posaconazole at a glance
Medicine class
Systemic triazole antifungal
Main roles
Treatment of selected serious fungal infections and prevention in people at high risk
Important formulation warning
Tablets, standard oral suspension and gastro-resistant oral powder are not directly interchangeable
Monitoring
Blood tests and sometimes posaconazole concentrations are used to check safety and exposure
What is posaconazole used for?
Licensed uses depend on the formulation, age, weight and clinical circumstances.
Treatment of invasive aspergillosis.
Treatment of refractory or poorly tolerated invasive aspergillosis, fusariosis, chromoblastomycosis, mycetoma and coccidioidomycosis.
Prevention of invasive fungal infections during prolonged neutropenia associated with AML or MDS chemotherapy.
Prevention of invasive fungal infections in high-risk stem-cell transplant recipients receiving intensive immunosuppression for graft-versus-host disease.
Standard oral suspension: treatment of severe oropharyngeal candidiasis in immunocompromised adults when a poor response to topical treatment is expected.
How does posaconazole work?
Fungi need ergosterol to build stable cell membranes. Posaconazole blocks fungal lanosterol 14α-demethylase, disrupting ergosterol production and stopping susceptible fungi from growing or surviving.
posaconazole preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 300 mg
Gastro-resistant tablet
Route: Oral
Strengths: 100 mg
Oral suspension
Route: Oral
Strengths: 40 mg/mL, 300 mg
How to take posaconazole
Use exactly the formulation stated on the prescription; never substitute another posaconazole product without specialist review.
Swallow gastro-resistant tablets whole with water. Do not crush, chew, dissolve or break them; they may be taken with or without food.
Shake standard oral suspension well before measuring it. Whenever possible, take it during or immediately after food or a nutritional drink.
Gastro-resistant powder and solvent must be prepared and measured using its supplied equipment and instructions; it is not interchangeable with standard oral suspension.
Intravenous posaconazole is prepared and administered by healthcare professionals.
posaconazole side effects
Common or expected effects
- Nausea, vomiting or diarrhoea
- Headache, dizziness, tiredness or sleepiness
- Reduced appetite, abdominal discomfort, indigestion or altered taste
- Rash or itching
- Fever
- Changes in potassium, magnesium, blood-cell counts or liver tests
Get urgent medical advice
- Severe allergic reaction
- Liver injury, including jaundice or dark urine
- Abnormal heart rhythm or fainting
- Severe or persistent vomiting or diarrhoea that may impair absorption
- Serious blood, electrolyte or neurological abnormalities
posaconazole in pregnancy
Human pregnancy information is insufficient, and animal studies found reproductive toxicity. Posaconazole should be used during pregnancy only when the expected maternal benefit clearly outweighs potential fetal risk. Effective contraception is required during treatment; contact the prescriber promptly if pregnancy occurs.
posaconazole while breastfeeding
It is unknown whether posaconazole enters human milk. The product information states that breastfeeding must stop when treatment begins; discuss feeding options with the specialist team.
posaconazole interactions
Posaconazole strongly inhibits CYP3A4 and is affected by medicines that alter absorption or transport. A complete interaction check is essential before starting, stopping or changing medicines.
Terfenadine, astemizole, cisapride, pimozide, halofantrine or quinidine
Contraindicated because increased concentrations can cause QT prolongation and potentially fatal arrhythmias.
Simvastatin, lovastatin or atorvastatin
Contraindicated because markedly increased statin exposure may cause rhabdomyolysis.
Ergotamine or dihydroergotamine
Contraindicated because increased exposure may cause ergot toxicity.
Common questions about posaconazole
Answers are fully visible for fast scanning and source review.
What is posaconazole used for?
Posaconazole treats selected serious fungal infections and prevents invasive fungal infection in people at high risk because of chemotherapy, stem-cell transplantation or intensive immunosuppression.
Is posaconazole an antibiotic?
No. Posaconazole is a triazole antifungal; it acts against susceptible fungi rather than bacteria.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.