Noxafil
Posaconazole (Noxafil) infusion is an azole antifungal. It's used to treat serious Aspergillus fungal infections in adults and children ages 13 years and older. It's also used to prevent Candida and Aspergillus infections (prophylaxis) in adults and children ages 2 years and older with weakened immune systems. Posaconazole (Noxafil) infusion is given as an infusion into the veins, typically twice a day on the first day and then once a day thereafter. This medication is available under the brand name Noxafil and as a lower-cost generic. Common side effects include diarrhea, nausea, and abnormal liver tests.
What is Posaconazole (Noxafil) infusion?
What is Posaconazole (Noxafil) infusion used for?
- Prevention of serious fungal infections caused by Candida and Aspergillus
- Treatment of serious Aspergillus infection
How Posaconazole (Noxafil) infusion works
Posaconazole (Noxafil) infusion is an azole antifungal. It works by damaging the protective outer layer of the fungus causing your infection.
Drug facts
Side effects of Posaconazole (Noxafil) infusion
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Diarrhea (32%)
- Low potassium levels (22%)
- Fever (21%)
- Nausea (19%)
- Rash (15%)
- Nose bleed (14%)
- Headache (14%)
- Stomach pain (13%)
- Vomiting (12%)
- Chills (12%)
- Swelling in arms or legs (12%)
Note: The side effects listed above were reported by adults taking posaconazole (Noxafil) infusion for prevention of fungal infections.
Less Common Side Effects
- Cough
- High blood pressure
- Poor appetite
- Feeling tired
- Constipation
Posaconazole (Noxafil) infusion serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious liver problems: nausea, vomiting, stomach pain, yellowing of the skin or whites of the eyes, flu-like symptoms
- Abnormal heart rhythm: irregular heartbeat, racing heart, chest pain, dizziness
- Changes in electrolytes: nausea, vomiting, muscle cramps, muscle weakness, abnormal heartbeat, feeling tired
The following Posaconazole (Noxafil) infusion side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Abdominal or stomach pain
black, tarry stools
bloody nose
blurred vision
body aches or pain
confusion
difficult or labored breathing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
drowsiness
fever or chills
fruit-like breath odor
heavy non-menstrual vaginal bleeding
increased thirst or urination
irregular heartbeats
loss of voice
muscle pain, spasms, or twitching
nausea or vomiting
numbness or tingling in the hands, feet, lips, mouth, or fingertips
painful cold sores or blisters on the lips, nose, eyes, or genitals
painful or difficult urination
pounding in the ears
slow or fast heartbeat
small red or purple spots on the skin
sores, ulcers, or white spots on the lips, tongue, or inside the mouth
sweating
tender, swollen glands in the neck
tightness in the chest
trembling
trouble swallowing
unexplained weight loss
yellow eyes or skin
Less common
Fainting
irregular heartbeat, recurrent
Incidence not known
change in mental status
chest pain or discomfort
darkening of the skin
itching or skin rash
mental depression
seizures
sudden shortness of breath or troubled breathing
swelling of the eyes or eyelids
swelling of the face, fingers, feet, or lower legs
weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
back pain
belching
difficulty having a bowel movement (stool)
muscle stiffness
pain in the joints
trouble sleeping
Less common
Bad, unusual, or unpleasant (after) taste
change in taste
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Posaconazole (Noxafil) infusion
Pros
- Can be used in adults and children
- Once-daily dosing after the first day
- A good option for people who can't take medications by mouth
Cons
- Many interactions with other medications
- Might not be a good option for people with moderate or severe kidney problems
- Might not be safe during pregnancy
Pharmacist tips for Posaconazole (Noxafil) infusion
- You'll typically receive posaconazole (Noxafil) infusion in a hospital setting or at home. Don't stop taking the medication early even if you feel better since this can put you at risk for an infection that's harder to treat.
- If you miss your dose of posaconazole (Noxafil) infusion, take it as soon as possible. If it's almost time for your next dose, skip the missed dose and return to your usual dosing schedule. Call your prescriber and let them know if you miss any doses.
- Posaconazole (Noxafil) infusion interacts with many medications, including alprazolam (Xanax), simvastatin (Zocor), and phenytoin (Dilantin). This isn't a complete list of all drug interactions, so please speak with your healthcare professional before starting posaconazole (Noxafil) infusion. Be sure to tell them about any over-the-counter medications, vitamins, and herbal products you take.
- If you're receiving posaconazole (Noxafil) infusion at home, your care team might ask you to store it there. Keep posaconazole (Noxafil) infusion vials in the refrigerator until you're ready for a dose. The vials must be mixed with a special type of solution before you can use them.
- Once mixed, posaconazole (Noxafil) infusion can be stored in the refrigerator for up to 24 hours. Throw away any medication that isn't used after you get your dose, and don't try to save any medication for later use.
