All the Drug Class Drugs
Antimycotic, Triazole Derivatives. Isavuconazole 100 mg. CAPS.: 14. Loading dose is 2 caps (200mg)×3/d every 8 hrs. for the first 48 hrs. (6 admin. in total).
Mainten. dose: 2 caps. (200mg)×1/d, start. 12-24 hrs. after the last load. dose. Durat. of ther. should be determin. by the clinic. response.
For long-term tmt. beyond 6 mnths., the benefit-risk balance should be careful. consid.
Tmt. of invas. aspergillosis; mucormycosis in pt. for whom amphotericin B is inapprop. Consider. should be given to offic. guidance on the approp. use of antifung. agents.
C/I: Hypersens. Co-admin. with ketoconazole. Co-admin. with high-dose ritonavir (>200 mg every 12 hrs). Co-admin. with strong CYP3A4/5 induc. such as rifampicin, rifabutin, carbamazepine, long-act. barbiturates (e.g. phenobarbital), phenytoin and St. John’s wort or with moder. CYP3A4/5 induc. such as efavirenz, nafcillin & etravirine. Pts. with famil. short QT syndr.
Antimycotic, Triazole Derivatives. Isavuconazole 200 mg. VIAL (pwdr. for concentrat. for sol. for infus.): 1×10ml. Load. dose: The recomm. load. dose is 1 vial after reconstit. & dilute. (equiv. to 200 mg of isavuconazole) every 8 hrs. for the first 48 hrs. (6 admin. in total).
Mainten. dose: The recom. mainten. dose is one vial after reconstit. and dilute. (equiv. to 200 mg of isavuconazole) once dly., starting 12- 24 hrs. after the last load. dose.
Durat. of therapy should be determ. by the clinical response.
For long-term tmt. beyond 6 mnths., the benefit-risk balance should be carefully considered.
Switch to oral isavuconazole: This drug is also available as hard caps. contain. 100 mg isavuconazole, equiv. to 186 mg isavuconazonium sulfate. See lit.
Indic. in adult. for the tmt. of: Invasive aspergillosis, mucormycosis in pts. for whom amphotericin B is inappropr.
Consideration should be given to official guidance on the appropr. use of antifung. agents.
C/I: Hypersens. Co-admin. with ketoconazole. Co-admin. with high-dose ritonavir (>200 mg every 12 hrs.).
Co-admin. with strong CYP3A4/5 induc. such as rifampicin, rifabutin, carbamazepine, long-act. barbiturates (e.g. phenobarbital), phenytoin and St. John’s wort or with moder. CYP3A4/5 induc. (e.g. efavirenz, nafcillin, etravirine). Pts. with familial short QT syndr.
Antifungal, Triazole Derivatives. Fluconazole 50 mg / 5 ml. BOTTLE (pwdr. for oral susp.): 35ml. Dosage should be just. individ.
Fungal infec.:
Cryptococcal meningit.
Coccidioidomycos.
Invas. candidias.
Mucos. candidias. includ. oropharyng., oesophag. candidias., candiduria, chron. mucocutaneous candidias.
Chron. oral atrophic candidias. (denture sore mouth) if dent. hygiene or topic. tmt. are insuffic.
Vagin. candidias., acute/recurrent; when local ther. is not appropr..
Candidal balanitis when local ther. is not approp.
Dermatomycos. include. tinea pedis, tinea corporis, tinea cruris, tinea versicolor, derm. candida infec. when system. ther. is indicated.
Tinea unguinium (onychomycosis) when other agents are not consid. appropriate.
Fluconazole is indic. in adult. for the prophylaxis of:
Relapse of cryptococcal meningit. in pts. with high risk of recur.
Relapse of oropharyng./oesophag. candidiasis in pts. infec. with HIV
and with high risk of experienc. relapse.
To reduce the incidence of recur. vag. candid. (4 or more episodes a year). Prophylaxis of candidal infec. in pts. with prolong. neutropen. (such as pts. with haematolog. malignan. receiv. chemother. or pts. receiving Hematopoietic Stem Cell Transplant.
Term newborn infan., infant., toddlers, child., adolescen. aged from 0 - 17 yrs. old:
Tmt. of mucosal candidiasis (oropharyngeal, oesophageal), invas. candidiasis and cryptococcal meningit. and the prophylaxis of candidal infec. in immunocomprom. pts. Fluconazole can be used as mainten. ther. to prevent relapse of cryptococcal meningitis in child. with high risk of reoccurrence.
