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
Clinical Breakpoints
| Species | ECV (μg/mL) | Breakpoints (μg/mL) | Breakpoints (mm) | ||||||
|---|---|---|---|---|---|---|---|---|---|
| S | SDD | I | R | S | SDD | I | 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 | |||||||||
Safety
Adverse Events
- Liver toxicity
- Generally transient and asymptomatic and self-limited
- See also LiverTox
