Лікарські препарати для лікування системних грибкових інфекцій

Medication

Uses

Potential Adverse Effects

Amphotericin B

Most fungal infections

Conventional formulation: Acute infusion reactions, neuropathy, gastrointestinal (GI) upset, renal failure, anemia, thrombophlebitis, hearing loss, rash, hypokalemia, hypomagnesemia

Lipid formulations: Infusion reactions*, renal failure*

Anidulafungin

Aspergillosis

Candidiasis, including candidemia

Hepatitis, diarrhea, hypokalemia, infusion reactions

Caspofungin

Aspergillosis

Candidiasis, including candidemia

Phlebitis, headache, GI upset, rash

Fluconazole

Mucosal and systemic candidiasis

Cryptococcal meningitis

Coccidioidal meningitis

GI upset, rash, hepatitis, QT prolongation

Flucytosine†

Candidiasis (systemic)

Cryptococcosis

Pancytopenia due to bone marrow toxicity, neuropathy, nausea, vomiting, hepatic and renal injury, colitis

Isavuconazonium (isavuconazole)‡

Aspergillosis

Mucormycosis

Nausea, vomiting, hepatitis, QT shortening with no evidence of cardiac risk, infusion-related reactions

Itraconazole

Dermatomycosis

Histoplasmosis, blastomycosis, coccidioidomycosis, sporotrichosis, aspergillosis

Hepatitis, GI upset, rash, headache, dizziness, hypokalemia, hypertension, edema, QT prolongation, heart failure

Micafungin

Aspergillosis

Candidiasis, including candidemia

Phlebitis, hepatitis, rash, headache, nausea, acute intravascular hemolysis

Posaconazole§

Aspergillosis

Mucormycosis

Prophylaxis for invasive fungal infection

Oral candidiasis refractory to fluconazole

Hepatitis, GI upset, rash, QT prolongation

Rezafungin

Candidemia

Invasive candidiasis

Photosensitivity, abnormal liver tests, infusion-related reactions (flushing, sensation of warmth, urticaria, nausea, chest tightness)

Voriconazole

Invasive aspergillosis

Candidiasis

Fusariosis

Scedosporiosis

GI upset, transient visual disturbances, peripheral edema, rash, hepatitis, QT prolongation

* This adverse effect is less common with lipid formulations than with the conventional formulation.

† Amphotericin B is used with flucytosine for serious Candida and cryptococcal infections.

‡ Isavuconazole is given as the prodrug isavuconazonium; 372 mg of isavuconazonium is equivalent to 200 mg of isavuconazole.

§ The delayed-release tablets, delayed-release oral suspension, and immediate-release oral suspension of posaconazole are NOT interchangeable because of differences in dosing.