Which medications in the drug class Antifungal agents, Azole derivatives are used in the treatment of Mucormycosis (Zygomycosis)?

Updated: Jul 06, 2021
  • Author: Avnish Sandhu, DO; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Antifungal agents, Azole derivatives

These agents inhibit the cytochrome P450-dependent 14-alpha-lanosterol demethylase of the fungal cell membrane. Toxic cell membrane sterols accumulate and ergosterol production is inhibited, leading to impaired growth and replication and, ultimately, cell death.

Isavuconazonium sulfate (Cresemba)

Novel triazole approved in 2015 for the treatment of mucormycosis. It has equivalent oral and IV bioavailability and a favorable safety/tolerability profile. The oral prodrug isavuconazonium sulfate is rapidly converted to the active isavuconazole moiety. Initial dosing is isavuconazonium sulfate 372 mg (isavuconazole 200 mg) every 8 hours for 6 doses, followed by maintenance with 372 mg once daily.

Posaconazole (Noxafil)

Used off-label for salvage therapy in patients intolerant to amphotericin B or as step-down therapy after initial polyene treatment. Administered as one 300-mg tablet twice on day 1 followed by 300 mg orally once daily with or without food. The delayed-release tablet formulation is preferred over the oral suspension because of its more reliable absorption. An intravenous formulation is also available.


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