Editing Amphotericin B (section)

===By mouth===
An oral preparation exists but is not widely available.<ref>{{cite journal | vauthors = Wasan KM, Wasan EK, Gershkovich P, Zhu X, Tidwell RR, Werbovetz KA, Clement JG, Thornton SJ | title = Highly effective oral amphotericin B formulation against murine visceral leishmaniasis | journal = The Journal of Infectious Diseases | volume = 200 | issue = 3 | pages = 357–360 | date = August 2009 | pmid = 19545212 | doi = 10.1086/600105 | doi-access =  }}</ref> The [[amphipathic]] nature of amphotericin along with its low solubility and permeability has posed major hurdles for oral administration given its low [[bioavailability]]. In the past it had been used for fungal infections of the surface of the GI tract such as [[Candidiasis|thrush]], but has been replaced by other antifungals such as [[nystatin]] and [[fluconazole]].<ref>{{cite journal | vauthors = Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE, Filler SG, Fisher JF, Kullberg BJ, Ostrosky-Zeichner L, Reboli AC, Rex JH, Walsh TJ, Sobel JD | title = Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America | journal = Clinical Infectious Diseases | volume = 48 | issue = 5 | pages = 503–535 | date = March 2009 | pmid = 19191635 | pmc = 7294538 | doi = 10.1086/596757 | doi-access = free }}</ref>

However, recently novel nanoparticulate drug delivery systems such as AmbiOnp,<ref name="AmbiOnp: solid lipid nanoparticles">{{cite journal | vauthors = Patel PA, Patravale VB | title = AmbiOnp: solid lipid nanoparticles of amphotericin B for oral administration | journal = Journal of Biomedical Nanotechnology | volume = 7 | issue = 5 | pages = 632–639 | date = October 2011 | pmid = 22195480 | doi = 10.1166/jbn.2011.1332 }}</ref> nanosuspensions, lipid-based drug delivery systems including cochleates, self-emulsifying drug delivery systems,<ref>{{cite journal | vauthors = Wasan EK, Bartlett K, Gershkovich P, Sivak O, Banno B, Wong Z, Gagnon J, Gates B, Leon CG, Wasan KM | title = Development and characterization of oral lipid-based amphotericin B formulations with enhanced drug solubility, stability and antifungal activity in rats infected with Aspergillus fumigatus or Candida albicans | journal = International Journal of Pharmaceutics | volume = 372 | issue = 1–2 | pages = 76–84 | date = May 2009 | pmid = 19236839 | doi = 10.1016/j.ijpharm.2009.01.003 }}</ref> solid lipid [[nanoparticle]]s<ref name="AmbiOnp: solid lipid nanoparticles"/> and polymeric nanoparticles<ref>{{cite journal | vauthors = Italia JL, Yahya MM, Singh D, Ravi Kumar MN | title = Biodegradable nanoparticles improve oral bioavailability of amphotericin B and show reduced nephrotoxicity compared to intravenous Fungizone | journal = Pharmaceutical Research | volume = 26 | issue = 6 | pages = 1324–1331 | date = June 2009 | pmid = 19214716 | doi = 10.1007/s11095-009-9841-2 | s2cid = 8612917 }}</ref>—such as amphotericin B in pegylated polylactide coglycolide copolymer nanoparticles<ref>{{cite journal | vauthors = Al-Quadeib BT, Radwan MA, Siller L, Horrocks B, Wright MC | title = Stealth Amphotericin B nanoparticles for oral drug delivery: In vitro optimization | journal = Saudi Pharmaceutical Journal | volume = 23 | issue = 3 | pages = 290–302 | date = July 2015 | pmid = 26106277 | pmc = 4475820 | doi = 10.1016/j.jsps.2014.11.004 }}</ref>—have demonstrated potential for oral formulation of amphotericin B.<ref>{{cite journal | vauthors = Patel PA, Fernandes CB, Pol AS, Patravale VB | title = Oral amphotericin B: challenges and avenues. | journal = Int. J. Pharm. Biosci. Technol. | date = 2013 | volume = 1 | issue = 1 | pages = 1–9 | url = https://www.researchgate.net/publication/236578662 }}</ref> The oral lipid nanocrystal amphotericin by Matinas Biopharma is furthest along, having completed a successful phase 2 clinical trial in cryptococcal meningitis.<ref>{{cite journal | vauthors = Boulware DR, Atukunda M, Kagimu E, Musubire AK, Akampurira A, Tugume L, Ssebambulidde K, Kasibante J, Nsangi L, Mugabi T, Gakuru J, Kimuda S, Kasozi D, Namombwe S, Turyasingura I, Rutakingirwa MK, Mpoza E, Kigozi E, Muzoora C, Ellis J, Skipper CP, Matkovits T, Williamson PR, Williams DA, Fieberg A, Hullsiek KH, Abassi M, Dai B, Meya DB | title = Oral Lipid Nanocrystal Amphotericin B for Cryptococcal Meningitis: A Randomized Clinical Trial | journal = Clinical Infectious Diseases | date = August 2023 | volume = 77 | issue = 12 | pages = 1659–1667 | pmid = 37606364 | doi = 10.1093/cid/ciad440 | doi-access = free | pmc = 10724459 }}</ref>