Drug Characteristics
  • Formulation

    Suspension: 40 mg/ml

  • Dose

    Refractory invasive fungal infections:

    Invasive aspergillosis:

    Second line if intolerant or resistant to standard therapy

    200 mg four times a day with food supplement or 400 mg twice a day

    Oropharyngeal candiasis:

    200 mg as an initial dose on day 1 followed by 100 mg for 13 days

  • Side Effects

    Neutropenia, electrolyte imbalance, anorexia, paresthesia, dizziness, somnolence, headache, QTc/QT prolongation, abnormal ECG, palpitation, vomiting, nausea, abdominal pain, diarrhoea, dyspepsia, dry mouth, flatulence, elevated liver function tests (including ALT, AST, bilirubin, alkaline phosphatase, GGT) rash, pyrexia (fever), asthenia, fatigue

  • Interactions

    Posaconazole is metabolized via UDP glucuronidation, and is a substrate for p-glycoprotein as well as an inhibitor of CYP3A4

    Posaconazole AUC is decreased 50% by rifabutin and phenytoin, and 40% by cimetidine

    Posaconazole increases AUC of rifabutin by 72%: avoid combination, or maintain vigilance for uveitis

    Posaconazole is expected to increase exposure of HIV PIs and NNRTIs, tacrolimus, ciclosporin, midazolam, digoxin, calcium antagonists, HMG-CoA reductase inhibitors (e.g. simvastatin, atorvastatin). Seek specialist HIV pharmacist advice.Administration with terfenadine, astemizole, cisapride, pimozide, halofantrine and quinidine may increase risk of QT prolongation, and is contraindicated.

  • Renal

    No dose adjustment required

  • Hepatic

    Limited data in hepatic impairment and no recommendation can be made

  • Pregnancy

    No Human Data – Animal Data Suggest Risk.

  • Other Information