It is also used to treat invasive infections by Candida, Mucor, and Aspergillus species in severely immunocompromised patients.
Clinical evidence for its utility in treatment of invasive disease caused by Fusarium species (fusariosis) is limited.
Mode of action
Posaconazole works by disrupting the close packing of acyl chains of phospholipids, impairing the functions of certain membrane-bound enzyme systems such as ATPase and enzymes of the electron transport system, thus inhibiting growth of the fungi. It does this by blocking the synthesis of ergosterol by inhibiting of the enzyme lanosterol 14α-demethylase and accumulation of methylated sterol precursors. Posaconazole is significantly more potent at inhibiting 14-alpha demethylase than itraconazole.
Posaconazole is active against the following microorganisms:
Posaconazole is absorbed within three to five hours. It is predominately eliminated through the liver, and has a half-life of about 35 hours. Oral administration of posaconazole taken with a high-fat meal exceeds 90% bioavailability and increases the concentration by four times compared to fasting state.
^Walsh TJ, Raad I, Patterson TF, et al. (January 2007). "Treatment of Invasive Aspergillosis with Posaconazole in Patients Who Are Refractory to or Intolerant of Conventional Therapy: An Externally Controlled Trial". Clin. Infect. Dis. 44 (1): 2–12. doi:10.1086/508774. JSTOR4485188. PMID17143808. – via JSTOR(subscription required)