Isavuconazole

Restricted
C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

$$$$

Spectrum Of Activity

Dosing

Loading Dosage
372 mg IV every 8 hours for 6 doses

Maintenance Dosage
372 mg IV once daily, starting 12 to 24 hours after the last loading dose

Loading Dose
372 mg (2 capsules) orally every 8 hours for 6 doses

Maintenance Dose
372 mg (2 capsules) once daily, starting 12 to 24 hours after the last loading dose

No adjustment

Child-Pugh class A and B
No dosage adjustment required

Child-Pugh class C
Use only if benefits outweigh potential risks; limited data

Infectious Diseases consult Required

General Information

Adverse Effects

  • GI upset

  • Elevated liver enzymes

  • Arrhythmias

  • QTc abnormalities

  • Hypokalemia

  • Cough

  • Peripheral edema

  • Peripheral neuropathy

  • CNS side effects

  • Renal failure

Drug Monitoring

Laboratory

  •  CBC, CMP at start weekly, then may do periodically after

Clinical

  • Liver disfunction

  •  QTc changes

  •  Hypokalemia

Major Interactions

CYP3A4 Interactions - multiple

Additional Information

Avoid in patients with familial short QTc syndrome

Common Usage

Invasive Aspergillus and Invasive Mucor