Amphotericin B: Why is this drug important in Black Fungus treatment, what are its common side effects, Zee explains

NEW DELHI: With several states reporting an alarming rise in cases of black fungus or mucormycosis- a rare fungal infection – the demand for Amphotericin drug which is used for treating the disease has risen in recent times.

Why is Amphotericin B important?

Amphotericin B, a rare drug that is being produced in a limited quantity in the country, is used in the treatment of black fungus or mucormycosis. It is not used for treating a minor fungal infection such as a yeast infection of the mouth, esophagus, or vagina. The drug is currently in a short supply and the Centre is taking adequate steps to ramp up its production and its availability to states where there is high demand for the drug.

Mucormycosis of black fungus primarily affects people recovering from COVID-19 and has been steadily rising across the country. Several states, including Telangana, Odisha, Karnataka, Tamil Nadu, Rajasthan, Gujarat, and Haryana, have already declared black fungus an epidemic.

The treatment of this fungal infection requires a multidisciplinary approach consisting of eye surgeons, ENT specialists, general surgeons, neurosurgeons, and dental maxillo-facial surgeons, among others, and institution of Amphotericin-B injection as an antifungal medicine.

How does it work?

This rare drug is used to treat a variety of serious, fatal fungal infections. It helps in stopping the growth of fungi.

How this drug is administered?

This drug is normally injected into the vein. Usually, a single dose of the drug is given to a patient daily, depending on his medical condition or as directed by his doctor. The injection is administered very slowly - over 2 to 5 hours. The dosage depends on a patient’s medical condition, weight, response to the test dose, and the therapy. 

In some cases, the drug is given to a patient for several days, weeks to several months in order to treat certain infections. 

What are the known side effects of this drug?

Fever, shivering, loss of appetite, dizziness, nausea, vomiting, headache, shortness of breath, or fast breathing are some of the common side effects of this drug. A patient must consult his doctor if he notices any serious side effects of this drug like swelling/pain at the injection site, muscle/joint pain, unusual tiredness, weakness, muscle cramping, signs of kidney problems, painful urination, numbness/tingling of arms/legs, vision changes, hearing changes, black stool, vomiting etc.

What is the Centre doing to scale up its production?

The Drug Controller General of India (DCGI) has recently granted approval to five pharma companies to start manufacturing antifungal anti-fungal drug Amphotericin B liposomal injection. 

The five companies that got DCGI's nod are - Alembic Pharmaceuticals, Emcure Pharmaceuticals, Gufic Biosciences, Lyca Pharmaceuticals, and Natco Pharma. Presently six firms - BDR Pharma, Bharat Serums and Vaccines, Mylan, Sun Pharma, Cipla, and Life Care - are producing the drug.

"The existing pharma companies have already started ramping up the production. Indian Companies has also placed orders for importing 6 lakh vials of AmphotericinB," Minister of State for Chemicals and Fertilisers Mansukh Mandaviya said.

The government is also actively exploring other global sources from where the Amphotericin-B drug can be imported, and the Union Health Ministry is also trying to procure other anti-fungal drugs that can be used in the treatment of Black Fungus.

It is believed that nearly 7,000 people have been infected in India with the black fungus and over 200 have lost their lives. Maharashtra has reported the highest number of black fungus cases. Excessive use of steroids during COVID treatment and those with diabetes are more prone to catching the black fungus infection.