C/I: Hypersens. Coadmin. with of terfenadine in pts. receiv. fluconazole at multiple doses of 400 mg/d or higher based upon results of a multiple dose interact. study. Coadmin. of other med. products known to prolong the QT interv. and which are metabolised via the P450 (CYP) 3A4 such as cisapride, astemizole, pimozide, quinidine, erythromycin.
Triazole Derivatives. Posaconazole 300 mg/vial. VIAL.: 1 × 300 mg. Refract. invas. fung. infect. (IFI)/pts. with IFI intoler. to 1st line ther.: Load. dose of 300 mg×2/d. on the 1st day, then 300 mg ×1/d thereafter. Duration of ther. should be based on the severity of the underl. dis., recovery from immunosuppress., and clinic. response.
Prophylaxis of invas. fung. infec.: Load. dose of 300 mg mg×2/d on the 1st day, then 300 mg mg ×1/d thereafter. Duration of ther. is based on recovery from neutropenia or immunosuppress. For pts. with AML or MDS, prophylaxis with Posaconazole should start several days before the anticip. onset of neutropenia and continue for 7 d. after the neutrophil count rises above 500 cells per mm³. See lit.
Tmt. of the follow. fung. infec. in adult.: Invasive aspergillosis in pts. with dis. that is refract. to amphotericin B or itraconazole or in pts. who are intoler. of these med. products;
Fusariosis in pts. with dis. that is refract. to amphotericin B or in pts. who are intolerant of amphotericin B;
Chromoblastomycosis and mycetoma in pts. with dis. that is refractory to itraconazole or in pts. who are intoler. of itraconazole;
Coccidioidomycosis in pts. with dis. that is refract. to amphotericin B, itraconazole or fluconazole or in pts. who are intoler. of these med. products.
Zygomycosis, in pts. intoler. of, or with dis. that is refract. to, alternat. ther.
Refractoriness is defined as progres. of infec. or fail. to improve after a min. of 7 d. of prior therapeutic doses of effective antifung. ther.
Pts. receiving remiss.-induc. chemother. for acute myelogenous leuk. (AML) or myelodysplastic syndr. (MDS) expected to result in prolong. neutropenia and who are at high risk of developing invas. fungal infec.;
Hematopoietic stem cell transplant (HSCT) recip. who are underg. high-dose immunosuppress. ther. for graft versus host dis. (GVHD) and who are at high risk of develop. invas. fungal infec.
C/I: Hypersens. Co-admin. with ergot alkaloids. Co-admin. with the CYP3A4 substr. terfenadine, astemizole, cisapride, pimozide, halofantrine or quinidine since this may result in incr. plasma conc. of these med. products, leading to QTc prolong. and rare occurrences of torsades de pointes. Co-admin. with the HMG-CoA reductase inhib. simvastatin, lovastatin and atorvastatin.
Triazole Derivatives. Posaconazole 40 mg/ml. BOTTLE: 105 ml. Refract. invas. fung. infect. (IFI)/pts. with IFI intoler. to 1st line ther.: 200 mg (5 mL) ×4/d. Alternatively, pts. who can tolerate food or a nutrit. supplem. may take 400 mg (10 mL) ×2/d during or immediat. follow. a meal or nutrit. supplem. Duration of ther. should be based on the sever. of the underl. dis., recovery from immunosuppress., and clinic. response.
Oropharyng. candidiasis: Loading dose of 200 mg (5 mL)×1/d on the 1st day, then 100 mg (2.5 mL)×1/d for 13 d. Each dose should be adm. during or immed. after a meal, or a nutrit. supplem. in pts. who cannot tolerate food to enhance the oral absorp. and to ensure adequate exposure.
Prophylaxis of invas. fungal infec.: 200 mg (5 mL) ×2/d. Each dose of Noxafil should be admin. during or immediate. after a meal, or a nutrit. supplem. in pts. who cannot tolerate food to enhance the oral absorp. and to ensure adequate exposure. The duration of ther. is based on recovery from neutropen. or immunosuppress. For pts. with acute myelogenous leukemia or myelodysplastic syndr., prophylaxis with Noxafil should start several days before the anticip. onset of neutropenia and continue for 7 d after the neutrophil count rises above 500 cells per mm³.
