400 mg PO BID, or
6 mg/kg IV q12h x 2 doses, then 200 mg PO BID, or
4 mg/kg IV q12h (reduce dose by 50% for less than 40 kg)
IVUse ideal body weight or adjusted body weight
Should only be used if benefit outweighs risk
Standard loading dose then reduce maintenance by 50%
Renal Impairment * No change for oral dose * If CrCl less than 50: DO NOT administer IV due to cyclodextrin accumulation
No change for oral dose
DO NOT administer IV due to cyclodextrin accumulation
Restricted to prophylaxis or treatment of aspergillus OR scedosporium OR fusarium OR in patients intolerant to or isolate resistant to amphotericin B deoxycholate or fluconazole.
Therapeutic drug monitoring may be helpful to ensure adequate concentrations and exclude toxicity (Discuss with ID).
QTc interval in patients at elevated risk.
Monitor hepatic profile.
Antimicrobial class: Triazole antifungal, Second generation
Pregnancy category: D
Urine penetration: Poor
Lung penetration: Therapeutic
CSF penetration: Therapeutic
