Sporanox vs. Ambisome for Fungal Infection: Important Differences and Potential Risks.

Key takeaways

Itraconazole (Sporanox, Tolsura) and Ambisome (amphotericin B liposome) are both antifungal medications, but they have some key differences. Both are availible in brand and generic forms. Itraconazole is taken orally while Ambisome is given through an IV. Itraconazole is used to treat severe fungal infections and fungal nail infections, whereas Ambisome is used for severe fungal infections in people with low white blood cell counts, cryptococcal meningitis in people with HIV, black fever, and when other antifungals do not work. Itraconazole must be taken with food, can interact with many medications, and can increase the risk of serious heart-related side effects. On the other hand, Ambisome is typically administered in a hospital or by a healthcare professional at home and can cause kidney and liver damage, as well as low magnesium and potassium levels. Both medications can cause serious side effects, but Ambisome is known for causing more immediate infusion-related reactions like chills and nausea.

Itraconazole

(Sporanox)

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Ambisome

(amphotericin B liposome)

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Summary for Sporanox

Prescription only

Itraconazole (Sporanox) capsule is used to treat various fungal infections. You might have to take it for several weeks or months. It interacts with many medications, which can lead to serious heart-related side effects.

Indications for Sporanox

Severe fungal infections in people with weakened or healthy immune systems - itraconazole (Tolsura) and itraconazole (Sporanox) capsule:

Blastomycosis
Histoplasmosis
Aspergillosis in people in which amphotericin b (Ambisome) hasn't worked or isn't tolerated

Fungal toenail and fingernail infections (onychomycosis) for people with healthy immune systems - itraconazole (Sporanox) capsule only

Pros and Cons for Sporanox

Pros

Works to treat some serious and life-threatening fungal infections
Available as a lower-cost generic
Can be taken once a day for most conditions

Cons

Can raise your risk for serious heart problems, including heart failure
Must be taken for several weeks to months
Interacts with many medications

Common Side Effects for Sporanox

Nausea (11%)
Rash (3-9%)
Vomiting (5%)
Swelling in the arms and legs (4%)
Headache (1-4%)

Warnings for Sporanox

Congestive heart failure (CHF)
Abnormal heart rhythm (QT prolongation)
Liver damage
Interactions with other medications
Hearing loss
Vision problems
Nerve damage (peripheral neuropathy)

Summary for Ambisome

Prescription only

Ambisome (amphotericin B liposome) is effective at treating many severe and deadly fungal infections, but it has many side effects.

Indications for Ambisome

Fungal infections in people with a fever and a low number of white blood cells
Cryptococcal meningitis in people with HIV
People with severe fungal infections caused by Aspergillus, Candida, or Cryptococcus who have already tried other antifungals or cannot take other antifungals
Black fever (visceral leishmaniasis)

Pros and Cons for Ambisome

Pros

Treats life-threatening infections
Works when other antifungals fail
Not as hard on your kidneys as Abelcet (amphotericin B lipid complex)
Has been used safely in children as young as 1 year old

Cons

Must be given through an IV line over 1 to 2 hours
Must be given in a hospital or by a trained home healthcare professional
Can be given for several weeks for more severe infections
Many side effects
Blood tests required

Common Side Effects for Ambisome

Chance of experiencing side effects from Ambisome (amphotericin B liposome) varies depending on the dose that's being given.

Chills (40-48%)
Low potassium (38-43%)
Nausea (26-40%)
Rash (24-25%)
Vomiting (22-32%)
Diarrhea (15-30%)
Trouble breathing (18-23%)
Changes to liver blood tests (7-22%)
Changes to kidney blood tests (20-22%)
Stomach pain (13-20%)
Fever, chills, hives, and itching while Ambisome (amphotericin B liposome) is being infused or shortly after (11-19%)
Swelling (13-14%)