isavuconazole

Brand: Cresemba

Prototype: voriconazole
Drug Class: triazole antifungal
Drug Family: antifungal
Subclass: extended-spectrum triazole (anti-Aspergillus, anti-Mucorales)
Organ Systems: infectious-disease

Mechanism of Action

Inhibits fungal CYP51; active against Aspergillus and Mucorales; prodrug isavuconazonium sulfate rapidly converted to active isavuconazole; fewer drug interactions than voriconazole; QTc-shortening rather than prolonging effect (unique).

fungal CYP51 (14-alpha-demethylase)

Indications

  • invasive aspergillosis (alternative to voriconazole)
  • invasive mucormycosis

Contraindications

  • isavuconazole hypersensitivity
  • familial short QT syndrome
  • concurrent strong CYP3A4 inducers (rifampin, carbamazepine)
  • concurrent ketoconazole (strong CYP3A4 inhibitor)

Adverse Effects

Common

  • nausea
  • vomiting
  • diarrhea
  • headache
  • liver test abnormalities

Serious

  • hepatotoxicity
  • QTc shortening (caution in familial short QT syndrome)
  • infusion-related reactions (IV)

Pharmacokinetics (ADME)

Absorption prodrug isavuconazonium converted to isavuconazole; oral bioavailability ~98%; not significantly affected by food
Distribution large Vd (450 L); extensive tissue distribution
Metabolism CYP3A4 and CYP3A5 substrate; also CYP3A4 inhibitor (moderate)
Excretion fecal (>46%) and renal (<1% unchanged)
Half-life 130 hours
Onset rapid
Peak 2–3 hours (oral)
Duration once-daily (after loading)
Protein Binding >99%
Vd very large (450 L)

Drug Interactions

Drug / Agent Mechanism Severity
tacrolimus/cyclosporine moderate CYP3A4 inhibition increases levels; monitor TDM major
rifampin/carbamazepine strong CYP3A4 induction reduces isavuconazole levels by >50%; contraindicated major
midazolam CYP3A4 inhibition increases midazolam by ~2-fold; use lowest effective benzodiazepine dose moderate

Nursing Considerations

  1. Oral formulation has near-complete bioavailability and can be taken with or without food — a significant practical advantage over posaconazole suspension.
  2. Isavuconazole shortens the QTc interval — monitor ECG; contraindicated in patients with familial short QT syndrome.
  3. Loading dose (200 mg three times daily for 2 days) then once-daily maintenance dosing; verify correct frequency.
  4. No dose adjustments needed for mild-to-moderate hepatic impairment — an advantage in patients with liver disease.

Clinical Pearls

  • Unlike all other triazoles, isavuconazole shortens rather than prolongs the QTc interval — while usually benign, this distinguishes it pharmacologically and requires ECG awareness in patients with short QT syndrome.
  • Isavuconazole is one of only two antifungals (with posaconazole) with FDA approval for mucormycosis treatment, making it valuable for this serious infection that is unresponsive to most antifungals.

Safety Profile

Pregnancy avoid
Lactation avoid
Renal Adjustment Not required
Hepatic Adjustment Not required
TDM Not required
Guideline Update pending

Concordance Terms

Cross-referenced clinical concepts — click any term to see all content where it appears.