Posaconazole Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Posaconazole Tablet is a triazole (azole) antifungal medicine used to treat and prevent serious fungal infections, including invasive aspergillosis and other difficult-to-treat fungal diseases. It works by damaging the fungal cell membrane, which kills the fungus or stops it from growing. The usual dose for adults is 300 mg once a day, and it is not recommended for use in children under 18 years.

What is Posaconazole Tablet

Posaconazole is an antifungal medicine used to kill or stop the growth of fungi that cause infections. It belongs to a group of medicines called triazole antifungals.

Posaconazole Tablet uses

• Treats invasive aspergillosis, a fungal infection that can affect the lungs or spread through the body
• Treats other serious fungal infections such as fusariosis, zygomycosis, chromoblastomycosis, and mycetoma, usually when other treatments have not worked or could not be tolerated
• Treats coccidioidomycosis, a rare and serious fungal infection
• Prevents fungal infections (yeasts and moulds) in patients at high risk of developing them, such as those with weakened immune systems or after a transplant
• Treats fungal infection of the mouth and throat (oropharyngeal candidiasis), including infections that did not respond to other antifungal medicines

Benefits of Posaconazole Tablet

• Helps prevent serious fungal infections
• Helps prevent Aspergillus infections
• Helps prevent Candida infections in high-risk patients
• Treats certain cases of invasive aspergillosis
• Helps protect people with severely weakened immune systems

How Posaconazole Tablet works

Posaconazole works by blocking an enzyme that fungi need to make a substance called ergosterol, which is an important part of their cell membranes. Without this substance, the fungal cell membrane becomes weak and damaged, causing the fungus to die and clearing the infection.

Posaconazole Tablet dosage

The tablet may be taken with or without food. Swallow the tablet whole with water; do not crush, chew, break, or dissolve it. Do not switch between the tablet and the oral suspension forms unless your doctor tells you to, because they are dosed differently. Keep taking this medicine for as long as your doctor recommends, and do not stop unless instructed. If you forget a dose, take it as soon as you remember; if it is close to your next dose, skip the missed dose and continue your normal schedule — do not double up.

Available forms and strengths

• Oral suspension (liquid)
• Powder for oral suspension
• Injection

Side effects of Posaconazole Tablet

Common

• Nausea, vomiting, or diarrhoea
• Headache and muscle pain
• High blood pressure, swelling in the arms and legs
• Difficulty sleeping
• Nose bleed
• Loss of appetite, upset stomach, stomach pain, gas, dry mouth, altered sense of taste
• Dizziness, sleepiness, tingling in fingers or toes
• Hot flushes
• Dry skin, rash, itchiness
• Back pain
• Fever

Serious

• Heart rhythm problems, e.g. very fast or very slow heartbeat, dizziness, fainting
• Signs of an allergic reaction: swollen face/eyes/lips/tongue, difficulty breathing, itchy rash over the whole body, hives
• Liver problems: dark urine, light-coloured stools, yellowing of the eyes or skin (jaundice), severe nausea, vomiting, loss of appetite
• Pancreas problems: severe abdominal or back pain, severe nausea, vomiting, loss of appetite
• Tingling or numbness of the hands or feet, or muscle weakness
• Swelling of the face, lips, mouth, throat or neck causing difficulty swallowing or breathing

Warnings and precautions

• Do not take posaconazole together with certain medicines, including some allergy medicines, a stomach medicine called cisapride, a mental health medicine called pimozide, a heart rhythm medicine called quinidine, migraine medicines called ergotamine and dihydroergotamine, an anti-malaria medicine called halofantrine, certain cholesterol-lowering statins, and some blood thinners, because of serious interaction risks.
• This medicine can cause a rare but dangerous heart rhythm problem; tell your doctor right away if you faint or notice your heartbeat racing or skipping.
• Serious liver damage can occur with this medicine and can be life-threatening; watch for signs like yellowing skin or eyes, dark urine, and severe tiredness.
• You should avoid too much sun exposure during treatment because your skin may become more sensitive to the sun; cover exposed skin and use a high-SPF sunscreen.
• This medicine is not recommended for children under 13 years of age (for this tablet formulation).
• Posaconazole may harm an unborn baby, so women who could become pregnant should use effective contraception while taking it and should tell their doctor right away if they become pregnant.
• It is not known if posaconazole passes into breast milk, so breastfeeding women should discuss the risks and benefits with their doctor; some guidance recommends not breastfeeding during treatment.
• The pharmacokinetics of oral posaconazole are not significantly affected by kidney impairment, so no dose adjustment is usually needed for oral forms; your doctor may still want to monitor your kidney function.
• Posaconazole can affect the liver, so your doctor may check your liver function with blood tests before and during treatment; tell your doctor if you have had liver problems.
• It is unclear if alcohol affects posaconazole tablets, but heavy drinking can weaken the immune system and make it harder for the body to fight infection; check with your doctor about alcohol use, especially with the powder form which should not be taken with alcohol.
• This medicine may cause dizziness, sleepiness, or blurred vision, so be careful before driving or using machines until you know how it affects you.

Storage

• Store in a cool and dry place, away from direct sunlight
• Keep this medication away from children
• Store below 30°C, in the original container, away from moisture, heat or sunlight
• Do not store in the bathroom or near a sink, and do not leave it in the car or on window sills
• Pack the medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin
• If you no longer need the medicine or it is out of date, take it to any pharmacy for safe disposal

When to see a doctor

• Get medical help immediately if you have swelling of the face, lips, mouth, throat or neck, or trouble breathing or swallowing, as these can be signs of a severe allergic reaction.
• Call your doctor straight away or go to the Emergency Department if you notice tingling or numbness of your hands or feet, or muscle weakness.
• Seek medical advice immediately if you think you have taken more than the recommended dose.
• Call your doctor right away if you faint or notice changes in your heart rate or rhythm, such as a fast or skipping heartbeat.
• Call your doctor right away if you notice signs of liver damage such as nausea, stomach pain, fever, unusual tiredness, loss of appetite, light-colored stools, dark urine, or yellowing of your skin or eyes.

Alternatives

• Itraconazole
• Voriconazole
• Fluconazole