Noxafil

Before taking this medicine

Do not take Noxafil if you have a known allergy to posaconazole or other azole antifungal medicines. It must not be taken with: • Sirolimus. • Pimozide or quinidine, because of the risk of dangerous heart rhythm changes. • Cholesterol-lowering statins that are mainly broken down by the liver enzyme CYP3A4. • Ergot alkaloids. • Venetoclax when starting treatment or during the gradual dose-increase phase in people with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Noxafil requires caution in people at risk of abnormal heart rhythms. It must not be combined with medicines that both prolong the heart’s QT interval and are broken down by CYP3A4. Potassium, magnesium and calcium imbalances should be checked and corrected before and during treatment. Noxafil can cause new or worsening high blood pressure and abnormal blood tests, so blood pressure and potassium levels need monitoring. Liver blood tests may become abnormal; monitoring and possible treatment discontinuation may be needed. Noxafil can increase cyclosporine and tacrolimus levels, requiring frequent monitoring. It can prolong midazolam’s sedative effects. Use with vincristine can cause nerve toxicity and other serious reactions; use alongside vinca alkaloids is reserved for people without alternative antifungal treatment options. Noxafil can also increase venetoclax toxicity, including serious infections, low white blood cell counts and tumor lysis syndrome. People with severe kidney impairment, severe diarrhea or vomiting need close monitoring for fungal infections developing during treatment. Based on animal studies, Noxafil may harm an unborn baby. Safety and effectiveness in children younger than 2 years have not been established.