Serum posaconazole levels among haematological cancer patients taking extended release tablets is affected by body weight and diarrhoea: single centre retrospective analysis.
Mycoses, 2015/7;58(7):432-6.
Miceli MH[1], Perissinotti AJ[2], Kauffman CA[1, 3], Couriel DR[4]
Affiliations
PMID: 26102575DOI: 10.1111/myc.12339
Impact factor: 4.931
Abstract
The posaconazole extended release tablet formulation was developed to improve bioavailability relative to the oral suspension. Therapeutic drug monitoring has been used to optimise posaconazole dosing to achieve a target trough level ≥0.7 μg ml(-1). We retrospectively evaluated 28 patients with haematological malignancies who received posaconazole tablets for antifungal prophylaxis. Posaconazole serum trough levels were obtained 5 days after initiation of therapy. Mean trough level was 1.19 ± 0.63 μg ml(-1), and 71% achieved a trough level ≥0.7 μg ml(-1). Diarrhoea was associated with lower mean trough levels (0.65 ± 0.08 μg ml(-1) vs. 1.31 ± 0.13 μg ml(-1)), P = 0.002. Mean trough levels were lower in patients ≥90 kg (0.74 ± 0.09 μg ml(-1)) vs. <90 kg (1.32 ± 0.14 μg ml(-1)), P = 0.002 and in patients with body mass index (BMI) ≥30 (0.89 ± 0.13 μg ml(-1)) vs. BMI <30 (1.29 ± 0.14 μg ml(-1)), P = 0.05. Posaconazole delayed release tablets attain appropriate trough levels in most patients, but patients with a higher weight and those experiencing diarrhoea are more likely to have lower levels.
Keywords: Posaconazole tablets; antifungals; therapeutic drug monitoring
MeSH terms
Administration, Oral; Adult; Aged; Antifungal Agents; Biological Availability; Body Mass Index; Body Weight; Delayed-Action Preparations; Diarrhea; Female; Hematologic Neoplasms; Humans; Male; Middle Aged; Mycoses; Retrospective Studies; Tablets; Triazoles; Young Adult
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