Infectious Disease Compendium

Posaconazole (Noxafil®)

Dosing

CrCl Formula

CrCl > 80: 200 mg tid. Only comes po.

CrCl 80-50:

CrCl 50-10:

CrCl < 10:

Hemodialysis:

Peritoneal dialysis:

Important side effects

"Posaconazole-induced hypertension and hypokalemia due to inhibition of the 11β-hydroxylase enzyme (Pubmed)."

Important drug interactions

These drugs interact with damn near everything else so check with your pharmacist or this reference at CID.

Rants and Screeds

Pearls

Low serum levels are associated with breakthrough fungal infections (PubMed). And high levels are associated with toxicity (PubMed). So if you can, get a level in patients on the drug long term.

Treatment of choice

Zygomycetes.

Use for

Aspergillus fumigatus - disseminated, Candida, Cryptococcus neoformans, Fusarium, disseminated phaeohyphomycosis, disseminated zygomycetes. Fungal prophylaxis in graft vs host disease.

Don't use for

Class

Triazole.

Last update 11/30/19