Spectrum Of Activity
Defined criteria for use and/or important safety considerations. See below for more information.
Obesity: use ideal or adjusted body weight. Consider using adjusted body weight in patients with life threatening infection and adequate hepatic function.
CrCl > 50 mL/min6 mg/kg IV q12h x 2 doses, then 4 mg/kg IV q12h
Weight ≥ 40 kgWeight < 40 kg400 mg PO q12h x 2 doses, then 200 mg PO q12h200 mg PO q12h x 2 doses, then 100 mg PO q12h
3-4 mg/kg PO q12h
Child-Pugh Class A-B (score 5-9)Usual loading dose, then 50% maintenance dose
Child-Pugh Class C (score 10-15)Should only be used if benefit outweighs risk
CrCl < 50 mL/minUse PO Contraindicated due to accumulation of IV vehicle cyclodextrin
No renal adjustment necessary
Use PO Contraindicated due to accumulation of IV vehicle cyclodextrin
Primary indication(s): Invasive Aspergillus infections (including CNS aspergillosis)
Alternative indication(s): Serious Candida infections, prophylaxis in high risk hematologic patients (e.g. prolonged neutropenia at high risk of for invasive aspergillosis, GVHD)
For urinary tract infections with fungal microorganisms
Therapeutic drug monitoring recommended to ensure adequate concentrations and exclude toxicity.
- Target 1 – 5.5 μg/mL, 5-7 days after starting therapy
QTc interval in patients at elevated risk.
Monitor hepatic profile.
Hepatic enzyme abnormalities
Rash - up to 20%
CYP450 interactions ++.
Other QTc prolonging agents.
Recommend review of concomitant medications due to high frequency of significant interactions.
Antimicrobial class: Triazole antifungal, Second generation
Pregnancy category: D
CSF penetration: Therapeutic
Lung penetration: Therapeutic
Urine penetration: Poor