Drug interactions
Amphotericin b + Flucytosine
Severity: Major
Amphotericin b and Flucytosine: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
The two antifungals are used together deliberately for cryptococcal meningitis because they act synergistically. Amphotericin-related renal impairment reduces flucytosine clearance, which can lead to accumulation and bone marrow suppression or hepatotoxicity.
What this interaction means in plain words
Amphotericin b and Flucytosine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amphotericin b belongs to Anti Fungals; Flucytosine belongs to Anti Fungals.
Why it happens
Pharmacodynamic synergy of antifungal action, plus reduced renal elimination of flucytosine when amphotericin B impairs kidney function.
What to do
Monitor renal function and complete blood counts frequently, and adjust flucytosine dose to creatinine clearance. Measure flucytosine concentrations where available.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Amphotericin b
- Amphotericin b + Cidofovir Contraindicated
- Adefovir + Amphotericin b Major
- Amikacin + Amphotericin b Major
- Amphotericin b + Arsenic trioxide Major
- Amphotericin b + Capreomycin Major
- Amphotericin b + Cephaloridine Major
Other interactions of Flucytosine
- Deferiprone + Flucytosine Major
- Flucytosine + Ifosfamide Major
- Flucytosine + Lomustine Major
- Fluconazole + Flucytosine Moderate
- Flucytosine + Ganciclovir Moderate
- Flucytosine + Hydroxycarbamide Moderate
Frequently asked questions
Can I take Amphotericin b with Flucytosine?
MediHelp rates the interaction as major. Amphotericin b and Flucytosine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. The two antifungals are used together deliberately for cryptococcal meningitis because they act synergistically. Amphotericin-related renal impairment reduces flucytosine clearance, which can lead to accumulation and bone marrow suppression or hepatotoxicity.
How serious is the interaction between Amphotericin b and Flucytosine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor renal function and complete blood counts frequently, and adjust flucytosine dose to creatinine clearance. Measure flucytosine concentrations where available.
What other medicines interact with Amphotericin b?
MediHelp also lists interactions of Amphotericin b with, for example, Cidofovir, Adefovir, Amikacin. The full list is on the Amphotericin b page.
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