Noxafil (Posaconazole)

Posaconazole is an azole antifungal used to manage serious fungal infections in high‑risk patient groups.

• Invasive aspergillosis: Provides treatment and prevention of disease progression.
• Invasive candidiasis: Helps eradicate Candida species from the bloodstream.
• Prophylaxis in hematologic malignancy patients: Reduces incidence of fungal infections during chemotherapy.
• Prophylaxis in stem‑cell transplant recipients: Lowers risk of invasive fungal disease post‑transplant.

• Posaconazole inhibits the fungal cytochrome P450 enzyme lanosterol 14α‑demethylase, blocking the conversion of lanosterol to ergosterol. This disruption impairs cell‑membrane synthesis, leading to increased membrane permeability and inhibition of fungal growth and replication.

Adverse reactions to intravenous posaconazole may vary in frequency and severity.

Common Side Effects

• Elevated ALT/AST liver enzymes
• Nausea or vomiting
• Diarrhea
• Headache
• Infusion‑related reactions such as flushing
• Mild fever

Serious or Rare Side Effects

• Severe hepatic injury
• Acute pancreatitis
• Anaphylactic or severe hypersensitivity reactions
• QT‑interval prolongation
• Severe electrolyte disturbances
• Renal impairment or failure

Posaconazole should be used with careful clinical monitoring and adherence to safety guidelines.

• Liver function monitoring: Check baseline and periodic liver enzymes.
• Electrolyte assessment: Monitor potassium and magnesium levels.
• Cardiac monitoring: Evaluate QT interval in patients with risk factors.
• Drug‑interaction vigilance: Review concomitant medications for CYP3A4 substrates.
• Pregnancy and lactation: Use only if clearly needed.
• Store at ambient room temperature: keep in original packaging, protect from moisture.

Posaconazole has a notable interaction profile that requires assessment before co‑administration.

Major Interactions (Avoid)

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