Posaconazole: Difference between revisions
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*For prophylaxis, target trough >0.7 mg/L, or random level 0.35 mg/L 48 h after starting therapy |
*For prophylaxis, target trough >0.7 mg/L, or random level 0.35 mg/L 48 h after starting therapy |
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*For treatment, target trough >1 mg/L |
*For treatment, target trough >1 mg/L |
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+ | *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]) |
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== Safety == |
== Safety == |
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