Posaconazole(pahs ah kon’ ah zall)
Noxafil
PREGNANCY CATEGORY C
Drug Class
Antifungal (triazole)
Therapeutic Actions
Inhibits the synthesis of ergosterol, a key component of the fungal cell membrane; this inhibition leads to inability of the fungus to form the fungal cell wall and results in cell death.
Indications
Prophylaxis of invasive Aspergillus and Candida infections in patients 13 yr and older
who are at risk of developing these infections because they are immunosuppressed because of prolonged neutropenia from antineoplastic chemotherapy, graft-versus-host disease secondary to bone marrow transplants, or hematologic malignancies
Treatment of oropharyngeal candidiasis including cases refractory to itraconazole or fluconazole
Contraindications and Cautions
Contraindicated with hypersensitivity to any component of the drug and with concurrent use of ergot alkaloids, drugs that are CYP3A4 substrates (pimozide, quinidine), sirolimus, simvastatin.
Use cautiously with liver impairment, concurrent use of cyclosporine, prolonged QT interval, HF, pregnancy, lactation.
Available Forms
Oral suspension—40 mg/mL
Dosages
Adults and children 13 yr and older
Prevention: 200 mg (5 mL) PO tid. Give with a full meal or liquid nutritional supplement.
Treatment: Loading dose of 100 mg (2.5 mL) PO bid on day 1; then 100 mg/day PO for 13 days. For refractory infection, 400 mg (10 mL) PO bid, with duration based on patient response.
Patients with hepatic impairment
Use cautiously and monitor closely.
Pharmacokinetics
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