Common questions about Posaconazole (Noxafil) infusion
The amount of time you'll need to receive posaconazole (Noxafil) infusion depends on different factors like why you're taking it and how well your infection is responding to treatment. If you're taking posaconazole (Noxafil) infusion to prevent fungal infections, your prescriber will likely have you continue to take it until your immune system is strong enough to fight off infections on its own. If you're receiving posaconazole (Noxafil) infusion to treat an infection, treatment typically lasts 6 to 12 weeks, depending on how quickly you recover. If you're able to take medications by mouth, your healthcare team might consider switching you from posaconazole (Noxafil) infusion to oral posaconazole (Noxafil) during treatment.
A posaconazole (Noxafil) infusion infusion typically takes around 30 to 90 minutes. This usually depends on where exactly the medication is getting infused. Follow up with your healthcare professional for more details on how long your infusion will take.
Some people taking posaconazole (Noxafil) infusion during clinical studies did experience having a lower white blood cell count. But it's unclear if this was caused by posaconazole (Noxafil) infusion or another reason. Taking posaconazole (Noxafil) infusion with certain medications, such as Venclexta (venetoclax), can raise your risk for lower white blood cell counts. Make sure to tell your care team about all of the medications you're taking before starting posaconazole (Noxafil) infusion. They can watch your white blood cell count through blood tests.
Hair loss wasn't a commonly-reported side effect during studies of posaconazole (Noxafil) infusion. If you notice more hair falling out than usual, contact your primary care provider so they can help you find the cause.
There isn't enough information to know how safe posaconazole (Noxafil) infusion is in humans during pregnancy. Posaconazole (Noxafil) infusion caused harm to unborn babies during studies in animals. While this doesn't always represent what happens in humans, the risk can't be ruled out. If you're pregnant or thinking of becoming pregnant, discuss the risks and benefits of this medication with your healthcare professional.
Although rare, posaconazole (Noxafil) infusion can cause liver problems. Most of the time, it's mild and you won't notice any symptoms. But your healthcare team might see abnormal liver enzyme levels on blood work that checks your liver health. Typically, your liver enzyme levels should go back to the normal range once you stop receiving posaconazole (Noxafil) infusion. But rarely, people have experienced serious liver problems that were life-threatening. As a precaution, your healthcare team might order blood work regularly during treatment to check your liver health. Let your care team know if you notice symptoms of liver problems, such as nausea, vomiting, stomach pain, and yellowing of the skin or whites of the eyes.
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Risks and warnings for Posaconazole (Noxafil) infusion
Posaconazole (Noxafil) infusion can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
QT prolongation (heart rhythm problem)
- Risk factors: History of abnormal heart rhythm | Taking other medications that cause heart rhythm problem | Taking medications that cause posaconazole (Noxafil) infusion to build up in your body
Posaconazole (Noxafil) infusion can cause a serious heart rhythm problem called QT prolongation. The risk is higher for people who already have heart rhythm problems or are taking medications that also have a risk of causing heart rhythm problems. Let your healthcare team know about all medications and supplements you're taking so they can check if you're at higher risk for QT prolongation.
Changes in electrolytes
Posaconazole (Noxafil) infusion can cause changes to electrolytes levels in your body like potassium, magnesium, and calcium. Usually, this change is minor and can be corrected with supplements. But if these levels drop too low, they can cause problems with your heart. Make sure you get any blood tests ordered by your prescriber done on time while taking posaconazole (Noxafil) infusion. This will help them catch problems earlier.
Liver damage
- Risk factors: History of liver problems
Posaconazole (Noxafil) infusion can cause liver problems. Most of the time, you won't experience any symptoms. But your healthcare team might note higher liver enzyme levels on blood work that checks your liver health. Typically, your liver enzyme levels should go back to the normal range once you stop receiving posaconazole (Noxafil) infusion. But rarely, people have experienced serious liver problems that were life-threatening. As a precaution, your healthcare team might order blood work regularly during treatment to check your liver health. If there are signs of liver problems, they might ask you to stop taking posaconazole (Noxafil) infusion. Get medical help right away if you feel symptoms of serious liver problems, such as unexplained stomach pain, nausea, or vomiting, dark urine, pale stools, or yellowing of your skin or eyes.
Interaction with transplant medications
- Risk factors: Taking calcineurin inhibitors
Posaconazole (Noxafil) infusion interacts with medications known as calcineurin inhibitors, which are usually taken by people who've had organ transplants or have certain immune conditions. Examples include cyclosporine (Sandimmune, Neoral) and tacrolimus (Prograf). Posaconazole (Noxafil) infusion can cause these medications to build up in your body. This can cause serious problems like brain damage (leukoencephalopathy) and kidney damage, which can be life-threatening. Be sure to tell your care team all the medications you take before starting posaconazole (Noxafil) infusion so they can help you check for interactions.
