Douglas J. Rhee, MD

Side EffectsDrug Preparation Side Effectsamphotericin B 1 Soln Burning, irritationSubconj Local ischemic necrosis, subconjunctival noduleIntravitreal Chemosis, corneal clouding, possible risk of retinal toxicityIntravenous We recommend giving in consultation with infectious disease specialist or physician familiar with itsuse (consider a test dose to monitor for severe reaction). Rapid infusion can result in hypotension,hypokalemia, arrhythmias, and shock. Fever, chills, hypoten sion, and dyspnea are common.Nephrotoxicity, renal tubular acidosis, electrolyte abnormalities (hypokalemia and hypomagnesemia),anemia, headache, nausea, vomiting, malaise, weight loss, phlebitis, thrombocytopenia, mildleukopenia.fluconazole 1,2 PO GI distress, allergic rash, eosinophillia, Stevens-Johnson syndrome, transaminase elevation,thrombocytopenia. Increases concentrations of phenytoin, sulfonylureas, warfarin, and cyclosporine .flucytosine 1 Soln Burning, irritation (typically less than amphotericin)PO Marrow suppression leading to leukopenia and thrombocytopenia, rash, nausea, vomiting, severeenterocolitis, hepatotoxicity, renal toxicity, and cardiac arrest.itraconazole 2 PO Nausea, vomiting, rash, pruritus, weakness, dizziness, vertigo, pedal edema, paresthesias, impotence,loss of libido.ketoconazole 1,2 PO Nausea, anorexia, vomiting, allergic rash, pruritus, gynecomastia, decreased libido/impotence,hypertension, and fluid retention secondary to concentrations of adreno-cortical steroids, ElevatedLFTsmiconazole Soln Burning, itching, irritationSubconj: Generally well toleratednatamycin Soln: less irritating than amphotericinvorconazole Soln Burning, irritation, conjunctival injectionPO Visies changes (blurred, changes in color vision, photophobia) fever, rash, nausea, vomiting, diarrhea,elevated LFT, readache, sepsis, peripheral edena, abdeninal pain, respiration disorders.1Toxic agent with potential severe side effects—refer to product information and warnings before use. Some side effects are listed above.2Drug has potential to interact with some medications and may precipitate acute ventricular arrythmia (i.e., terfenadine, astemizole, cisapride triazolam).Antifungal Agents 35