Nebulized Amphotericin B
Please Read This Sheet with Care
This sheet tells you about the medicine that
your doctor has prescribed for you. If any of
this information concerns you, check with
your doctor, respiratory therapist, or
Use of This Medicine
Amphotericin B (am-fo-ter-i-sin) is an
antifungal medicine used to treat infections
caused by several types of fungus such as
Candida sp. or Aspergillus sp. Antifungal
medicines kill the fungus by preventing its
growth. These drugs are sometimes used to
control frequent lung infections that occur
with cystic fibrosis or after lung transplant
The supplies listed will provide treatment
for one month of amphotericin inhalation
therapy (2.5mg nebulized twice daily).
ξ Amphotericin B 50mg vial #4
ξ Sterile Water for Injection Without
Preservatives 10mL vial #4
ξ Dispensing Pins #8
ξ 3 mL syringes #60
ξ 10 mL syringes #4
ξ Sterile Water for Inhalation Unit Dose
Packets 5mL #60
How to Use
Amphotericin B comes as a powder in 50-
mg vials and must be diluted before using.
The vials should be stored in your
refrigerator before and after diluting. Sterile
water from your supplies is used to dilute
this medicine. Wipe the tops of both the
Sterile Water for Injection and the
amphotericin vial with an alcohol swab.
The medicine can be withdrawn from the
vial by using one of two methods. You may
be taught to remove the water and drug
using a needle and syringe. Be sure to
properly dispose of the needle and syringe
after use. Ask your health care provider for
information on disposal of needles and
Another way to remove fluid from the vial is
to insert a dispensing pin in the top. A
needle is not used with this method. To
follow this method:
1. Insert one dispensing pin into the sterile
water for injection vial and one
dispensing pin into the amphotericin
2. Remove the twist caps, setting them
sterile side up and not touching that side
with your fingers.
3. Then, twist on the syringe to the vial
with sterile water. Turn over the sterile
water vial and pull back on the syringe
to 10mL of sterile water and add this
fluid to the amphotericin B 50 mg vial.
4. When finished return the twist cap to the
amphotericin dispensing pin. The
dispensing pin can remain in the vial
until the vial is empty or is discarded.
5. Gently swirl the amphotericin vial to
mix. Return the amphotericin vial to the
The amphotericin mixture needs to be
further diluted before nebulizing. Sterile
Water for Inhalation unit dose packets are
used for this purpose.
1. Sterile Water for Inhalation 2.5ml (1/2
packet) is poured into the medicine
reservoir of the nebulizer.
2. Then draw up 0.5 mL (2.5mg) of
amphotericin B with a 3mL syringe and
put into the Sterile Water for Inhalation
in the nebulizer cup.
3. Gently swirl to mix. Do not use saline
(salt water) to mix with amphotericin,
because it is not compatible.
4. Put the nebulizer together and start the
5. Discard the remaining Sterile Water for
6. You have been instructed to nebulize
2.5mg (0.5ml) of amphotericin 2 times
Take slow, deep breaths while you are
inhaling the medicines into your lungs. It
takes about 10-15 minutes before the
medicine cup is empty. Remember to hold
the cup upright so that the medicine does not
spill. If the medicine sticks to the sides of
the cup, gently tap the side of the cup. A
new syringe and/or needle should be used
for every treatment. Replace the cap on the
amphotericin vial so that the solution that
remains can be used for the next treatment.
Follow the instructions from your health
care provider to nebulize. Take apart the
nebulizer and rinse the parts with hot
water after each treatment.
Place unused amphotericin vial in the
refrigerator for the next treatment. Diluted
amphotericin B can be stored in the
refrigerator for one week and then must be
thrown out. Undiluted amphotericin
(powder) should also be stored in the
refrigerator until used.
When It Should Be Used?
Amphotericin should be used on a regular
basis to control fungal lung infections.
Treatments are often scheduled twice daily.
If you are using a bronchodilator inhaler, use
it before the nebulizer treatment. Your
symptoms should improve as you keep
doing this treatment. If your infection does
not improve, or worsens, you should contact
When inhaled, this medicine may cause
some irritation to the lungs, or coughing. If
these occur, tell your doctor or respiratory
therapist right away.
Cleaning and Disinfecting the Small
All of your nebulizer parts can be cleaned
and disinfected in your dishwasher twice a
week except for the blue reservoir tubing.
The blue tubing cannot be placed in the
dishwasher. This piece needs to be cleaned
according to the “non-dishwasher”
1. Take the nebulizer apart.
2. Place the pieces in a dishwasher basket
on the top rack of the dishwasher.
3. After the dishwasher cycle is done,
remove the pieces and shake out the
4. Air-dry the nebulizer pieces on a dry
Can I Clean and Disinfect my Nebulizer
without the Dishwasher?
If you would prefer not to use the
dishwasher, follow the steps below.
1. Take the nebulizer apart and wash the
pieces in warm soapy water.
2. Rinse with hot tap water.
3. Place the nebulizer pieces in a bowl and
add enough rubbing alcohol (isopropyl
alcohol) to completely cover the
4. Soak the nebulizer for 5 minutes.
5. Rinse all of the parts of the nebulizer
with sterile water. DO NOT USE WATER
FROM THE FAUCET, BOTTLED, OR
DISTILLED WATER. You can make water
sterile by boiling it for 5 minutes. Use
this water once, and then throw it out.
6. Place the pieces on a paper towel to dry.
If you have questions or need more supplies,
contact your Home Health Equipment
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor.
This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because
each person’s health needs are different, you should talk with your doctor or others on your health care team
when using this information. If you have an emergency, please call 911. Copyright © 3/2017 University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5370