200 - 400 mg 2-3 times daily, based on indication and pathogen.
300 mg q12 h x 2 doses, then 300 mg daily.
Treatment of invasive zygomycosis in combination with Amphotericin B
Monotherapy for zygomycosis after 7 days of combination therapy with Amphotericin B
Note: posaconazole requires up to 7 days to achieve steady state concentrations. ID consult is advised.
Primary treatment of aspergillosis
Prophylaxis of invasive fungal infection in immunocompromised patients such as stem cell transplant recipients
Treatment of invasive fungal infections such as candidiasis if conventional therapy has failed
Hepatic enzymes at baseline and every 1-2 weeks after
Therapeutic drug monitoring at steady state (5-7 days). Target >1.25 mcg/mL for invasive fungal disease or >0.7 mcg/mL for prophylaxis
Prolongation of QT interval with risk factors
GI upset (~40%),
Elevation in hepatic enzymes
Rare but serious effects include QTc prolongation
Posaconazole is an inhibitor and is metabolized by cytochrome P4503A4; therefore, coadministration with other agents that are cytochrome P450 substrates, inducers, or inhibitors will result in significant drug interactions.
You must check for potential drug interactions when initiating Posaconazole therapy or starting a new medication in patients already receiving Posaconazole therapy.
Administration of the following agents with Posaconazole is contraindicated:
Posaconazole inhibits metabolism of the following agents. Dose reductions and close monitoring are recommended when Posaconazole is used with agents concomitantly:
High pharmacokinetic variability, dependent on fatty food administration (for solution).
The two oral formulations of posaconazole (delayed-release tablets and an oral suspension) are not interchangeable, and cannot be directly substituted without a change in dosage.
All orders for posaconazole must specify the dosage form, strength, and frequency
Antimicrobial class: azole
Pregnancy category: C