Spectrum Of Activity
Invasive aspergillosisCandidemia in non-neutropenic patientsDisseminated candidiasisScedosporiosis, fusariosis6 mg/kg IV q12h 2 doses, then 4 mg/kg IV q12h6 mg IV q12h 2 doses, then 3 mg/kg IV q12h 6 mg IV q12h 2 doses, then 4 mg/kg IV q12h6 mg/kg IV q12h 2 doses, then 4 mg/kg IV q12h
Maintenance therapy for invasive aspergillosis, candidemia in non-neutropenic patients, disseminated candidiasisEsophageal candidiasisBW <40 kg200 mg PO q12h200 mg PO q12h Oral dose should be reduced to 100-150 mg PO q12h
Safety and effectiveness in pediatric patients <12y of age have not been established
Mild or moderate hepatic impairmentSevere hepatic impairment50% maintenance doseNo data
CrCl ≥50CrCl <50No dose adjustmentAvoid
No dose adjustment
Candida infections both mucocutaneous and invasive (i.e. Candidemia).
Antifungal prophylaxis in immunocompromised patients.
Monitor renal function, especially serum creatinine.
Obtain fungal cultures and other relevant laboratory studies such as histopathology prior to therapy.
Assess visual function if used beyond 28 days.
Monitor serum transaminase levels, bilirubin, serum trough concentrations, and hepatic function.
Prolonged QT interval
Torsades de pointes
Liver failure (rare)
Alkaloids (including ergotamine and dihydroergotamine)
HMG-CoA reductase inhibitors
QT interval prolonging drugs
CYP450 interactions ++
Review of patient medications due to high frequency of significant interactions.
Antimicrobial class: Antifungal, 2nd Generation Triazole
Pregnancy category: D
CSF penetration: Therapeutic
Lung penetration: Therapeutic
Urine penetration: Poor
Avoid IV formulation in patients with moderate or severe renal impairment (ie, CrCl <50 mL/min) unless benefits justify use.
Use cautiously in patients with hypersensitivity to other azole antifungal agents.
Pediatric patients at increased risk for phototoxic reactions; monitoring recommended.
Monitoring recommended for liver enzyme elevations and hepatic reactions.
Do not administer tablets to patients with galactose intolerance.
If phototoxic reactions occur, refer patient to dermatologist and consider discontinuation of therapy.