Posaconazole (Intravenous)

When patients have an illness or are undergoing treatment that lowers their immune system they are given Posaconazole to prevent certain fungus infections from taking hold.

Overview

Posaconazole is an antifungal medication that is used in the prevention of fungal infections in patients who have a lowered immune system.

The immune system can be lowered because of illnesses such as blood cancer or can occur following certain treatments that cause a lowering of the white blood cells. When the count of white blood cells is lower in the body, the ability to fight infection is dramatically reduced. Posaconazole helps to prevent the development of yeast infections in these patients.

This treatment is given as an injected solution and should only be administered under the direct supervision of the prescribing doctor. It is administered under the brand name of Noxafil and needs to be administered through infusion over a period of 30-90 minutes.

Condition treated

  • Fungal infection
  • prevention of

Type Of Medicine

  • Antifungal

Side Effects

In addition to the antifungal effects of Posaconazole, the medication can also have unwanted side effects on the patient. While not all of the side effects listed herein may occur, in some cases they require that the patient seek medical attention. In some cases side effects can be a sign that wider medical conditions are developing.

When taking Posaconazole you should contact your doctor immediately if you begin to experience any of the following side effects:

  • Black stools with a tarry appearance
  • Blurring of the vision
  • Changed heartbeat
  • Chills
  • Decrease in urine output
  • Dizziness
  • Feverishness
  • Headache
  • Increased thirst
  • Irregularity of heartbeat
  • Lost appetite
  • Mental changes
  • Mood swings
  • Muscle cramping
  • Muscle pain
  • Muscle spasms and/or twitching
  • Nausea
  • Nervousness
  • Numbness or tingling of the hands, feet or lips
  • Pounding sensation in the ears
  • Red spots appearing on the skin
  • Swollen hands, ankles, feet or lower legs
  • Trembling
  • Troubled breathing
  • Unusual bleeding
  • Unusual bruising
  • Unusual tiredness
  • Unusual weakness
  • Vomiting

Other side effects may occur that would not normally require that you seek the attention of a doctor. These side effects are usually more mild and will abate as the body becomes used to the medication. If these side effects become bothersome or are ongoing, however, then inform your doctor and they may be able to help alleviate them:

  • Abdominal pain
  • Coughing
  • Diarrhea
  • Difficulty passing a bowel movement
  • Rash
  • Red or purple spots appearing on the skin
  • Stomach pain

Other side effects can occur from the use of this medication that may not have been listed here. In the case that you experience other side effects you should inform your doctor promptly. If you are worried about your immediate health, however, then you should always seek emergency treatment.

Dosage

This medication will be administered in the hospital or clinic by a trained medical professional and under the direct supervision of a doctor. It is administered directly into the veins of the patient using IV. The process will take between 30-90 minutes because the medication needs to be introduced into the blood stream at a slow rate.

Before receiving this treatment you should be given a patient information leaflet that you should read thoroughly and ensure that you understand before taking this treatment. Ask your doctor if you have any questions.

Interactions

Before you begin use of any medication it is vital to ensure that it will not interact with any other medications or drugs that you are taking in the body. In some cases doing so can cause severe or even life-threatening side effects. In other cases one drug may stop another from working or may increase the risk of occurrence of certain other side effects. Before treatment you should ensure that your doctor is aware of all medications that you are taking.

The use of Posaconazole is not recommended with any of the following medications. If you are taking any of the following medications then your doctor may choose not to administer Posaconazole or to change one of your other treatments. Alternative treatments may be found in such cases:

