Stability of Amphotericin B in CAPD Fluid

Amphotericin B is the drug of choice in continuous ambulatory peritoneal dialysis (CAPD) associated fungal peritonitis and is usually administered intra peritoneally. The drug is stated to be incompatible with anions. All CAPD fluids contain chloride and lactate anions. Therefore, the physical and chemical compatibility of amphotericin B with dextrose 5%, Dianeal 1.36% CAPD fluid, and Dianeal 1.36% peritoneal effluent was studied at amphotericin B concentrations of 1, 2, and 5 mg/L. Amphotericin B was most stable in Dianeal CAPD fluid. The rate of degradation was concentration dependent in dextrose 5% and peritoneal effluent. The higher the concentration, the lower the rate of degradation. After an incubation of 6 h at 37°C, no significant decomposition was found at all concentrations studied in Dianeal CAPD fluid whereas 12–18% decomposition was found in effluent. No physical incompatibility with any solution was observed.