactions such as chest pain, dyspnea, hypoxia, abdominal pain, flushing and urticaria. |
Can be used instead of Amphotericin B in patients with renal insufficiency or infusion related toxicity to Amphotericin B. |
