title: Review of the new delayed-release oral tablet and intravenous dosage forms of posaconazole.
abstract: The triazole antifungal posaconazole was first approved as an oral suspension formulation. Despite pharmacokinetic target attainment and clinical efficacy in premarketing trials, postmarketing analyses indicated unpredictable bioavailability resulting in subtherapeutic concentrations and reports of breakthrough fungal infections. The newly approved posaconazole delayed-release tablet and intravenous formulations display more consistent bioavailability in the presence of concomitant disease states, medications, and dietary considerations that classically alter drug concentrations of the oral suspension. Both the delayed-release tablet and intravenous formulation display a similar adverse-effect profile to the oral suspension. The posaconazole delayed-release oral tablet is not significantly affected by gastric acid suppression therapy, and the intravenous dosage form provides an option for patients who are intubated or unable to tolerate oral medications. Pharmacoeconomic considerations, particularly with intravenous posaconazole, will likely play a role in dosage form selection and frequency of use. Due to sustained, higher drug concentrations, the new posaconazole formulations hold promise for greater efficacy in antifungal prophylaxis and bring opportunity for further study in the treatment of invasive mycoses.
authors: Department of Pharmacy Practice, Mylan School of Pharmacy at Duquesne University, Pittsburgh, Pennsylvania.
authors: Anthony J
authors: AJ
authors: Guarascio
authors: Douglas
authors: D
authors: Slain
mesh_terms: D061605:Administration, Intravenous; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001682:Biological Availability; D003692:Delayed-Action Preparations; D006801:Humans; D009181:Mycoses / Q000188:drug therapy*; D013607:Tablets; D014230:Triazoles / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D003692:Delayed-Action Preparations; D013607:Tablets; D014230:Triazoles; C101425:posaconazole
keywords: antifungal prophylaxis; delayed-release oral tablet; dosage form; intravenous; posaconazole; triazole antifungal