Posaconazole

MEDICATION TYPE

Antifungal

INDICATIONS

invasive aspergillosis; serious infections caused by Scedosporium spp; Fusarium spp. or invasive Candida spp resistant to fluconazole. ABPA in conjunction with steroids.

DRUG INTERACTIONS

Amphoteracin
Possibly antagoinse effect of amphoteracin.

Carbamazepine
Reduces plasma concentration of voriconazole.

Ciclosporin
Increases plasma concentration of ciclosporin.

Coumarins (inc warfarin)
Enhanced anticoagulant effect.

Methadone
Increases plasma concentration of methadone, consider reducing dose.

Omeprazole
Increases plasma concentration of omeprazole – reduce dose.

Phenytoin
Increased plasma concentration of phenytoin – monitor for signs of toxicity. Reduced plasma voriconale concentration – increase dose of voriconazole.

Pimozide
Increased risk of ventricular arrythmias.

Primadone
Reduces plasma concentration of voriconazole – avoid concomitant use.

Quetiapine
Increased plasma concentration of quetiapine – reduce dose.

Quinidine
Increases plasma concentration of quinidine – increased risk of ventricular arrythmias avoid cincomitant use.

Rifabutin
Rifabuitin plasma concentration increased- monitor for signs of toxicity, voriconazole plasma conc decreased, increase dose of voriconazole.

Rifampicin
Plasma concentration of voriconazole reduced – avoid concomitant use.

Sirolimus
Increases plasma concentration of sirolimus – avoid concomitant use.

Sulphonylureas
Increased plasma concentration of sulphonylureas.

Tacrolimus
Increases plasma concentration of tacrolimus.

NOTES

Tablets preferred (better bioavailability). TDM recommended.