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Revision | Operations | |
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09-20-23 by Annie Kim | current revision | |
07-20-23 by ripal121 | ||
02-16-21 by conan.macdougal... | ||
08-27-20 by conan.macdougal... | ||
08-20-20 by [email protected] | ||
08-20-20 by [email protected] | ||
08-12-20 by conan.macdougal... | ||
08-12-20 by conan.macdougal... | ||
08-12-20 by conan.macdougal... | ||
08-12-20 by conan.macdougal... | ||
08-12-20 by conan.macdougal... | ||
07-10-20 by [email protected] | ||
04-21-20 by ucsf_admin |
Dosing: Adult Antimicrobial Dosing, Non-dialysis
Indication | Dosing | Notes |
---|---|---|
All Indications (IV or Delayed-release tablet) | 300 mg IV/PO q12h x 2 doses, then 300 mg IV/PO q24h | No renal dose adjustment (avoid IV if possible in patients with CrCl <50 mL/min due to accumulation of IV vehicle) |
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
Indication | Dosing | Notes |
---|---|---|
All Indications (IV or Delayed-release tablet) | 300 mg IV/PO q12h x 2 doses, then 300 mg IV/PO q24h | No dose adjustment in hemodialysis |
Dialysis Notes
Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min. For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.
Take with food. Posaconazole SOLUTION has more frequent dosing, low bioavailability, and significant food restrictions. Do not substitute SOLUTION for TABLETS or IV without discussion with ID Pharmacy.
Review medications for potential drug interactions.
Posaconazole trough levels should be obtained in most patients, whether receiving the agent for prophylaxis or treatment of fungal infections. Trough samples should be obtained 5-7 days after:
-start of therapy
-change in dose
-change in route of administration
-change in potentially interacting drugs
See UCSF Lab Posaconazole Recommendations for specifics of monitoring.
IV formulation - Restriced to ID or Antimicrobial Stewardship
PO formulation - Restricted to ID or Antimicrobial Stewardship except:
1) For prophylaxis against fungal infections in prophylaxis against fungal infections in patients on a hematology/BMT or lung transplant service with intolerance or contraindications to voriconazole