Noxafil

Adult Dosing .

Dosage forms:  DR TAB: 100 mg; SUSP: 40 mg per mL; INJ: various

Special Note

[formulation clarification]

Info: posaconazole susp not bioequivalent or interchangeable w/ tab and IV form; reassess dose if switching between products

invasive fungal infection prophylaxis, immunocompromised pts

[delayed-release form]

Dose: 300 mg DR PO qd; Start: 300 mg DR PO bid x1 day; Info: 1st-line tx for invasive aspergillosis prophylaxis; duration based on immunosuppression recovery; do not cut/crush/chew DR tab

[suspension form]

Dose: 200 mg susp PO tid; Info: duration based on immunosuppression recovery; give w/ full meal, liquid nutrient supplement, or acidic carbonated beverage

[IV form]

Dose: 300 mg IV q24h; Start: 300 mg IV q12h x1 day; Info: duration based on immunosuppression recovery

candidiasis, oropharyngeal

[suspension form]

Dose: 100 mg susp PO qd x13 days; Start: 100 mg susp PO bid x1 day; Info: give w/ full meal, liquid nutrient supplement, or acidic carbonated beverage

candidiasis, refractory oropharyngeal

[suspension form]

Dose: 400 mg susp PO bid x3 days, then 400 mg susp PO qd for up to 28 days; Info: for itraconazole- or fluconazole-refractory dz; duration based on underlying dz severity, tx response; give w/ full meal, liquid nutrient supplement, or acidic carbonated beverage

aspergillosis, invasive

[delayed-release form]

Dose: 300 mg DR PO qd for at least 6-12wk; Start: 300 mg DR PO bid x1 day; Info: do not cut/crush/chew DR tab

[IV form]

Dose: 300 mg IV q24h for at least 6-12wk; Start: 300 mg IV q12h x1 day

[suspension form (off-label)]

Dose: 200 mg susp PO tid for at least 6-12wk; Info: give w/ full meal, liquid nutrient supplement, or acidic carbonated beverage

candidiasis, esophageal (off-label)

[delayed-release form]

Dose: 300 mg DR PO qd; Info: for fluconazole-refractory dz; do not cut/crush/chew DR tab

[suspension form]

Dose: 400 mg susp PO bid; Info: for fluconazole-refractory dz; give w/ full meal, liquid nutrient supplement, or acidic carbonated beverage

renal dosing

[PO route]

renal impairment: no adjustment; Info: monitor for breakthrough invasive fungal infection if eGFR <20

HD/PD: not defined

[IV route]

eGFR <50: avoid use; Info: risk of IV vehicle accumulation

HD/PD: not defined

hepatic dosing

[no adjustment]

Peds Dosing .

Dosage forms:  DR TAB: 100 mg; SUSP: 40 mg per mL; DR SUSP: 30 mg per mL; INJ: various

Special Note

[formulation clarification]

Info: posaconazole IR susp not bioequivalent or interchangeable w/ tab, DR susp, and IV form; reassess dose if switching between products

invasive fungal infection prophylaxis, immunocompromised pts

[delayed-release suspension form, 2 yo and older, 10-11 kg]

Dose: 90 mg DR susp PO qd; Start: 90 mg DR susp PO bid x1 day; Info: duration based on immunosuppression recovery; give w/ food

[delayed-release suspension form, 2 yo and older, 12-16 kg]

Dose: 120 mg DR susp PO qd; Start: 120 mg DR susp PO bid x1 day; Info: duration based on immunosuppression recovery; give w/ food

[delayed-release suspension form, 2 yo and older, 17-20 kg]

Dose: 150 mg DR susp PO qd; Start: 150 mg DR susp PO bid x1 day; Info: duration based on immunosuppression recovery; give w/ food

[delayed-release suspension form, 2 yo and older, 21-25 kg]

Dose: 180 mg DR susp PO qd; Start: 180 mg DR susp PO bid x1 day; Info: duration based on immunosuppression recovery; give w/ food

[delayed-release suspension form, 2 yo and older, 26-35 kg]

Dose: 210 mg DR susp PO qd; Start: 210 mg DR susp PO bid x1 day; Info: duration based on immunosuppression recovery; give w/ food

[delayed-release suspension form, 2 yo and older, 36-40 kg]

Dose: 240 mg DR susp PO qd; Start: 240 mg DR susp PO bid x1 day; Info: duration based on immunosuppression recovery; give w/ food

[delayed-release tablet form, 2 yo and older, >40 kg]

Dose: 300 mg DR tab PO qd; Start: 300 mg DR tab PO bid x1 day; Info: duration based on immunosuppression recovery; do not cut/crush/chew DR tab

[immediate-release suspension form, 13 yo and older]

Dose: 200 mg IR susp PO tid; Info: duration based on immunosuppression recovery; give w/ full meal, liquid nutrient supplement, or acidic carbonated beverage

[IV form, 2 yo and older]

Dose: 6 mg/kg/dose IV q24h; Start: 6 mg/kg/dose IV q12h x1 day; Max: 300 mg/dose; Info: duration based on immunosuppression recovery

candidiasis, oropharyngeal

[immediate-release suspension form, 13 yo and older]

Dose: 100 mg IR susp PO qd x13 days; Start: 100 mg IR susp PO bid x1 day; Info: give w/ full meal, liquid nutrient supplement, or acidic carbonated beverage

candidiasis, refractory oropharyngeal

[immediate-release suspension form, 13 yo and older]

Dose: 400 mg IR susp PO bid x3 days, then 400 mg IR susp PO qd for up to 28 days; Info: for itraconazole- or fluconazole-refractory dz; duration based on underlying dz severity, tx response; give w/ full meal, liquid nutrient supplement, or acidic carbonated beverage

aspergillosis, invasive

[delayed-release tablet form, 13 yo and older]

Dose: 300 mg DR tab PO qd for at least 6-12wk; Start: 300 mg DR tab PO bid x1 day; Info: do not cut/crush/chew DR tab

[IV form, 13 yo and older]

Dose: 300 mg IV q24h for at least 6-12wk; Start: 300 mg IV q12h x1 day

renal dosing

[PO route]

renal impairment: no adjustment; Info: monitor for breakthrough invasive fungal infection if eGFR <20

HD/PD: not defined

[IV route]

eGFR <50: avoid use; Info: risk of IV vehicle accumulation

HD/PD: not defined

hepatic dosing

[no adjustment]