Posaconazole

Antimycotic (approved for adults in Germany since October 2005) from the group of azoles (triazole). Posaconazole inhibits the ergosterol biosynthesis and is considered to be an antimycotic, which is used in severe or in itraconazole- or amphotericin B-resistant fungal infections, especially in immunocompromised patients.

• Onychomycosis(resistance to therapy with terbinafine or itraconazole).
• Invasive aspergillosis in patients whose disease is resistant to therapy with amphotericin B or itraconazole or who are intolerant to these drugs. The preparation is also used as a prophylactic in patients with severe immunosuppression.
• Fusariosis in patients whose disease is resistant to therapy with Amphotericin or intolerance to Amphotericin B.
• Chromoblastomycosis and Myzetom in patients whose disease is resistant to therapy with itraconazole or intolerance to itraconazole.
• Coccidioidomycosis in patients whose disease is resistant to therapy with amphotericin B, itraconazole or fluconazole or intolerance to these drugs.
• Oropharyngeal candidosis.

• Therapy-resistant invasive mycosis/patients with intolerance to other systemic antifungal drugs: 2 times/day 400 mg (10 ml) p.o. (daily dose 800 mg) or 4 times/day 200 mg (5 ml) p.o. The duration of therapy depends on the severity of the underlying disease, recovery from immunosuppression if necessary and the clinical response.
• Oropharyngeal candidosis: Initial (initial dose) 1 time / day 200 mg (5 ml) on the first day, then 1 time / day 100 mg (2.5 ml) p.o. for 13 days.
• Prophylaxis of invasive mycoses: 3 times/day 200 mg (5 ml) p.o. The duration of therapy in immunocompromised patients depends on the recovery from neutropenia or immunosuppression.
• Dosage (for therapy-resistant onychomycosis): 1x /day 200 - 400mg p.o.

Remember! To be taken with meals or, in patients who cannot eat a meal, with a food supplement to increase absorption and ensure adequate exposure.

• Hypersensitivity to the active substance or any of the other ingredients.
• Concomitant use of ergot alkaloids, terfenadine, astemizole, cisapride, pimozide, halofantrine or quinidine (QTc prolongation and in rare cases for the occurrence of torsades de pointes), HMG-coA reductase inhibitors such as simvastatin, lovastatin and atorvastatin.

1. Schiller DS, Fung HB (2007) Posaconazole: an extended-spectrum triazole antifungal agent. Clin Ther 29: 1862-1886
2. Elewski B et al (2012) A randomized, placebo- and active-controlled, parallel-group, multicentre, investigator-blinded study of four treatment regimens of posaconazole in adults with toenail onychomycosis.br J Dermatol 166:389-398.