Interaction with midazolam
Posaconazole (Noxafil) infusion interacts with midazolam (Seizalam), a medication used for seizures and anesthesia. Posaconazole (Noxafil) infusion causes midazolam to build up in your body, making it more likely you'll have side effects or have trouble waking up. This interaction is life-threatening, so you shouldn't take these two medications together. Make sure you tell your prescriber if you take midazolam before starting posaconazole (Noxafil) infusion. If you need to have any surgical procedures done while taking posaconazole (Noxafil) infusion, be sure to tell your surgeon you are taking this medication so they can pick anesthesia that won't interact with posaconazole (Noxafil) infusion.
Interaction with vincristine
Posaconazole (Noxafil) infusion interacts with a cancer medication called vincristine. Taking these medications together can cause seizures, nerve damage, or bowel blockages. Make sure you tell the healthcare professional prescribing posaconazole (Noxafil) infusion if you take any cancer medications. Your healthcare team might only ask you to take this combination if there are no safer alternative treatments available. If so, they'll go over the risks and benefits of treatment and monitor you closely for side effects.
Interaction with venetoclax
Posaconazole (Noxafil) infusion interacts with a medication called Venclexta (venetoclax). Taking these medications together can raise the risk of life-threatening side effects, such as tumor lysis syndrome (TLS) and serious infections. Review of list of your current medications with your prescriber before taking posaconazole (Noxafil) infusion. Your healthcare team can help you check for interactions and talk with you about alternative options if needed.
Posaconazole (Noxafil) infusion dosage
Typical dosage for Posaconazole (Noxafil) infusion
Treatment of serious Aspergillus infection:
- Adults and children ages 13 years and older: The typical dose is 300 mg infused into the vein twice a day for the first day, followed by 300 mg once a day thereafter.
Prevention of serious Candida and Aspergillus infections:
- Adults: The typical dose is 300 mg infused into the vein twice a day for the first day, followed by 300 mg once a day thereafter.
- Children ages 2 to 17 years old: The typical dose is 6 mg/kg of body weight (up to 300 mg) infused into the vein on the first day, followed by 6 mg/kg (up to 300 mg) once a day thereafter.
Interactions between Posaconazole (Noxafil) infusion and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Alfuzosin
- Alprazolam
- Amiodarone
- Aripiprazole
- Astemizole
- Atorvastatin
- Bedaquiline
- Bepridil
- Buprenorphine
- Cisapride
- Citalopram
- Clarithromycin
- Clozapine
- Colchicine
- Conivaptan
- Crizotinib
- Dabrafenib
- Dasatinib
- Dihydroergotamine
- Disopyramide
- Dofetilide
- Domperidone
- Donepezil
- Dronedarone
- Eletriptan
- Eliglustat
- Encorafenib
- Entrectinib
- Eplerenone
- Ergonovine
- Ergotamine
- Erythromycin
- Flibanserin
- Fluvastatin
- Glasdegib
- Halofantrine
- Haloperidol
- Iloperidone
- Isavuconazonium Sulfate
- Itraconazole
- Ivabradine
- Ivosidenib
- Lapatinib
- Lomitapide
- Lopinavir
- Lovastatin
- Lumefantrine
- Lurasidone
- Macimorelin
- Maraviroc
- Mefloquine
- Mesoridazine
- Methadone
- Methylergonovine
- Methysergide
- Mifepristone
- Mirtazapine
- Naloxegol
- Nelfinavir
- Nilotinib
- Nimodipine
- Ondansetron
- Osilodrostat
- Pazopanib
- Pimozide
- Piperaquine
- Propafenone
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Ribociclib
- Saquinavir
- Selpercatinib
- Simvastatin
- Sirolimus
- Solifenacin
- Sorafenib
- Sparfloxacin
- Sunitinib
- Tacrolimus
- Tamoxifen
- Telithromycin
- Terfenadine
- Thioridazine
- Tolvaptan
- Toremifene
- Trazodone
- Ubrogepant
- Vardenafil
- Vemurafenib
- Venetoclax
- Vilanterol
- Voclosporin
- Voriconazole
- Ziprasidone
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acalabrutinib
- Ado-Trastuzumab Emtansine
- Alfentanil
- Amitriptyline
- Amprenavir
- Anagrelide
- Apalutamide
- Apomorphine
- Aprepitant
- Arsenic Trioxide
- Asenapine
- Avanafil
- Avapritinib
- Axitinib
- Azithromycin
- Benzhydrocodone
- Bosutinib
- Brentuximab Vedotin
- Brexpiprazole
- Brigatinib
- Bromocriptine
- Buserelin
- Cabazitaxel
- Cabozantinib
- Calcifediol
- Capmatinib
- Cariprazine
- Ceritinib
- Chloroquine
- Chlorpromazine
- Cilostazol
- Cimetidine
- Ciprofloxacin
- Clofazimine
- Clomipramine
- Cobimetinib
- Codeine
- Copanlisib
- Cyclobenzaprine
- Cyclosporine
- Daclatasvir
- Deflazacort
- Degarelix
- Delamanid
- Desipramine
- Deslorelin
- Deutetrabenazine
- Dexamethasone
- Dihydrocodeine
- Docetaxel
- Dolasetron
- Doxepin
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Droperidol
- Duvelisib
- Ebastine
- Efavirenz
- Elagolix
- Elexacaftor
- Enzalutamide
- Eribulin
- Erlotinib
- Escitalopram
- Esomeprazole
- Eszopiclone
- Etravirine
- Everolimus
- Famotidine
- Fedratinib
- Felbamate
- Fentanyl
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Fluticasone
- Formoterol
- Fosamprenavir
- Fosaprepitant
- Foscarnet
- Fosphenytoin
- Fostemsavir
- Galantamine
- Gatifloxacin
- Gemifloxacin
- Gonadorelin
- Goserelin
- Granisetron
- Histrelin
- Hydrocodone
- Hydroquinidine
- Hydroxychloroquine
- Hydroxyzine
- Ibrutinib
- Ibutilide
- Idelalisib
- Ifosfamide
- Imipramine
- Inotuzumab Ozogamicin
- Irinotecan
- Irinotecan Liposome
- Istradefylline
- Ivacaftor
- Larotrectinib
- Lasmiditan
- Lefamulin
- Lemborexant
- Lenvatinib
- Levofloxacin
- Levomilnacipran
- Lofexidine
- Lorlatinib
- Lumacaftor
- Lumateperone
- Lurbinectedin
- Macitentan
- Manidipine
- Meperidine
- Methotrimeprazine
- Metronidazole
- Midazolam
- Midostaurin
- Mizolastine
- Moricizine
- Moxifloxacin
- Nafarelin
- Neratinib
- Nifedipine
- Norfloxacin
- Octreotide
- Ofloxacin
- Olanzapine
- Olaparib
- Osimertinib
- Oxaliplatin
- Oxycodone
- Ozanimod
- Palbociclib
- Paliperidone
- Panobinostat
- Papaverine
- Paroxetine
- Pasireotide
- Pemigatinib
- Pentamidine
- Pentazocine
- Perphenazine
- Pexidartinib
- Phenytoin
- Pimavanserin
- Pipamperone
- Pitolisant
- Ponatinib
- Ponesimod
- Pralsetinib
- Probucol
- Procainamide
- Prochlorperazine
- Promethazine
- Protriptyline
- Reboxetine
- Regorafenib
- Retapamulin
- Rifabutin
- Rifampin
- Rimegepant
- Risperidone
- Ritonavir
- Romidepsin
- Ruxolitinib
- Salmeterol
- Selumetinib
- Sertindole
- Sertraline
- Sevoflurane
- Simeprevir
- Siponimod
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Sonidegib
- Sotalol
- Sufentanil
- Sulpiride
- Sultopride
- Suvorexant
- Tamsulosin
- Tazemetostat
- Telaprevir
- Telavancin
- Tetrabenazine
- Tezacaftor
- Thiotepa
- Tolterodine
- Trabectedin
- Tramadol
- Triclabendazole
- Trimipramine
- Triptorelin
- Valbenazine
- Vandetanib
- Venlafaxine
- Vilazodone
- Vinblastine
- Vincristine
- Vincristine Sulfate Liposome
- Vinflunine
- Vinorelbine
- Vorapaxar
- Vorinostat
- Voxelotor
- Warfarin
- Zanubrutinib
- Zolpidem
- Zotepine
- Zuclopenthixol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Lorazepam
- Topiramate
How much does Posaconazole (Noxafil) infusion cost?
Posaconazole (Noxafil) infusion contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Posaconazole (Noxafil) infusion will not be safe for you to take.
- Allergic to azole antifungals
- Taking posaconazole (Noxafil) infusion together with sirolumus (Rapamune)
- Taking posaconazole (Noxafil) infusion with certain medications that can cause QT prolongation (e.g., pimozide, quinidine)
- Taking posaconazole (Noxafil) infusion with certain statin medications (e.g., atorvastatin (Lipitor), lovastatin, and simvastatin (Zocor))
- Taking posaconazole (Noxafil) infusion with ergot alkaloids (e.g., ergotamine and dihydroergotamine)
- Taking posaconazole (Noxafil) infusion with Venclexta (venetoclax)
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