Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.
IV formulation contains sulfobutyl ether beta-cyclodextrin (SBECD) which may accumulate in renal insufficiency.
In pediatric patients <12 years, bioequivalence between the oral tablet and suspension has not been determined; due to possible shortened gastric transit time in infants and children, absorption of tablets may be different than adults
Therapeutic drug monitoring may be helpful to ensure adequate concentrations and exclude toxicity (discuss with ID). Target trough 1-6 mg/L. Collect in heparinized red top tube 0-30 minutes prior to dose and send to Toronto Sick Kids for analysis
Monitor QTc interval in patients at elevated risk
Monitor hepatic profile
Hepatic enzyme abnormalities
Rash - up to 20%
Visual disturbances may occur
Many via CYP450- suggest review interactions with pharmacist.
Risk when combining with other QTc prolonging agents
Antimicrobial class: Triazole antifungal, second generation
Average serum half life: Variable and dose dependent.
Route of Elimination: Urine (<2% as unchanged drug)