Medications for Systemic Fungal Infections

Medications for Systemic Fungal Infections
Medication	Uses	Potential Adverse Effects
Amphotericin BAmphotericin B	Most fungal infections	Conventional formulation: Acute infusion reactions, neuropathy, gastrointestinal (GI) upset, renal failure, anemia, thrombophlebitis, hearing loss, rash, hypokalemia, hypomagnesemia
Amphotericin BAmphotericin B	Most fungal infections	Lipid formulations: Infusion reactions, renal failure
AnidulafunginAnidulafungin	Invasive candidiasis, including candidemia	Hepatitis, diarrhea, hypokalemia, infusion reactions
CaspofunginCaspofungin	Invasive candidiasis, including candidemia	Phlebitis, headache, GI upset, rash
FluconazoleFluconazole	Mucosal and systemic candidiasis Cryptococcal meningitis Coccidioidal meningitis	GI upset, rash, hepatitis, QT prolongation
Flucytosine†Flucytosine†	Candidiasis (systemic) Cryptococcosis	Pancytopenia due to bone marrow toxicity, neuropathy, nausea, vomiting, hepatic and renal injury, colitis
Isavuconazonium sulfate (isavuconazole)‡ Isavuconazonium sulfate (isavuconazole)‡	Aspergillosis Mucormycosis	Nausea, vomiting, hepatitis, QT shortening with no evidence of cardiac risk, infusion-related reactions
ItraconazoleItraconazole	Dermatomycosis Histoplasmosis, blastomycosis, coccidioidomycosis, paracoccidioidomycosis, sporotrichosis, aspergillosis, chromoblastomycosis	Hepatitis, GI upset, rash, headache, dizziness, hallucinations, hypokalemia, hypertension, edema, QT prolongation, heart failure
MicafunginMicafungin	Invasive candidiasis, including candidemia	Phlebitis, hepatitis, rash, headache, nausea, acute intravascular hemolysis
Osteoconazole	Vulvovaginal candidiasis	Headache, nausea, indigestion, hot flushes, painful urination, heavy menstrual periods, vaginal irritation
Posaconazole§Posaconazole§	Aspergillosis Mucormycosis Prophylaxis for invasive fungal infection Histoplasmosis	Hepatitis, GI upset, rash, QT prolongation
RezafunginRezafungin	Invasive candidiasis, including candidemia	Photosensitivity, abnormal liver tests, infusion-related reactions (flushing, sensation of warmth, urticaria, nausea, chest tightness)
VoriconazoleVoriconazole	Invasive aspergillosis Candidiasis, including candidemia Fusariosis Scedosporiosis	GI upset, transient visual disturbances, peripheral edema, rash, hepatotoxicity, hallucinations, QT prolongation
* These adverse effects are less common with lipid formulations than with the conventional formulation.
† Amphotericin B is used with flucytosine for serious † Amphotericin B is used with flucytosine for seriousCandida and cryptococcal infections.
‡ Isavuconazole is given as the prodrug isavuconazonium sulfate; 372 mg of ‡ Isavuconazole is given as the prodrug isavuconazonium sulfate; 372 mg ofisavuconazonium sulfate is equivalent to 200 mg of isavuconazole.
§ The delayed-release tablets, delayed-release oral suspension, and immediate-release oral suspension of posaconazole are NOT interchangeable because of differences in dosing.§ The delayed-release tablets, delayed-release oral suspension, and immediate-release oral suspension of posaconazole are NOT interchangeable because of differences in dosing.

* These adverse effects are less common with lipid formulations than with the conventional formulation.

† Amphotericin B is used with flucytosine for serious † Amphotericin B is used with flucytosine for seriousCandida and cryptococcal infections.

‡ Isavuconazole is given as the prodrug isavuconazonium sulfate; 372 mg of ‡ Isavuconazole is given as the prodrug isavuconazonium sulfate; 372 mg ofisavuconazonium sulfate is equivalent to 200 mg of isavuconazole.

§ The delayed-release tablets, delayed-release oral suspension, and immediate-release oral suspension of posaconazole are NOT interchangeable because of differences in dosing.§ The delayed-release tablets, delayed-release oral suspension, and immediate-release oral suspension of posaconazole are NOT interchangeable because of differences in dosing.

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Antifungal Medications