International Journal of Hepatology / 2012 / Article / Tab 4

Review Article

Fungal Infections: Their Diagnosis and Treatment in Transplant Recipients

Table 4

Current contraindications and FDA warnings for each antifungal agent available.


Amphotericin B deoxycholateHypersensitivity to amphotericin BAnaphylaxis

Lipid formulations of AMBHypersensitivity to amphotericin BAnaphylaxis

FluconazoleHypersensitivity to fluconazoleHepatic injury, anaphylaxis, and dermatologic

ItraconazoleTerfenadine, astemizole, dofetilide, pimozide, quinidine, oral midazolam, triazolam, cisapride, and statins should also be discontinued during therapyBlack box for terfenadine and congestive Heart failure see contraindications

PosaconazoleHypersensitivity to the active substance or excipients, ergot alkaloids, coadministration with 3A4 substrates (terfenadine, astemizole, cisapride, pimozide, halofantrine, and quinidine)Hypersensitivity, hepatic toxicity, recommended monitoring of hepatic function (LFTs), cyclosporine, tacrolimus, and sirolimus

VoriconazoleHypersensitivity to voriconazole, CYP3A4 inhibitors (terfenadine, astemizole, cisapride, pimozide, and quinidine), sirolimus, rifampin, carbamezapine, long acting barbiturates, ritonavir, efavirenz, rifabutin, and ergot alkaloids (ergotamine and dihydroergotamine)Visual disturbances, hepatic toxicity, recommended monitoring of LFTs and bilirubin, pregnancy category D, and galactose intolerance

AnidulafunginHypersensitivity to anidulafungin or other echinocandinsNone

CaspofunginHypersensitivity to caspofungin or other echinocandinsElevated liver enzymes with cyclosporine

MicafunginHypersensitivity to micafungin or other echinocandinsHypersensitivity, hematological effects (hemolysis, hemolytic anemia, and hemoglobinuria), hepatic effects (abnormal LFTs, hepatic dysfunction, hepatitis, and hepatic failure), and renal effects (elevations of BUN and creatinine, renal dysfunction, and acute renal failure)

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