posaconazole
Brand names: Noxafil
Posaconazole is an antifungal medicine. It helps prevent certain fungal infections in people with weakened immune systems.
Drug Shortage Alert
posaconazole is currently listed as to be discontinued by the FDA. Affected manufacturer: Merck Sharp & Dohme Corp..
View all drug shortages →Drug Pricing (NADAC)
Generic Price
$4.10/unit
Generic Available
Yes (18 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Posaconazole prevents Aspergillus and Candida infections.
Common side effects
Diarrhea, Nausea, Fever
Key warnings
Posaconazole can interact with many other medicines.
How It Works
Posaconazole belongs to a class of drugs called azole antifungals. It works by stopping the growth of fungi. This helps your body fight off the infection.
How to Take It
Take posaconazole tablets exactly as your doctor tells you. For adults, the starting dose is usually 300 mg (three 100 mg tablets) twice on the first day. After the first day, you will usually take 300 mg (three 100 mg tablets) once a day. You can take posaconazole tablets with or without food.
Pregnancy & Breastfeeding
Posaconazole may harm an unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if posaconazole passes into breast milk, so talk to your doctor if you are breastfeeding.
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 continue with your regular schedule.
Storage
Store posaconazole tablets at room temperature (68° to 77°F).
Side Effects (from patient reports)
Based on 9,491 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 15,332 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
15,332
Death-Related Reports
3,711
Hospitalization Reports
6,890
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | OFF LABEL USE | 1,542 |
| 2 | DRUG INEFFECTIVE | 1,434 |
| 3 | FEBRILE NEUTROPENIA | 1,017 |
| 4 | DRUG INTERACTION | 930 |
| 5 | DEATH | 928 |
| 6 | PRODUCT USE IN UNAPPROVED INDICATION | 926 |
| 7 | PYREXIA | 850 |
| 8 | NEUTROPENIA | 705 |
| 9 | PNEUMONIA | 653 |
| 10 | THROMBOCYTOPENIA | 505 |
| 11 | DIARRHOEA | 498 |
| 12 | NAUSEA | 478 |
| 13 | SEPTIC SHOCK | 441 |
| 14 | CONDITION AGGRAVATED | 422 |
| 15 | SEPSIS | 416 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Posaconazole can interact with many other medicines. It can cause heart rhythm problems (QT prolongation). It can also cause liver problems. Tell your doctor about all the medicines you take.
Known Drug Interactions
Interaction Drug Interaction Rifabutin, phenytoin, efavirenz, cimetidine, esomeprazole* Avoid coadministration unless the benefit outweighs the risks ( 7.6 , 7.7 , 7.8 , 7.9 ) Other drugs metabolized by CYP3A4 Consider dosage adjustment and monitor for adverse effects and toxicity ( 7.1 , 7.10 , 7.11 ) Digoxin Monitor digoxin plasma concentrations ( 7.12 ) Fosamprenavir, metoclopramide* Monitor for breakthrough fungal infections ( 7.6 , 7.13 ) *The drug interactions with esomeprazole and metoclopramide do not apply to posaconazole tablets.
Mechanism: Esomeprazole changes the acid levels in the stomach, which can prevent certain forms of posaconazole from being absorbed into the body. This may make the antifungal treatment less effective.
What to do: Avoid taking these together unless your doctor determines the benefits are greater than the risks. Note that this warning may not apply if you are taking the tablet form of posaconazole.
Interaction Drug Interaction Rifabutin, phenytoin, efavirenz, cimetidine, esomeprazole* Avoid coadministration unless the benefit outweighs the risks ( 7.6 , 7.7 , 7.8 , 7.9 ) Other drugs metabolized by CYP3A4 Consider dosage adjustment and monitor for adverse effects and toxicity ( 7.1 , 7.10 , 7.11 ) Digoxin Monitor digoxin plasma concentrations ( 7.12 ) Fosamprenavir, metoclopramide* Monitor for breakthrough fungal infections ( 7.6 , 7.13 ) *The drug interactions with esomeprazole and metoclopramide do not apply to posaconazole tablets. 7.12 Digoxin Increased plasma concentrations of dig...
Mechanism: Posaconazole can cause the amount of digoxin in your blood to rise to higher levels. This increases the risk of digoxin toxicity, which can affect your heart rhythm.
What to do: Your healthcare provider should closely monitor the levels of digoxin in your blood to ensure they stay within a safe range.
