Isavuconazole

No dose adjustment required.

Renal impairment

IV and oral: No dose adjustment required.

Hepatic impairment

IV and oral:

• Mild or moderate hepatic impairment (Child-Pugh Classes A and B): No dose adjustment required 
• Severe hepatic impairment (Child-Pugh Class C): Isavuconazole has not been studied in this patient group. Use in these patients is not recommended unless the potential benefit is considered to outweigh the risks.

Therapeutic Drug Monitoring is required see Therapeutic Drug Monitoring (TDM) for Antifungal Agents

Before isavuconazole is started see the Summary of Product Characteristics (SPC) for isavuconazole for information about interactions, cautions and contraindications.

• Isavuconazole is a substrate of CYP3A4 and CYP3A5. Co-administration with CYP inhibitors/inducers will increase/decrease concentration of isavuconazole.
• The co-administration of isavuconazole with several medications is contraindicated. See SPC for more information.
• Caution is recommended for the use of isavuconazole with several medications. See SPC for more information.
• Some medications require a dose adjustment when they are used concomitantly with isavuconazole. See SPC for more information.

Contraception: Woman of childbearing age MUST use effective contraception during treatment with isavuconazole.  See SPC for more information.

Pregnancy: Discuss with Micro/ID. Manufacturer recommends avoid unless severe or potentially life threatening infection and potential benefit to mother outweighs potential risk to foetus. Insufficient data in pregnant people. Toxicity shown in animal studies.

Breastfeeding: Women should not breastfeed whilst taking isavuconazole.

• Isavuconazole is contraindicated in patients with familial short QT syndrome

• Isavuconazole has high oral bioavailability. Intravenous and oral formulations are bioequivalent.

• The OUH Antifungal Patient Information Leaflet can be found HERE

• Pfizer Limited. Summary of Product Characteristics.Cresembra 200mg powder for concentrate for solution for infusion [online]. Last revision of the text: 09/24. Accessed via: www.emc.medicines.org.uk Accessed 1/5/25

• Pfizer Limited. Summary of Product Characteristics.Cresembra 100mg hard capsules [online]. Last revision of the text: 09/24. Accessed via: www.emc.medicines.org.uk Accessed 1/5/25

• BNF online accessed via www.medicinescomplete.com Accessed 1/5/25

• The Renal Drug Database. Isavuconazole. [internet]. Last updated: 11/7/24. Accessed via: https://renaldrugdatabase.com Accessed 1/5/25

• Sanford Guide. Isavuconazonium sulfate [Internet] Last revision of the text: 7/4/25

• Sanford Guide. Obesity dosing adjustment [Internet] Last revision of the text: 25/4/25

• LactMed. Isavuconazole [Internet] Last updated 15th April 2024. Accessed 1/5/25