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Mycoplasma Pneumonia — SCE Infectious Diseases MCQ

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HardRespiratory InfectionMycoplasma PneumoniaSCE Infectious Diseases

A patient with CLL is about to start venetoclax dose titration and also requires mould-active azole prophylaxis. Which posaconazole principle is correct?

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Correct answer: B — Use alternative antifungal prophylaxis throughout venetoclax initiation and dose titration

Explanation lettering: E = shown as B · B = shown as C · C = shown as D · D = shown as E

E is correct. Posaconazole strongly inhibits CYP3A4 and can markedly increase venetoclax exposure. During CLL initiation and dose titration the combination is contraindicated because toxicity, including tumour-lysis syndrome and neutropenia, can rise. Dose timing, alternate-day administration and changing posaconazole formulation do not remove enzyme inhibition. Once titration is complete, any co-administration requires the product-specific venetoclax dose adjustment and specialist monitoring; the immediate decision here is to choose a compatible prophylaxis strategy.

Reference: Noxafil gastro-resistant tablets SmPC: https://www.medicines.org.uk/emc/product/5388/smpc