Isavuconazole
From IDWiki
Background
Mechanism of Action
- Azole antifungal that inhibits lanosterol 14-α demethylase in the peptidoglycan synthesis pathway
Spectrum of Activity
- Active against Candida, Cryptococcus, Aspergillus including Aspergillus flavus, Aspergillus fumigatus, and Aspergillus niger, and Mucorales
- Indications include Chromoblastomycosis, Cladophialophora, Coccidioides immitis
Dosing
- Isavuconazole 200 mg IV tid for 6 doses followed by 200 mg IV daily
Renal Dosing
- No adjustment needed
Hepatic Dosing
- No adjustment needed
Safety
Adverse Drug Reactions
- Nausea, vomiting, diarrhea
- Elevated liver enzymes
- Generally transient ALT elevation that does not require change in therapy
- May also include severe cholestatic or hepatocellular enzyme rises within the first few months of therapy
- See also LiverTox
- Hypokalemia
Drug-Drug Interactions
- Increases levels of sirolimus and tacrolimus
- Increases levels of cyclosporine
- Contraindicated with carbamazepine
