Your Patients Need Amphotericin B — Here's How to Help Them Find It

When a patient with mucormycosis, cryptococcal meningitis, or another life-threatening fungal infection needs Amphotericin B and your pharmacy is out, the clinical stakes are high. As the prescribing physician or a member of the care team, you're often the patient's best advocate in navigating the shortage.

This guide provides practical, actionable steps you can take — and delegate — to help your patients access Amphotericin B during the ongoing supply disruption. For a broader clinical briefing on the shortage, see our provider shortage update for 2026.

Current Availability Overview

As of early 2026, here's the supply picture:

• Conventional Amphotericin B deoxycholate (X-Gen): Active shortage. Sporadic availability. No consistent resupply date.
• Abelcet / ABLC (Leadiant Biosciences): On back order. No estimated release date.
• AmBisome / Liposomal (Gilead): Generally available through standard distribution. Significantly higher cost ($300–$1,200+ per vial vs. $49–$70 for conventional).

The liposomal formulation remains the most reliably accessible option, though cost and prior authorization requirements can create barriers for patients — particularly in outpatient infusion settings.

Why Patients Can't Find It on Their Own

Unlike oral medications where patients can call around to retail pharmacies, Amphotericin B presents unique challenges:

• Hospital-based administration: This is an IV medication given over 2–6 hours, typically in a hospital or infusion center. Patients can't simply "shop around" at pharmacies.
• Single-source vulnerability: With one manufacturer for the conventional form, supply is binary — either the manufacturer is shipping or they're not.
• Formulary decisions: Hospital pharmacy and therapeutics committees make formulary decisions that patients have no visibility into. A facility may have Amphotericin B but restrict it to certain patient populations.
• Insurance complexity: Switching to a lipid formulation often requires prior authorization, creating delays when time is critical.

This is why provider involvement is essential in locating supply.

Five Steps to Help Your Patients Access Amphotericin B

Step 1: Check Your Network's Inventory

Start with the resources closest to you:

• Contact your hospital pharmacy director to check system-wide inventory. Multi-hospital systems often redistribute medications from facilities with surplus.
• Check with your health system's drug shortage committee — most large systems have one — about current allocation policies and expected resupply.
• Ask pharmacy if they've been able to obtain any formulation of Amphotericin B from their wholesaler or through secondary distribution channels.

Step 2: Use Medfinder for Providers

Medfinder for Providers is designed to help clinicians quickly locate medications during shortages. You can:

• Search for Amphotericin B availability by location
• Identify hospitals and infusion centers with current stock
• Share results with your patients or care coordinators

This is particularly useful when you need to transfer a patient's care or arrange infusion at an alternative facility.

Step 3: Contact Specialty Infusion Pharmacies

Specialty pharmacies that handle injectable and infusion medications may have supply channels that hospital pharmacies don't access. Consider reaching out to:

• National specialty pharmacies (e.g., Option Care Health, BioScrip)
• Regional infusion therapy providers
• Compounding pharmacies (for conventional Amphotericin B, if applicable under FDA guidance)

Your pharmacist can help identify appropriate specialty pharmacy contacts in your region.

Step 4: Expedite Prior Authorization for AmBisome

If the conventional form is unavailable and your patient needs Amphotericin B specifically (e.g., for mucormycosis), switching to AmBisome may be the fastest path. To expedite authorization:

• Document the shortage explicitly in your prior authorization request — cite ASHP or FDA drug shortage listings
• Include clinical justification for why an alternative antifungal is not appropriate
• Request urgent/expedited review — most payers have a process for shortage-related switches
• Have your care coordinator or social worker follow up with the payer

Step 5: Reach Out to Academic Medical Centers

Major academic medical centers and tertiary referral hospitals typically:

• Maintain larger inventory buffers for critical medications
• Have dedicated drug shortage management protocols
• May accept transfers for patients who need medications their current facility can't supply

If your patient is at a community hospital without Amphotericin B, consider whether transfer to an academic center is clinically appropriate.

Alternative Antifungal Agents

While Amphotericin B remains irreplaceable for some indications, many infections can be treated with alternative agents:

• Voriconazole: First-line for invasive aspergillosis per IDSA guidelines. Available IV and oral.
• Echinocandins (Caspofungin, Micafungin, Anidulafungin): First-line for invasive candidiasis. Better safety profile. IV only.
• Isavuconazonium (Cresemba): Alternative for mucormycosis. Available IV and oral. Growing evidence base.
• Posaconazole: Useful for step-down therapy in mucormycosis and aspergillosis prophylaxis.
• Fluconazole: Maintenance therapy for cryptococcal meningitis. First-line for less severe candidiasis.

For detailed comparison, see our article on alternatives to Amphotericin B.

Workflow Tips for Your Practice

Here are some operational suggestions to manage the shortage more efficiently:

Proactive Communication

• Alert your pharmacy 48–72 hours in advance when you anticipate prescribing Amphotericin B, giving them time to source it.
• Develop standing orders for AmBisome as a backup when conventional Amphotericin B is unavailable.
• Create a provider reference card with dosing equivalences between formulations (conventional: 0.5–1.5 mg/kg/day; liposomal: 3–6 mg/kg/day; lipid complex: 5 mg/kg/day).

Patient Communication Templates

• Develop a brief, plain-language explanation of the shortage to share with patients
• Provide patients with resources for locating Amphotericin B — direct them to medfinder.com/providers or the patient-facing articles on our blog
• Set expectations about potential treatment modifications or formulation switches

Documentation

• Document shortage-related treatment decisions in the medical record
• Note the specific formulation prescribed and the rationale for any switches
• Record prior authorization efforts and outcomes for continuity of care

Final Thoughts

The Amphotericin B shortage demands proactive involvement from providers. By leveraging tools like Medfinder for Providers, coordinating with pharmacy, and having contingency plans ready, you can ensure your patients get the antifungal therapy they need — even when supply is limited.

For the patient-facing version of this information, share our article on how to find Amphotericin B in stock with your patients and their caregivers.