Posaconazole: Difference between revisions

From IDWiki
No edit summary
No edit summary
 
(6 intermediate revisions by the same user not shown)
Line 1: Line 1:
  +
== Background ==
−
== Therapeutic Drug Monitoring ==
  
  +
−
* Measure trough 7 days after starting or adjusting dose, or adjusting interacting medications, or concerns of poor adherence or absorption
  
  +
* Azole antifungal
−
* For prophylaxis, target trough >0.7 mg/L, or random level 0.35 mg/L 48 h after starting therapy
  
  +
−
* For treatment, target trough >1 mg/L
  
  +
=== Pharmacokinetics and Pharmacodynamics ===
  +
  +
* Generally distributes well, with the notable exception of non-inflamed brain
  +
  +
===Clinical Breakpoints===
  +
{| class="wikitable"
  +
! rowspan="2" |Species
  +
! rowspan="2" |ECV (μg/mL)
  +
! colspan="4" |Breakpoints (μg/mL)
  +
|-
  +
!S
  +
!I
  +
!SDD
  +
!R
  +
|-
  +
|[[Candida albicans]]
  +
|0.06
  +
|≤0.06
  +
| colspan="2" rowspan="9" |
  +
|≥0.12
  +
|-
  +
|[[Candida dubliniensis]]
  +
|
  +
|
  +
|
  +
|-
  +
|[[Candida glabrata]]
  +
|2
  +
|
  +
|
  +
|-
  +
|[[Candida guilliermondii]]
  +
|0.5
  +
|
  +
|
  +
|-
  +
|[[Candida kefyr]]
  +
|0.25
  +
|
  +
|
  +
|-
  +
|[[Candida krusei]]
  +
|0.5
  +
|
  +
|
  +
|-
  +
|[[Candida lusitaniae]]
  +
|0.12
  +
|
  +
|
  +
|-
  +
|[[Candida parapsilosis]]
  +
|0.25
  +
|≤0.06
  +
|≥0.12
  +
|-
  +
|[[Candida tropicalis]]
  +
|0.12
  +
|≤0.06
  +
|≥0.12
  +
|-
  +
|[[Cryptococcus neoformans]]
  +
|
  +
| colspan="4" rowspan="2" |
  +
|-
  +
|[[Cryptococcus gattii]]
  +
|
  +
|-
  +
|[[Aspergillus flavus]]
  +
|0.5
  +
|—
  +
| colspan="2" rowspan="5" |
  +
|—
  +
|-
  +
|[[Aspergillus fumigatus]]
  +
|0.25
  +
|≤0.125
  +
|>0.25
  +
|-
  +
|[[Aspergillus nidulans]]
  +
|0.5
  +
|—
  +
|—
  +
|-
  +
|[[Aspergillus niger]]
  +
|0.5
  +
|—
  +
|—
  +
|-
  +
|[[Aspergillus terreus]]
  +
|0.25
  +
|≤0.125
  +
|>0.25
  +
|}
  +
  +
== Dosing ==
  +
  +
=== Therapeutic Drug Monitoring ===
  +
*Measure trough 7 days after starting or adjusting dose, or adjusting interacting medications, or concerns of poor adherence or absorption
  +
*For prophylaxis, target trough >0.7 mg/L, or random level 0.35 mg/L 48 h after starting therapy
  +
*For treatment, target trough >1 mg/L
  +
*In Ontario, it may be available through [https://www.chusj.org/labotest/accueil CHU Saine-Justine] in Quebec ([https://chusj.omni-assistant.net/labo/AnalysisRegistry/AnalysisView.aspx?PK_Analysis=446 link to LTIG entry])
  +
  +
== Safety ==
  +
  +
=== Adverse Events ===
  +
  +
* Liver toxicity
  +
** Generally transient and asymptomatic and self-limited
  +
** See also [https://www.ncbi.nlm.nih.gov/books/NBK548934/ LiverTox]
   
 
[[Category:Triazoles]]
  
[[Category:Triazoles]]

Latest revision as of 11:00, 22 October 2024

Background

  • Azole antifungal

Pharmacokinetics and Pharmacodynamics

  • Generally distributes well, with the notable exception of non-inflamed brain

Clinical Breakpoints

Species ECV (μg/mL) Breakpoints (μg/mL)
S I SDD R
Candida albicans 0.06 ≤0.06 ≥0.12
Candida dubliniensis
Candida glabrata 2
Candida guilliermondii 0.5
Candida kefyr 0.25
Candida krusei 0.5
Candida lusitaniae 0.12
Candida parapsilosis 0.25 ≤0.06 ≥0.12
Candida tropicalis 0.12 ≤0.06 ≥0.12
Cryptococcus neoformans
Cryptococcus gattii
Aspergillus flavus 0.5 — —
Aspergillus fumigatus 0.25 ≤0.125 >0.25
Aspergillus nidulans 0.5 — —
Aspergillus niger 0.5 — —
Aspergillus terreus 0.25 ≤0.125 >0.25

Dosing

Therapeutic Drug Monitoring

  • Measure trough 7 days after starting or adjusting dose, or adjusting interacting medications, or concerns of poor adherence or absorption
  • For prophylaxis, target trough >0.7 mg/L, or random level 0.35 mg/L 48 h after starting therapy
  • For treatment, target trough >1 mg/L
  • In Ontario, it may be available through CHU Saine-Justine in Quebec (link to LTIG entry)

Safety

Adverse Events

  • Liver toxicity
    • Generally transient and asymptomatic and self-limited
    • See also LiverTox
Retrieved from "https://idwiki.org/index.php?title=Posaconazole&oldid=10928"
Powered by MediaWiki
Powered by Semantic MediaWiki