Amphotericin B has major nephrotoxicity. How do lipid formulations modify this risk?

• A. Hepatotoxicity; lipid formulations reduce hepatic injury.
• B. Nephrotoxicity; lipid formulations reduce nephrotoxicity.
• C. Neurotoxicity; lipid formulations increase neuropathy.
• D. Cardiotoxicity; lipid formulations reduce heart damage.

Answer: (B)

Lipid formulations reduce nephrotoxicity. Conventional amphotericin B can directly injure renal tubular cells and decrease kidney perfusion, making nephrotoxicity the dose-limiting toxicity. Encapsulating the drug in liposomes or lipid complexes alters its distribution, so less drug reaches the kidneys while still delivering effective antifungal activity. This lowers renal exposure and tubular injury, reducing nephrotoxicity. Hepatic, neurological, or cardiac toxicities are not the primary benefits of these formulations, though they may have different side-effect profiles in other areas.