  • Ziprasidone
  • Voriconazole
  • Vilanterol
  • Venetoclax
  • Vemurafenib
  • Vardenafil
  • Trazodone
  • Toremifene
  • Tolvaptan
  • Thioridazine
  • Terfenadine
  • Telithromycin
  • Tamoxifen
  • Sunitinib
  • Sparfloxacin
  • Sorafenib
  • Solifenacin
  • Sirolimus
  • Simvastatin
  • Saquinavir
  • Salmeterol
  • Ranolazine
  • Quinine
  • Quinidine
  • Quetiapine
  • Propafenone
  • Piperaquine
  • Pimozide
  • Pazopanib
  • Ondansetron
  • Nimodipine
  • Nilotinib
  • Nelfinavir
  • Naloxegol
  • Mifepristone
  • Methysergide
  • Methylergonovine
  • Methadone
  • Mesoridazine
  • Mefloquine
  • Maraviroc
  • Lurasidone
  • Lumefantrine
  • Lovastatin
  • Lopinavir
  • Lomitapide
  • Lapatinib
  • Ivabradine
  • Itraconazole
  • Isavuconazonium Sulfate
  • Iloperidone
  • Haloperidol
  • Halofantrine
  • Fluvastatin
  • Flibanserin
  • Erythromycin
  • Ergotamine
  • Ergonovine
  • Eplerenone
  • Eletriptan
  • Dronedarone
  • Donepezil
  • Domperidone
  • Dofetilide
  • Disopyramide
  • Dihydroergotamine
  • Dasatinib
  • Dabrafenib
  • Crizotinib
  • Conivaptan
  • Clarithromycin
  • Citalopram
  • Cisapride
  • Bepridil
  • Bedaquiline
  • Atorvastatin
  • Astemizole
  • Aripiprazole
  • Amisulpride
  • Amiodarone
  • Amifampridine
  • Alfuzosin

The use of Posaconazole in conjunction with the following medications is not normally recommended. In some cases both may be prescribed together but your doctor may make changes to the dose or frequency of use of one or other of the treatments:

  • Zuclopenthixol
  • Zolpidem
  • Warfarin
  • Vorapaxar
  • Vinorelbine
  • Vincristine Sulfate Liposome
  • Vincristine
  • Vinblastine
  • Vilazodone
  • Triptorelin
  • Trimipramine
  • Trabectedin
  • Tizanidine
  • Tetrabenazine
  • Telavancin
  • Telaprevir
  • Tamsulosin
  • Tacrolimus
  • Suvorexant
  • Sulpiride
  • Sotalol
  • Sonidegib
  • Sodium Phosphate, Monobasic
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate
  • Simeprevir
  • Sevoflurane
  • Ruxolitinib
  • Romidepsin
  • Rifampin
  • Rifabutin
  • Retapamulin
  • Regorafenib
  • Reboxetine
  • Protriptyline
  • Promethazine
  • Prochlorperazine
  • Procainamide
  • Ponatinib
  • Phenytoin
  • Perflutren Lipid Microsphere
  • Pasireotide
  • Paliperidone
  • Palbociclib
  • Oxycodone
  • Olaparib
  • Ofloxacin
  • Octreotide
  • Norfloxacin
  • Nifedipine
  • Nafarelin
  • Moxifloxacin
  • Midazolam
  • Metronidazole
  • Manidipine
  • Macitentan
  • Lumacaftor
  • Levomilnacipran
  • Levofloxacin
  • Leuprolide
  • Ivacaftor
  • Irinotecan Liposome
  • Irinotecan
  • Imipramine
  • Ifosfamide
  • Idelalisib
  • Ibutilide
  • Ibrutinib
  • Hydroxyzine
  • Hydroxychloroquine
  • Hydrocodone
  • Histrelin
  • Granisetron
  • Goserelin
  • Gonadorelin
  • Gemifloxacin
  • Gatifloxacin
  • Fosphenytoin
  • Fosaprepitant
  • Fosamprenavir
  • Fluticasone
  • Fluoxetine
  • Fluconazole
  • Flecainide
  • Fingolimod
  • Fentanyl
  • Everolimus
  • Etravirine
  • Eszopiclone
  • Esomeprazole
  • Erlotinib
  • Enzalutamide
  • Efavirenz
  • Droperidol
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Dolasetron
  • Deslorelin
  • Desipramine
  • Degarelix
  • Daclatasvir
  • Cyclosporine
  • Cobimetinib
  • Clomipramine
  • Ciprofloxacin
  • Cimetidine
  • Cilostazol
  • Chlorpromazine
  • Chloroquine
  • Ceritinib
  • Cariprazine
  • Calcifediol
  • Cabozantinib
  • Cabazitaxel
  • Buserelin
  • Bromocriptine
  • Brexpiprazole
  • Brentuximab Vedotin
  • Bosutinib
  • Azithromycin
  • Axitinib
  • Avanafil
  • Asenapine
  • Arsenic Trioxide
  • Aprepitant
  • Apomorphine
  • Anagrelide
  • Amprenavir
  • Amitriptyline
  • Ado-Trastuzumab Emtansine