Interaction Drug Interaction Rifabutin, phenytoin, efavirenz, cimetidine, esomeprazole* Avoid coadministration unless the benefit outweighs the risks ( 7.6 , 7.7 , 7.8 , 7.9 ) Other drugs metabolized by CYP3A4 Consider dosage adjustment and monitor for adverse effects and toxicity ( 7.1 , 7.10 , 7.11 ) Digoxin Monitor digoxin plasma concentrations ( 7.12 ) Fosamprenavir, metoclopramide* Monitor for breakthrough fungal infections ( 7.6 , 7.13 ) *The drug interactions with esomeprazole and metoclopramide do not apply to posaconazole tablets.
Mechanism: Cimetidine changes the environment in the stomach, which can prevent the body from absorbing enough posaconazole into the bloodstream.
What to do: Avoid taking these two medicines together unless your doctor determines that the benefits are greater than the risks.
Interaction Drug Interaction Rifabutin, phenytoin, efavirenz, cimetidine, esomeprazole* Avoid coadministration unless the benefit outweighs the risks ( 7.6 , 7.7 , 7.8 , 7.9 ) Other drugs metabolized by CYP3A4 Consider dosage adjustment and monitor for adverse effects and toxicity ( 7.1 , 7.10 , 7.11 ) Digoxin Monitor digoxin plasma concentrations ( 7.12 ) Fosamprenavir, metoclopramide* Monitor for breakthrough fungal infections ( 7.6 , 7.13 ) *The drug interactions with esomeprazole and metoclopramide do not apply to posaconazole tablets. 7.13 Gastrointestinal Motility Agents Concomitant a...
Mechanism: Metoclopramide speeds up how fast medicine moves through the digestive system, which can lower the amount of posaconazole that gets absorbed.
What to do: Watch closely for signs that the fungal infection is returning, but note that this interaction does not occur with the tablet form of posaconazole.
Interaction Drug Interaction Rifabutin, phenytoin, efavirenz, cimetidine, esomeprazole* Avoid coadministration unless the benefit outweighs the risks ( 7.6 , 7.7 , 7.8 , 7.9 ) Other drugs metabolized by CYP3A4 Consider dosage adjustment and monitor for adverse effects and toxicity ( 7.1 , 7.10 , 7.11 ) Digoxin Monitor digoxin plasma concentrations ( 7.12 ) Fosamprenavir, metoclopramide* Monitor for breakthrough fungal infections ( 7.6 , 7.13 ) *The drug interactions with esomeprazole and metoclopramide do not apply to posaconazole tablets. 7.8 Phenytoin Phenytoin induces UDP-glucuronidase a...
Mechanism: Phenytoin causes the body to break down posaconazole much faster than usual, which can make the antifungal medicine less effective.
What to do: Avoid using these medicines at the same time unless your doctor decides it is necessary and monitors you closely.
Common Questions
Can I crush or chew the tablets?
What if I can't swallow pills?
Can I take posaconazole with other antifungal medicines?
How long will I need to take posaconazole?
What should I do if I feel sick while taking posaconazole?
Can posaconazole affect my liver?
Can posaconazole affect my heart?
Do I need to avoid any foods or drinks while taking posaconazole?
Can I drive or operate machinery while taking posaconazole?
What if I have kidney problems?
What are the common side effects of posaconazole?
Does posaconazole interact with other medications?
What drug class is posaconazole?
Is posaconazole safe during pregnancy?
Is posaconazole currently in shortage?
Related Medications in Azole Antifungal
Other drugs grouped near posaconazole — same-class peers and common alternatives.
acyclovir
Zovirax
Acyclovir is an antiviral medicine.
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albendazole
Albenza
Albendazole is a medicine that fights parasites.
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amphotericin B
Ambisome, Fungizone
Amphotericin B liposome is an antifungal medicine.
Compare with posaconazole →
anidulafungin
Eraxis
Eraxis is an antifungal medicine.
Compare with posaconazole →
atovaquone/proguanil
Malarone
Malarone is a drug used to prevent and treat malaria.
Compare with posaconazole →
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for posaconazole
The FDA label for posaconazole (sold under brand names such as Noxafil) classifies it as a prescription-only medication in the Azole Antifungal class. Posaconazole prevents Aspergillus and Candida infections. Official labeling lists 18 commonly reported side effects, including Diarrhea, Nausea, Fever.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 9,491 voluntary reports. The database also lists 27 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $4.10.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: September 25, 2024
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages