Isavuconazole
Pronunciation: (eye-sa-VOO-koe-na-zole).
- Generic name
- Isavuconazole
- Brand names
- Cresemba, Isavucon, Isavuca, Isavunox
- Drug class
- Antifungal (Triazole antifungal agent)
Availability and supply rules vary by country
Trade names by country: United Kingdom
Australia: · Full directory
What Isavuconazole is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Isavuconazole works
Isavuconazole inhibits the fungal cytochrome P450 enzyme lanosterol 14α-demethylase, which is essential for the synthesis of ergosterol, a key component of the fungal cell membrane. Inhibition of ergosterol synthesis leads to increased membrane permeability and cell death. Isavuconazole is active against a broad range of yeasts and molds, including Aspergillus and Mucorales species. (2)
What Isavuconazole is used for
Invasive aspergillosis
Invasive aspergillosis (2)
Invasive mucormycosis
Invasive mucormycosis (2)
Before taking Isavuconazole
Do not take / not appropriate for
- Hypersensitivity to isavuconazole or excipients. (Contraindication) (2)
- coadministration with strong CYP3A4 inducers or substrates with narrow therapeutic index metabolized by CYP3A4. (Contraindication) (2)
Tell your clinician about
(2)How to take Isavuconazole
- General Instructions: Take isavuconazole exactly as prescribed by your healthcare provider. Do not skip doses or stop early unless advised by your doctor.. Adult Dosing: For invasive aspergillosis and mucormycosis: Loading dose of 372 mg (equivalent to 200 mg isavuconazole) every 8 hours for 6 doses, followed by a maintenance dose of 372 mg once daily, either orally or intravenously.. Pediatric Dosing: Isavuconazole is FDA-approved for children 1 to under 18 years using weight-based IV dosing (loading 10-15 mg/kg every 8 hours for 6 doses, then once daily; maximum single dose 372 mg), and for ages 6-<18 years an oral capsule weight-based regimen is also approved. Pediatric treatment is directed by a specialist.. Administration: Capsules can be taken with or without food. Swallow capsules whole; do not crush or chew. Intravenous administration should be performed by a healthcare professional.. When To Stop: Continue taking isavuconazole for the full prescribed duration, even if symptoms improve. If you experience severe side effects, seek medical advice promptly; let the clinician you see advise on whether to continue or stop treatment.. Storage: Store capsules at controlled room temperature 20-25C (68-77F) in original packaging, away from moisture and heat. The intravenous form is stored refrigerated before reconstitution, per hospital pharmacy protocols. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take an extra dose to catch up.
Overdose
In case of overdose, seek emergency medical attention or call your local poison control center immediately. Symptoms may include severe nausea, vomiting, or abnormal heart rhythms. Supportive care is recommended as there is no specific antidote. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Diarrhea
Incidence: Reported in the clinician-authored database; frequency not established
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Elevated liver enzymes
Incidence: Reported in the clinician-authored database; frequency not established
Hypokalemia
Incidence: Reported in the clinician-authored database; frequency not established
QTc interval shortening
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
May cause liver toxicity — serious
Symptoms: May cause liver toxicity; monitor liver function regularly. Can cause changes in heart rhythm (QT interval shortening). Serious drug interactions possible; review all medications with your doctor. Not recommended during pregnancy unless clearly needed. Use caution in patients with severe hepatic impairment.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindications: Hypersensitivity to isavuconazole or excipients; coadministration with strong CYP3A4 inducers or substrates with narrow therapeutic index metabolized by CYP3A4. Precautions: Use with caution in patients with hepatic impairment, history of arrhythmias, or risk factors for QT interval changes. Monitor for signs of liver dysfunction and hypersensitivity reactions.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Isavuconazole is also contraindicated in patients with familial short QT syndrome, consistent with its known effect of shortening (not prolonging) the QTc interval — serious
Symptoms: Isavuconazole is also contraindicated in patients with familial short QT syndrome, consistent with its known effect of shortening (not prolonging) the QTc interval. It is contraindicated with strong CYP3A4 inhibitors (e.g., ketoconazole, high-dose ritonavir) as well as strong CYP3A4 inducers (e.g., rifampin, carbamazepine, St. John's wort, long-acting barbiturates).
