Posaconazole

Edina Avdic, Pharm.D., Shmuel Shoham, M.D.
Pediatric Dosing Author: Bethany Sharpless Chalk, Pharm.D., BCPPS
Posaconazole is a topic covered in the Johns Hopkins ABX Guide.

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INDICATIONS

FDA

  • Prophylaxis of invasiveAspergillus and disseminated candidiasis in severely immunocompromised hosts
    • Such as hematopoietic stem cell transplant recipients with graft vs. host disease (GVHD) or those with hematologic malignancies with prolonged neutropenia from chemotherapy- all formulations.
  • Treatment of oropharyngeal candidiasis, including itraconazole and/or fluconazole refractory cases- oral suspension only.

NON-FDA APPROVED USES

  • Treatment of invasive fungal infections (aspergillosis, histoplasmosis, coccidioidomycosis, candidiasis) in patients who are intolerant to, or whose infections are refractory to standard therapy.
  • Maintenance therapy for Mucorales in patients whose infection has been controlled with standard therapy (e.g., liposomal amphotericin B +/- surgery)
  • Alternative treatment of infections due to hyaline fungi (e.g. Scedosporium spp., Acremonium spp., Scopulariopsis spp., Purpureocillium spp.).
  • Posaconazole may be effective in combination with surgery for eumycotic mycetoma (localized fungal infections that may involve cutaneous and subcutaneous tissue, fascia and bone).
  • Based on in-vitro data and limited clinical experience, posaconazole may be effective for infections due to certain dematiaceous fungi.

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INDICATIONS

FDA

  • Prophylaxis of invasiveAspergillus and disseminated candidiasis in severely immunocompromised hosts
    • Such as hematopoietic stem cell transplant recipients with graft vs. host disease (GVHD) or those with hematologic malignancies with prolonged neutropenia from chemotherapy- all formulations.
  • Treatment of oropharyngeal candidiasis, including itraconazole and/or fluconazole refractory cases- oral suspension only.

NON-FDA APPROVED USES

  • Treatment of invasive fungal infections (aspergillosis, histoplasmosis, coccidioidomycosis, candidiasis) in patients who are intolerant to, or whose infections are refractory to standard therapy.
  • Maintenance therapy for Mucorales in patients whose infection has been controlled with standard therapy (e.g., liposomal amphotericin B +/- surgery)
  • Alternative treatment of infections due to hyaline fungi (e.g. Scedosporium spp., Acremonium spp., Scopulariopsis spp., Purpureocillium spp.).
  • Posaconazole may be effective in combination with surgery for eumycotic mycetoma (localized fungal infections that may involve cutaneous and subcutaneous tissue, fascia and bone).
  • Based on in-vitro data and limited clinical experience, posaconazole may be effective for infections due to certain dematiaceous fungi.

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Last updated: May 8, 2020