硫酸艾沙康唑胶囊
生产厂家：瑞士Basilea
功能主治：侵袭性曲霉病广谱抗菌药，全因死亡率降低
用法用量：用法用量 剂量 早期靶向治疗(先发制人或诊断驱动的治疗)可能会在等待通过特定诊断测试确认疾病的情况下进行。 然而，一旦获得这些结果，应相应调整抗真菌治疗。 负荷剂量 推荐的负荷剂量是前48小时内每8小时服用两粒胶囊(相当于200毫克艾沙康唑)。 维持剂量 推荐的维持剂量是每天一次两粒胶囊(相当于200毫克艾沙康唑)，在最后一次负荷剂量后12至24小时开始。 治疗持续时间应由临床反应决定。 对于超过6个月的长期治疗，应仔细考虑收益-风险平衡。 改用静脉输液 CRESEMBA也可作为含有200mg艾沙康唑的输注溶液的浓缩粉剂提供。 基于高口服生物利用度(98%)，当有临床指征时，静脉给药和口服给药之间切换是合适的。 老年 老年患者无需调整剂量;然而，老年患者的临床经验有限。 肾功能不全 肾功能不全患者，包括终末期肾病患者无需调整剂量。 肝功能损害 轻度或中度肝功能损害(Child-PughA级和B级)患者无需调整剂量。 尚未在严重肝功能损害(Child-PughC级)患者中研究艾沙康唑。 除非认为潜在益处大于风险，否则不推荐在这些患者中使用。 儿科人群 尚未确定CRESEMBA在18岁以下儿童中的安全性和有效性。 没有可用数据。 给药方法 CRESEMBA胶囊可以在有或没有食物的情况下服用。 CRESEMBA胶囊应整片吞服。 不要咀嚼、压碎、溶解或打开胶囊。
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Isavuconazonium sulfate (ISA) is a prodrug of isavuconazole, an azole antifungal agent that is used to treat invasive fungal infections. ISA is an intravenous (IV) and oral formulation, which is rapidly converted to isavuconazole after administration. The drug is approved for the treatment of invasive aspergillosis and mucormycosis, two life-threatening infections that are commonly seen in immunocompromised patients.
Invasive aspergillosis is caused by the fungus Aspergillus, which can infect the lungs, sinuses, and other organs. The infection can quickly spread to other parts of the body, causing damage to vital organs and tissues. Mortality rates for invasive aspergillosis remain high, especially for patients with underlying conditions such as cancer, transplant recipients, and those with severe burns.Mucormycosis is caused by a group of fungi known as Mucorales, which can invade the sinuses, lungs, and other organs. The infection can rapidly spread to the brain, causing a deadly condition called cerebral mucormycosis. Mucormycosis primarily affects individuals who have a weakened immune system, such as those with uncontrolled diabetes, cancer, and organ transplant recipients.
ISA works by inhibiting the synthesis of ergosterol, a critical component of fungal cell membranes. Inhibition of ergosterol synthesis disrupts fungal cell membrane integrity, leading to fungal cell death. ISA also has activity against other fungi such as Candida and some molds.
Clinical trials have demonstrated the safety and efficacy of ISA for the treatment of invasive aspergillosis and mucormycosis. In addition, recent studies have shown that ISA may be effective in the treatment of other fungal infections such as candidemia and aspergillus sinusitis. ISA has a favorable safety profile, with common side effects including nausea, vomiting, and headache.
ISA has several advantages over other antifungal agents such as amphotericin B and posaconazole. ISA has a more favorable drug-drug interaction profile than amphotericin B, which can cause severe nephrotoxicity. ISA also has better oral bioavailability than posaconazole, which is an important consideration for long-term treatment of fungal infections.
In conclusion, ISA is a promising antifungal agent that offers a new treatment option for patients with invasive fungal infections. The drug has demonstrated safety and efficacy in clinical trials and has several advantages over other antifungal agents. Further studies are needed to evaluate the efficacy of ISA for the treatment of other fungal infections and to determine its optimal dosing regimens.
