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Why does amphotericin B lead to rigors and fever?
I learned about his side effect by the moniker "shake and bake" (thank you First Aid).
Let's have a brief look at this commonly tested side-effect.
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Amphotericin B was introduced in the 1950s.
It was clear early on that fevers and chills were common side effects.
More contemporary data show lower - though still relevant - rates of both side effects.
pubmed.ncbi.nlm.nih.gov/13749466/ - 1960
pubmed.ncbi.nlm.nih.gov/10072411/ - 1999
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When thinking back to the mechanism of fever, recall that PGE₂ is a key mediator.
Amphotericin B leads to an increase in PGE₂. This is likely the mechanism of chills and fever.
As this study shows, amphotericin B acts in a similar way to LPS!
pubmed.ncbi.nlm.nih.gov/3309074/
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Given these effects, amphotericin has been examined as an "immunostimulant" in combination with antineoplastic chemotherapy.
I am unaware of its use in any current regimen.
pubmed.ncbi.nlm.nih.gov/7362372/
This is my first follow-up to a tweetorial on fevers, chills, and rigors.
Next up: meperidine (Demerol)
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