Isavuconazonium Sulfate Capsules (Cresemba) is a broad-spectrum triazole antifungal medication used to treat severe fungal infections such as invasive aspergillosis and mucormycosis. As a prescription drug, understanding its potential side effects and medication precautions is crucial for ensuring treatment efficacy.
What Are the Side Effects of Isavuconazonium Sulfate Capsules (Cresemba)
Common Adverse Reactions in Adult Patients
Gastrointestinal Symptoms: Nausea (27.6%), vomiting (24.9%), diarrhea (23.7%), abdominal pain (16.7%), constipation (14%), and dyspepsia (6.2%).
Neurological Symptoms: Headache (16.7%) is relatively common.
Metabolic Abnormalities: Hypokalemia (19.1%) is prominent.
Liver Function Abnormalities: Approximately 17.1% of patients experience elevated liver enzymes.
Respiratory Symptoms: Dyspnea (17.1%) and cough (15.2%).
Characteristics of Adverse Reactions in Pediatric Patients
More Prominent Gastrointestinal Symptoms: Diarrhea (26%), abdominal pain (23%), vomiting (21%), and nausea (13%).
Relatively Common Skin Reactions: Rash (14%) and pruritus (13%).
Neurological Symptoms: The incidence of headache (12%) is similar to that in adults.
Liver Function Abnormalities: Approximately 18% of pediatric patients experience elevated liver enzymes.
Severe Side Effects of Isavuconazonium Sulfate Capsules (Cresemba) to Be Alert For
Hepatotoxic Reactions
Isavuconazonium sulfate may cause severe hepatic adverse reactions, including hepatitis, cholestasis, and even liver failure (fatal cases have been reported).
Clinical Monitoring Recommendations: Liver function must be checked before medication administration.
Regularly monitor liver enzymes (ALT, AST, alkaline phosphatase, total bilirubin) during treatment.
Seek medical attention immediately if jaundice, severe fatigue, or gastrointestinal symptoms occur.
Infusion-Related Reactions
The intravenous formulation may cause severe infusion reactions.
Manifestations include:
Hypotension.
Dyspnea.
Chills.
Management Principles:
Stop the infusion immediately.
Provide symptomatic supportive treatment.
Precautions for Using Isavuconazonium Sulfate Capsules (Cresemba)
Capsule Administration
Swallow the capsule whole; do not chew, crush, or open it.
It can be taken with food or on an empty stomach.
Be careful not to accidentally ingest the desiccant when removing the capsule from the blister packaging.
Special Requirements for Intravenous Administration
An in-line filter (pore size 0.2-1.2 μm) must be used.
The infusion time should be no less than 1 hour.
It cannot be infused simultaneously with other intravenous drugs.
Flush the infusion line with normal saline or 5% glucose before and after administration.
Nasogastric Tube Administration
Restricted to patients aged ≥ 6 years and with a body weight ≥ 16 kg.
Administer the prepared intravenous formulation within 1 hour.
After administration, flush the tube with 15 mL of water in three portions.
