Posaconazole, Oral/Injection

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KEY POINTS

• This medicine is taken by mouth or given by IV to prevent or treat fungal infections. Take it exactly as directed.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antifungal

Generic and brand names: posaconazole, oral; posaconazole, injection; Noxafil

What is this medicine used for?

This medicine is taken by mouth or given by IV infusion (slow drip through a needle into a large vein) to prevent or treat fungal infections in people with weakened immune systems. This medicine will not cure viral infections such as colds and the flu.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Blood circulation problems
• Liver or kidney disease
• Heart disease or heart rhythm problems
• Long QT syndrome (problems with electrical activity in the heart muscle)
• Low levels of calcium, magnesium, or potassium in your blood

Tell your healthcare provider about any other prescription or nonprescription medicines, vitamins, or herbal products you are taking. This medicine can cause life-threatening side effects if you take it with certain other medicines.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your healthcare provider's approval, even if you feel better.

Check with your healthcare provider before using this medicine in children under age 13.

This medicine may come in different forms. Do not change the form of this medicine that you take without talking to your healthcare provider and pharmacist. Other dosage forms can affect you differently. If you have the delayed-release tablets, do not break, crush, or chew them. Swallow them whole, with food.

If you have the liquid, shake the medicine well before you take a dose. Use the measuring spoon, cup, dropper, or oral syringe that comes with the medicine, or ask your pharmacist for one. Do not use a kitchen spoon because the dose may not be correct. Take the liquid with a meal or within 20 minutes after a full meal. If you cannot eat a full meal, take each dose with a liquid nutritional supplement.

Infusions of this medicine are usually given by your healthcare provider.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may make you dizzy. Do not drive or operate machinery unless you are fully alert.

If you develop severe diarrhea or vomiting, contact your healthcare provider.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

If you have diabetes: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; tightness in your chest; swelling of your lips, tongue, or throat; trouble breathing).

Serious (Report these to your healthcare provider right away.): Slow, fast, or irregular heartbeat; chest pain; shortness of breath; swelling in your arms or legs; severe dizziness or fainting; fever; severe diarrhea; severe nausea or vomiting; unusual tiredness or weakness; unusual bruising or bleeding; yellowing of skin or eyes; dark urine; light-colored bowel movements; itchy skin; unusual muscle cramps, pain, or weakness; unexplained mood changes; seizures.

Other: Headache, dizziness, nausea, vomiting, dry mouth, blurred vision, diarrhea, constipation, trouble sleeping, tiredness, loss of appetite, cough, stomach pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Anagrelide (Agrylin)
• Antianxiety medicines such as alprazolam (Xanax), chlordiazepoxide, diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antibiotics such as azithromycin (Zithromax, Zmax), bedaquiline (Sirturo), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), levofloxacin (Levaquin), moxifloxacin (Avelox), rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and telithromycin (Ketek)
• Antidepressants such as amitriptyline, citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), mirtazapine (Remeron), nefazodone, nortriptyline (Pamelor), sertraline (Zoloft), and venlafaxine (Effexor)
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), iloperidone (Fanapt), lurasidone (Latuda), olanzapine (Zyprexa), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), thioridazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), fosphenytoin (Cerebyx), phenobarbital, phenytoin (Dilantin, Phenytek), and valproic acid (Depacon, Depakene, Depakote)
• Apomorphine (Apokyn)
• Bosentan (Tracleer)
• Calcium channel blockers such as amlodipine (Norvasc), amlodipine/atorvastatin (Caduet), diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Cancer medicines such as arsenic trioxide (Trisenox), axitinib (Inlyta), bosutinib (Bosulif), cabozantinib (Cometriq), ceritinib (Zykadia), crizotinib (Xalkori), everolimus (Afinitor, Zortress), lapatinib (Tykerb), nilotinib (Tasigna), paclitaxel (Abraxane, Taxol), toremifene (Fareston), vandetanib (Caprelsa), vemurafenib (Zelboraf), vinblastine, and vincristine (Marqibo)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor), lomitapide (Juxtapid), lovastatin (Altoprev), and simvastatin (Zocor)
• Cimetidine (Tagamet)
• Cinacalcet (Sensipar)
• Colchicine (Colcrys)
• Corticosteroids such as budesonide (Entocort, Rhinocort, Uceris), dexamethasone, fluticasone (Flonase, Flovent, Veramyst), and methylprednisolone (Medrol, Solu-Medrol)
• Diabetes medicines such as glipizide (Glucotrol), glyburide (Glynase), and saxagliptin (Onglyza)
• Digoxin (Lanoxin)
• Eliglustat (Cerdelga)
• Enlarged prostate medicines such as alfuzosin (Uroxatral), silodosin (Rapaflo), and tamsulosin (Flomax)
• Eplerenone (Inspra)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Ergot medicines such as cabergoline, dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar), and methylergonovine
• Fingolimod (Gilenya)
• Heart medicines such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), ivabradine (Corlanor), procainamide, quinidine, ranolazine (Ranexa), and sotalol (Betapace, Sorine)
• HIV medicines such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Macitentan (Opsumit)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine primaquine, and quinine
• Medicines to block or prevent stomach acid such as dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and rabeprazole (AcipHex)
• Medicines to treat low sodium levels such as conivaptan (Vaprisol) and tolvaptan (Samsca)
• Medicines to treat or prevent blood clots such as apixaban (Eliquis), cilostazol (Pletal), clopidogrel (Plavix), dabigatran (Pradaxa), prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), vorapaxar (Zontivity), and warfarin (Coumadin)
• Metoclopramide (Metozolv, Reglan)
• Midazolam (Versed)
• Mifepristone (Korlym, Mifeprex)
• Migraine medicines such as almotriptan (Axert) and eletriptan (Relpax)
• Naloxegol (Movantik)
• Nausea medicines such as aprepitant (Emend), dolasetron (Anzemet), granisetron (Sancuso), and ondansetron (Zofran)
• Pain medicines such as fentanyl, methadone (Dolophine, Methadose), oxycodone (OxyContin, Roxicodone), and tramadol (ConZip, Ultram)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Red yeast rice
• Salmeterol (Serevent)
• Simeprevir (Olysio)
• Sleeping pills such as flurazepam, triazolam (Halcion), and zolpidem (Ambien, Edluar, Intermezzo)
• Stimulants such as armodafinil (Nuvigil) and modafinil (Provigil)
• Sucralfate (Carafate)
• Tetrabenazine (Xenazine)
• Tofacitinib (Xeljanz)

Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.