- Prevention of candida or aspergillosis in high-risk patients (e.g. prolonged neutropenia, post-stem-cell transplant patients)
- Treatment of invasive aspergillosis refractory to amphotericin B.
- Suspected or confirmed mucormycosis
- Supplied as 18 mg/mL clear, colourless-to-yellow injectable solution
- 300 mg/vial preservative free - discard unused solution
- Store vial in refrigerator; do not freeze
- Bring to room temperature prior to dilution
- Diluted solution stable 24 hours refrigerated
- Solutions Compatible: D5W, 0.45% NaCl, 0.9% NaCl
- Y-site Compatible: amikacin, caspofungin, ciprofloxacin, hydromorphone, levofloxacin, lorazepam, morphine, potassium chloride 20 mmol/L, vancomycin
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
|IV Intermittent Infusion||
Peripheral line: over 30 minutes, one time, until CVL obtained
Infuse through 5 micron or smaller in-line filter
|IV Continuous Infusion||NO|
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Adolescents / Adults: 300 mg IV q12h x 1 day, then 300 mg IV daily
Pediatrics (off-label dosing): 10 mg/kg/dose (max 400 mg) IV q12h x 1 day, then 10 mg/kg/dose (max 400 mg) IV once daily
Modification for kidney or liver dysfunction: avoid in patients with a GFR of less than 50
mL/min due to accumulation of the IV vehicle, SBECD ( Betadex Sulfobutyl Ether Sodium)
- Peripheral administration: multiple peripheral infusions given through the same vein may result in infusion-site reactions.
- Arrhythmia, especially in patients with prolonged QT syndrome or on other agents that prolong the QT interval
- Hepatic dysfunction (increased AST, ALT, bilirubin, alk phos, clinical hepatitis)
- Electrolyte abnormalities: hypokalemia, hypomagnesemia
- Anemia, thrombocytopenia
- Chills, fatigue, headache, abdominal pain, vomiting
- Metabolized through CYP3A4; CYP3A4 inhibitor; avoid with CYP3A4 substrates that prolong the QT interval; check for drug interactions with any new medications
- Monitor serum drug concentrations prior to 7th dose (steady state). There is some evidence that serum trough concentration at 3 days is predictive of the steady state levels.
- Target trough concentration for treatment dosing: > 1 mcg/mL (at steady state) Contact pharmacy for details.
- Posanol Product Monograph, Accessed 27Feb2017
- Lexicomp online; accessed 27Feb2017
- A. Teusink-Cross, IV Posaconazole in Pediatric patients. Powerpoint presentation at BMT Tandem Meeting February 2017.