黴菌感染
Invasive Aspergillosis: For patients ≥13 years of age)
Prophylaxis against invasive fungal infections: For patients ≥2 years of age; Prophylaxis of invasive Aspergillus and Candida infections in severely immunocompromised patients

Antifungal Agent, Azole Derivative
Interferes with fungal cytochrome P450 (lanosterol-14α-demethylase) activity, decreasing ergosterol synthesis (principal sterol in fungal cell membrane) and inhibiting fungal cell membrane formation.

Absorption:
Tmax: 1.5 hours
Distribution:
1. Protein binding, Albumin: >98%
2. Vd: 261 L
Metabolism:
1. Hepatic: primarily glucuronidation
2. Substrate of P-glycoprotein, uridine diphosphate (UDP)-glucuronidation; Inhibitor of CYP3A4
3. Elimination Half Life: 27 hours
Excretion:
1. Fecal: 71% (66% unchanged); Renal: 13% (<0.2% unchanged)
2. Total body clearance: 7.3 L/hr

1. Concomitant use with ergot alkaloids, HMG-CoA reductase inhibitors primarily metabolized by CYP3A4 (eg, atorvastatin, lovastatin, and simvastatin), sirolimus, or CYP3A4 substrates that prolong the QT interval (eg, pimozide and quinidine)
2. Hypersensitivity to posaconazole or other azole antifungals

C(FDA)

N/A

1. Endocrine metabolic: Hypokalemia
2. Gastrointestinal: Diarrhea, Nausea, Vomiting
3. Neurologic: Headache
4. Other: Fever
5. Cardiovascular: Prolonged QT interval, Torsades de pointes
6. Hepatic: Cholestasis, Liver failure
7. Respiratory: Cough, dyspnea, epistaxis
8. postmarketing: Cholestasis, prolonged Q-T interval on ECG

Aspergillosis:
1. Chronic cavitary pulmonary: 300 mg twice daily for 2 doses, then 300 mg once daily; duration ≥6 months, some require prolonged therapy
2. Invasive: 300 mg twice daily for 2 doses, then 300 mg once daily; minimum duration 6-12 weeks
Prophylaxis against invasive fungal infections:
300 mg twice daily for 2 doses, then 300 mg once daily

N/A

1. eGFR ≥50 mL/minute/1.73 m2: No dosage adjustment necessary.
2. eGFR <50 mL/minute/1.73 m2: Avoid use unless risk/benefit has been assessed; monitor serum creatinine levels, consider oral therapy if increases occur
3. CVVH: No specific dosing recommendations can be made

1. Child-Pugh class A, B, or C: No dosage adjustment necessary
2. Hepatotoxicity during treatment: There are no dosage adjustments provided in the manufacturer's labeling; consider discontinuing therapy.

N/A