The following medications will cause an increased risk of certain side effects to occur when used with Posaconazole. Your doctor may still prescribe both but may make changes to the dose or frequency of use of the treatment or treatments:

  • Topiramate
  • Lorazepam

Interactions with other medications that have not been listed herein could also occur. This list has been compiled due to the severity of interactions only so you should be sure that your doctor knows of all substances you take before you begin treatment with Posaconazole.

Other medical conditions from which you suffer may also impact the use of this medication. You should share your full medical history with your doctor before use. This is especially important if you have any of the following conditions:

The following conditions may increase the severity of side effects from treatment:

  • History of heart disease
  • Heart rhythm problems
  • Liver disease
  • Mineral imbalance

Use is not recommended in patients who suffer from the following condition:

  • Moderate to severe kidney disease

Other medical conditions may also affect the use of Posaconazole so patients must share all medical information with their doctor before use.

Warnings

Before making the decision to take any medication you should consider the risks of doing so against the benefits of use with your doctor. For Posaconazole you should ensure that you have considered all of the following factors before use:

Allergies “ You must inform your doctor if you have ever reacted unusually to any medications in the past. You should also tell them about any other allergies from which you have suffered. Allergies can in some cases prohibit use of certain medications.

Pediatric “ The safety and efficiency of use of this treatment in children has not been established. You should discuss this with your doctor before use.

Geriatric “ There are no known age-related limitations to the use of this treatment in the elderly. Elderly patients are, however, more likely to have moderate to severe kidney problems that would prohibit the use of Posaconazole.

Pregnancy “ You must inform your doctor before use if you are pregnant. There is a risk to the use of Posaconazole during pregnancy that must be discussed with your doctor.

Breastfeeding “ You should discuss the benefits against the risks with your doctor before nursing a child. The risk has not been established so you should consider this seriously.

During use your doctor will need to monitor you and you will need to make return visits so that they can check on your health. Blood and urine tests can be required to check for unwanted side effects and to monitor health.

The use of Posaconazole can cause changes to the patient's heartbeat to occur. This can potentially be very dangerous and should be reported to the doctor immediately. You should contact your doctor right away if you have any symptoms of this including:

  • Fainting
  • Fast heartrate
  • Pounding heart
  • Irregularity of heartbeat

Serious liver problems may also develop from the use of this treatment. You should report any symptoms of liver problems to your doctor straight away. These symptoms include the following:

  • Stomach pains
  • Unusual tiredness
  • Darkened urine
  • Pale stools
  • Black stools
  • Bloody stools
  • Unusual weakness
  • Yellowing of the skin or eyes

If you have severe diarrhea or vomiting following treatment then you should contact your doctor immediately.

You should not take any other medications in conjunction with this treatment unless you have been directed to by your doctor. This includes all over the counter treatments as well as any other prescribed medications.

You should inform all medical professionals with whom you interact that you have had this treatment before receiving any other treatments, tests or surgeries.

Storage

  • Before mixing Posaconazole can be stored at 2-8°C for up to 3 years or until expiry date.
  • Once mixed the treatment should be stored for no more than 24 hours at 2-8°C

Summary

Posaconazole is a treatment administered by infusion directly into the veins of the patient to prevent fungal infections from occurring. It is used in cases where the patient's natural immune system is depleted. This may occur because of illness or because of medical treatments that temporarily lower the white blood cell count in the patient's system. When the white blood cell count is lowered the body's ability to fight infection is reduced and this treatment helps to prevent yeast and other fungal infections in this period.

Posaconazole is administered in a hospital over a period of 30-90 minutes and should only ever be used under the direct supervision of a doctor. Before use the patient will be given a patient information booklet to read that explains the potential risks of use.

Posaconazole interacts with a wide range of medications so it is vital that you inform your doctor of all other medications you are taking. No other medications or treatments should be used in conjunction with this treatment unless it has been approved by the doctor administering Posaconazole.