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Isavuconazole is metabolized by CYP3A4 and can interact with many medications, including immunosuppressants (e.g., tacrolimus, cyclosporine), certain antivirals, and other antifungals. Strong CYP3A4 inducers can reduce its effectiveness, while inhibitors may increase its levels. Always inform your healthcare provider of all medications and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Isavuconazole may cause fetal harm. Females of reproductive potential are advised to use effective contraception during treatment and for 28 days after the final dose. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus, as judged by the treating clinician. (2)
Breastfeeding
Breastfeeding is discontinued during treatment with isavuconazole, per the treating clinician's guidance. (2)
Children
Frequency: FDA-approved weight-based dosing exists for ages 1 to under 18 years (this corrects an earlier internal note that had said pediatric use was not recommended and safety was not established).. Weight Based: Yes, for IV use in children 1-<18 years (loading 10-15 mg/kg every 8 hours for 6 doses, then once daily) and for oral capsules in children 6-<18 years.. Max Daily Dose: Maximum individual dose is 372 mg, matching the adult dose.. Max Single Dose: 372 mg.. Age Restrictions: Not established for children under 1 year. (2)
Renal_impairment
Renal impairment: no dose adjustment is necessary for mild, moderate, or severe renal impairment, or for end-stage renal disease. Hepatic impairment: standard dosing applies for mild-to-moderate impairment; for severe impairment (Child-Pugh Class C), use only when the benefits outweigh the risks, with clinical monitoring, as directed by the treating clinician. (2)
Hepatic_impairment
Renal impairment: no dose adjustment is necessary for mild, moderate, or severe renal impairment, or for end-stage renal disease. Hepatic impairment: standard dosing applies for mild-to-moderate impairment; for severe impairment (Child-Pugh Class C), use only when the benefits outweigh the risks, with clinical monitoring, as directed by the treating clinician. (2)
Monitoring
(2)Storage
Capsules: store at controlled room temperature, 20-25C (68-77F), in original packaging to protect from moisture (excursions to 15-30C permitted). Intravenous form: unreconstituted vials are refrigerated at 2-8C; once reconstituted, use within the timeframe specified by hospital pharmacy protocols (typically up to 6 hours at room temperature or 24 hours refrigerated after dilution). Keep out of reach of children.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Invasive aspergillosis
Dose summary: Adults: loading dose 372 mg IV or orally every 8 hours for 6 doses (48 hours), followed by a maintenance dose of 372 mg once daily starting 12-24 hours after the last loading dose. Pediatric (1-<18 years): weight-based IV loading 10-15 mg/kg every 8 hours for 6 doses, then once daily (max 372 mg/dose); oral capsule weight-based dosing is also approved for ages 6-<18 years.
Renal context: No dose adjustment is necessary for mild, moderate, or severe renal impairment, or for end-stage renal disease. Hepatic: standard dosing for mild-to-moderate impairment; for severe impairment (Child-Pugh Class C), use only if benefits outweigh risks, with monitoring. (2)
Frequently asked questions
What infections does isavuconazole treat?
Isavuconazole is used to treat invasive aspergillosis and invasive mucormycosis, which are serious fungal infections often seen in immunocompromised patients.
How long do I need to take isavuconazole?
The duration depends on the type and severity of infection and your response to treatment. Your doctor will determine the appropriate length of therapy, which may range from several weeks to months.
Can I take isavuconazole with food?
Yes, isavuconazole capsules can be taken with or without food. Swallow the capsules whole.
What should I do if I experience side effects?
Contact your healthcare provider if you experience mild side effects. Seek immediate medical attention for severe reactions such as jaundice, severe rash, or difficulty breathing.
Is isavuconazole safe during pregnancy?
Isavuconazole should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Discuss with your doctor if you are pregnant or planning to become pregnant.
Are there any foods or drugs I should avoid while taking isavuconazole?
Avoid grapefruit products and strong CYP3A4 inducers such as rifampin and St. John's wort. Always review your medication list with your healthcare provider.
How is isavuconazole different from other antifungals?
Isavuconazole has a broad spectrum of activity and is effective against both Aspergillus and Mucorales species. It also has a lower risk of causing QT prolongation compared to other azoles, but may shorten the QT interval.
What happens if I take too much Isavuconazole?
Taking too much Isavuconazole can lead to an overdose, potentially causing exacerbated side effects such as severe gastrointestinal issues, liver problems, or neurological symptoms. If you suspect an overdose, it is crucial to seek immediate emergency medical attention. Do not attempt to self-treat or wait for symptoms to worsen, as prompt intervention is vital for your safety.
Can I drink alcohol while taking Isavuconazole?
It is generally advisable to avoid or limit alcohol consumption while taking Isavuconazole. Both alcohol and Isavuconazole are metabolized by the liver, and combining them can increase the risk of liver damage or exacerbate side effects like nausea and dizziness. Always consult your healthcare provider for personalized advice regarding alcohol intake during your treatment with Isavuconazole.
What is the mechanism of action of Isavuconazole?
Isavuconazole inhibits the fungal cytochrome P450 enzyme lanosterol 14α-demethylase, which is essential for the synthesis of ergosterol, a key component of the fungal cell membrane. Inhibition of ergosterol synthesis leads to increased membrane permeability and cell death. Isavuconazole is active against a broad range of yeasts and molds, including Aspergillus and Mucorales species. (2)
What is the generic name of Isavuconazole?
The generic name is Isavuconazole. It is sold under brand names including Cresemba, Isavucon, Isavuca, Isavunox.
What class of drug is Isavuconazole?
Isavuconazole is classed as: Antifungal (Triazole antifungal agent).
References
- Isavuconazole - MedGuideGlobal Clinician-Authored Medicine RecordMedGuideGlobal · International · accessed 2026-08-06 · source 1
- CRESEMBA (isavuconazonium sulfate) capsules and injection — prescribing informationU.S. Food and Drug Administration · United States · dated 2026 · accessed 2026-08-06 · source 2
Brand names by country
Single-ingredient Isavuconazole names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United Kingdom
- CRESEMBA 100 mg hard capsules100 mg · Pfizer Limited
- CRESEMBA 40 mg hard capsules40 mg · Pfizer Limited
- CRESEMBA 200 mg powder for concentrate for solution for infusion200 mg · Pfizer Limited