Posaconazole: Difference between revisions

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== Therapeutic Drug Monitoring ==
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==Therapeutic Drug Monitoring==
  +
* Measure trough 7 days after starting or adjusting dose, or adjusting interacting medications, or concerns of poor adherence or absorption
 
  +
*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
+
*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===
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{| class="wikitable"
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! rowspan="2" |Species
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! rowspan="2" |ECV (μg/mL)
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! colspan="4" |Breakpoints (μg/mL)
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! colspan="4" |Breakpoints (mm)
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|-
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!S
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!SDD
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!I
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!R
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!S
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!SDD
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!I
  +
!R
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|-
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|[[Candida albicans]]
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|0.06
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|≤0.06
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|
  +
|
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|≥0.12
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|
  +
|
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|
  +
|
  +
|-
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|[[Candida dubliniensis]]
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|
  +
|
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|
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|
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|
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|
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|
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|
  +
|
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|-
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|[[Candida glabrata]]
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|2
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|
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|
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|
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|
  +
|
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|
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|
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|
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|-
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|[[Candida guilliermondii]]
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|0.5
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|
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|
  +
|
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|
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|
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|
  +
|
  +
|
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|-
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|[[Candida kefyr]]
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|0.25
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|
  +
|
  +
|
  +
|
  +
|
  +
|
  +
|
  +
|
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|-
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|[[Candida krusei]]
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|0.5
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|
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|
  +
|
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|
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|
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|
  +
|
  +
|
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|-
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|[[Candida lusitaniae]]
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|0.12
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|
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|
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|
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|
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|
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|
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|
  +
|
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|-
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|[[Candida parapsilosis]]
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|0.25
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|≤0.06
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|
  +
|
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|≥0.12
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|
  +
|
  +
|
  +
|
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|-
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|[[Candida tropicalis]]
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|0.12
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|≤0.06
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|
  +
|
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|≥0.12
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|
  +
|
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|
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|
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|-
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|[[Cryptococcus neoformans]]
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|
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| colspan="8" rowspan="2" |
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|-
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|[[Cryptococcus gattii]]
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|
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|}
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  +
== Safety ==
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  +
=== Adverse Events ===
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* Liver toxicity
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** Generally transient and asymptomatic and self-limited
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** See also [https://www.ncbi.nlm.nih.gov/books/NBK548934/ LiverTox]
   
 
[[Category:Triazoles]]
 
[[Category:Triazoles]]

Latest revision as of 09:24, 30 March 2022

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