Amphotericin B-associated hypertension.
OBJECTIVE
To report two cases of hypertension related to amphotericin B infusion.


METHODS
A 63-year-old woman with Candida albicans bacteremia and an 84-year-old man with Aspergillus fumigatus pneumonia developed hypertension within minutes of amphotericin B administration. Both patients' blood pressure returned to baseline soon after the infusion of amphotericin B was stopped. Neither patient was rechallenged.


CONCLUSIONS
A causal relationship may exist between the administration of amphotericin B and these hypertensive episodes. Blood pressure in both patients normalized without treatment on discontinuation of the infusion. The mechanism of amphotericin B-associated hypertension is unclear but could include vasoconstricting properties of the drug or the administration of intravenous NaCl 0.9% prior to amphotericin B infusion. We recommend that intravenous NaCl 0.9% be administered following amphotericin B infusion and that the infusion be stopped if hypertensive episodes arise.


CONCLUSIONS
Both acute hypertension and hypotension can occur in patients receiving amphotericin B for systemic fungal infections.
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Department of Pharmacy, Veterans Administration Medical Center, Providence, RI, USA.
Rana
K Z
KZ
Dudley
M N
MN
D000368:Aged; D000666:Amphotericin B / Q000009:adverse effects*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001228:Aspergillosis / Q000188:drug therapy*; D001232:Aspergillus fumigatus; D002177:Candidiasis / Q000188:drug therapy*; D002440:Cefoxitin / Q000008:administration & dosage; D002513:Cephamycins / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D017964:Itraconazole / Q000008:administration & dosage; D008297:Male; D011014:Pneumonia / Q000188:drug therapy; D012965:Sodium Chloride / Q000494:pharmacology
D000935:Antifungal Agents; D002513:Cephamycins; D017964:Itraconazole; D012965:Sodium Chloride; D002440:Cefoxitin; D000666:Amphotericin B