Tmt. of the follow. fung. infec. in adult.: Invasive aspergillosis in pts. with dis. that is refract. to amphotericin B or itraconazole or in pts. who are intoler. of these med. products;
Fusariosis in pts. with dis. that is refract. to amphotericin B or in pts. who are intolerant of amphotericin B;
Chromoblastomycosis and mycetoma in pts. with dis. that is refractory to itraconazole or in pts. who are intoler. of itraconazole;
Coccidioidomycosis in pts. with dis. that is refract. to amphotericin B, itraconazole or fluconazole or in pts. who are intoler. of these med. products.
Zygomycosis, in pts. intoler. of, or with dis. that is refract. to, alternat. ther.
Refractoriness is defined as progres. of infec. or fail. to improve after a min. of 7 d. of prior therapeutic doses of effective antifung. ther.
Pts. receiving remiss.-induc. chemother. for acute myelogenous leuk. (AML) or myelodysplastic syndr. (MDS) expected to result in prolong. neutropenia and who are at high risk of developing invas. fungal infec.;
Hematopoietic stem cell transplant (HSCT) recip. who are underg. high-dose immunosuppress. ther. for graft versus host dis. (GVHD) and who are at high risk of develop. invas. fungal infec.
C/I: Hypersens. Co-admin. with ergot alkaloids. Co-admin. with the CYP3A4 substr. terfenadine, astemizole, cisapride, pimozide, halofantrine or quinidine since this may result in incr. plasma conc. of these med. products, leading to QTc prolong. and rare occurrences of torsades de pointes. Co-admin. with the HMG-CoA reductase inhib. simvastatin, lovastatin and atorvastatin.
Triazole Derivatives. Posaconazole 100 mg. GASTRO-RESIS. TABS.:24. Refract. invas. fung. infect. (IFI)/pts. with IFI intoler. to 1st line ther.: Load. dose of 300 mg (three 100 mg tabs.) ×2/d on the 1st day, then 300 mg (three 100 mg tabs.) ×1/d thereafter.
Each dose may be taken without regard to food intake. Duration of ther. should be based on the severity of the underl. dis., recovery from immunosuppress., and clinic. response.
Prophylax. of invas. fung. infec.: Load. dose of 300 mg (three 100 mg tabs.) ×2/d on the 1st day, then 300 mg (three 100 mg tabs.) ×1/d thereafter.
Each dose may be taken without regard to food intake. Duration of ther. is based on recovery from neutrop. or immunosuppress. For pts. with acute myelogenous leukem. or myelodysplas. syndr., prophylax. with posaconazole should start several days before the anticip. onset of neutropen. and cont. for 7 d. after the neutrophil count rises above 500 cells per mm3. See lit.
Tmt. of the follow. fung. infec. in adult.
Invas. aspergillos. in pts. with dis. that is refract. to amphotericin B or itraconazole or in pts. who are intoler. of these med. products;
Fusariosis in pts. with dis. that is refract. to amphotericin B or in pts. who are intoler. of amphotericin B;
Chromoblastomycosis & mycetoma in pts. with dis. that is refract. to itraconazole or in pts. who are intoler. of itraconazole;
Coccidioidomycosis in pts. with dis. that is refract. to amphotericin B, itraconazole or fluconazole or in pts.who are intoler. of these med. products.
Zygomycosis in pts. intoler. of or with dis. that is refract. to alternat. ther.
Refractoriness is defined as progres. of infec. or failure to improve after a min. of 7 d. of prior therap. doses of effective antifung. ther.
Prophylax. of invas. fung. infect. in the follow.: Pts. receiv. remiss. –induct. chemother. for acute myelogenous leukemia (AML) or myelodysplastic syndr. (MDS) expected to result in prolong. neutropen. and who are at high risk of develop. invas. fung. infect.;
Hematopoiet. stem cell transplant (HSCT) recipients who are underg. high-dose immunosuppress. ther. for graft versus host dis. and who are at high risk of develop. invas. fung. infect.
C/I: Hypersens. Co-admin. with ergot alkaloid. Co-admin. with the CYP3A4 substrates terfenadine, astemizole, cisapride, pimozide, halofantrine or quinidine since this may result in incr. plasma conc. of these med. products, leading to QTc prolong. and rare occurrences of torsades de pointes.
Co-admin. with the HMG-CoA reductase inhib. simvastatin, lovastatin and atorvastatin.
