Isavuconazonium

Dosing

Aspergillosis, invasive Mucormycosis, invasive

  • Loading: 372 mg PO (2 capsules) or IV q8h for 6 doses

  • Maintenance: 372 mg PO (2 capsules) or IV once daily, starting 12-24h after last loading dose

  • Duration: 6-12w depending on disease

Available in bioequivalent oral and IV formulations; may switch between formulations.No renal dose adjustment

Safety and efficacy in pediatric patients <18y of age have not been established

No dose adjustment

General Information

  • Aspergillosis, invasive

  • Mucormycosis, invasive

Evaluate liver function tests at the beginning of and during treatment.

Monitor adverse reactions in patients with severe hepatic impairment.

Common

  • Peripheral edema

  • Hypokalemia

  • Diarrhea

  • Constipation

  • Nausea

  • Vomiting

  • Backache

  • Cough

  • Headache

  • Dyspnea

Serious

  • Cholestasis

  • Hepatitis

  • Increased liver function test

  • Liver failure

  • Renal failure

  • Acute respiratory failure

  • Infusion reaction

  • Hypersensitivity reaction

Contraindications:

  • CYP3A4 inducers/inhibitors

  • Ritonavir

  • Itraconazole

  • Mephobarbital

Major drug-drug interactions:

  • Lopinavir

  • P-gp and CYP3A4 substrates with narrow therapeutic index

  • Mycophenolate mofetil

  • Midazolam

  • Atorvastatin

Antimicrobial class: Antifungal, Triazole

Pregnancy category: May cause fetal harm

Average serum half life: 130 hours (Isavuconazole)

Precautions: Discontinue if severe cutaneous reaction develops.

Use cautiously in patients with hypersensitivity to other azole antifungals.

Hypotension, dyspnea, chills, dizziness, paraesthesia, hypoesthesia have been reported during IV administration; discontinue.

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