Drug Index



Mechanism :

Interferes with fungal cytochrome P450 (lanosterol-14a-demethylase) activity, decreasing ergosterol synthesis.

Indication :

• Prophylaxis of invasive Aspergillus and Candida infections

• Oropharyngeal candidiasis (13 years and older)

Contraindications :

Co-administration with sirolimus, ergot alkaloids, HMG-CoA reductase inhibitors that are primarily metabolized through CYP3A4, or CYP3A4 substrates that prolong the QT interval; hypersensitivity to posaconazole, other azole antifungal agents, or any component of the formulation.

Dosing :

Candida and aspergillosis prophylaxis:

≥13 years:

Oral: Suspension: 200 mg 3 times daily.

IV: Initial: 300 mg twice daily on day 1; Maintenance dose: 300 mg once daily on day 2 and thereafter.

Duration of therapy is based on recovery from neutropenia or immunosuppression.

Treatment of Oropharyngeal infection:

≥13 years: Initial: 100 mg PO twice daily on day 1. Maintenance: 100 mg OD on day 2 and thereafter for 13 days. For infections refractory to itraconazole and fluconazole, the FDA-labelled dose is 400 mg PO twice daily.

Mucocutaneous candidiasis:

≥13 years: 400 mg PO twice daily for 14 to 21 days in patients with refractory disease.

Disseminated histoplasmosis:

≥13 years: 400 mg PO twice daily for at least 12 months.

Adverse Effect :

Thrombophlebitis, hypertension, peripheral edema, headache, rigors, fatigue, skin rash, hypokalemia, hypermagnesemia, hyperglycemia, diarrhea, vomiting, nausea, anorexia, constipation, thrombocytopenia, anemia. Neutropenia, increased AST, musculoskeletal pain, cough, dyspnea, fever.

Interaction :

Antineoplastic Agents (Vinca Alkaloids): Posaconazole may enhance the adverse/toxic effect of Antineoplastic Agents (Vinca Alkaloids).
CYP3A4 Substrates: CYP3A4 Inhibitors may decrease the metabolism of CYP3A4 Substrates.
Digoxin: Posaconazole may increase the serum concentration of Digoxin.
Dihydroergotamine: Posaconazole may increase the serum concentration of Dihydroergotamine.

01/30/2020 05:43:12 Posaconazole
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