What is in this leaflet
This leaflet answers some common questions about NOXAFIL. It does not contain all the available information.
It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you having NOXAFIL against the benefits this medicine
is expected it will have.
If you have any concerns about NOXAFIL, ask your doctor, pharmacist or nurse.
Read this leaflet carefully.
Keep this leaflet.
You may need to read it again.
What NOXAFIL is used for
NOXAFIL contains the active ingredient, posaconazole. Posaconazole is a medicine that belongs to the triazole group of antifungal
NOXAFIL works by killing or stopping the growth of the fungi causing these infections.
NOXAFIL is used for:
The treatment of invasive aspergillosis, a fungal infection caused by a fungus called aspergillus
The treatment of other serious fungal infections called fusariosis, zygomycosis, chromoblastomycosis and mycetoma.
These types of fungal infections usually occur in some patients who may have lowered resistance to infection due to poor immunity.
Treatment of these serious fungal infections with NOXAFIL is usually reserved for patients who do not respond to or cannot
tolerate other medicines used to treat these types of fungal infections.
NOXAFIL is also used to treat coccidioidomycosis, a rare and serious fungal infection.
NOXAFIL is also used to prevent fungal infections, such as yeasts and moulds, from occurring in patients who are at high-risk
of developing these infections.
NOXAFIL is only for use in adults (18 years of age and older).
Before you are given NOXAFIL
When you must not be given it
You should not be given NOXAFIL if:
1. you have an allergy to:
posaconazole or any other triazole antifungal medicines
any of the ingredients listed at the end of this leaflet (See Product Description)
Symptoms of an allergic reaction may include skin rash, itching, hives, shortness of breath, difficulty breathing, swelling
of the face, tongue or other parts of the body.
2. you are pregnant or may become pregnant.
3. you are taking any of the following medicines:
certain medicines used to treat allergy or hay fever (terfenadine or astemizole)
cisapride, a medicine used to treat certain stomach problems
pimozide, a medicine used to treat certain mental disorders
quinidine, a medicine used to treat irregular heart beat
ergotamine and dihydroergotamine, which are medicines used to treat migraine
halofantrine, a medicine used to treat malaria
simvastatin, lovastatin, atorvastatin or similar medicines (called HMG-CoA reductase inhibitors or statins) that are used
to treat high cholesterol levels.
Before you are given it
Tell your doctor, pharmacist or nurse if:
1. you have any allergies to any other medicines, especially other antifungal medicines such as itraconazole (Sporanox®), fluconazole (Diflucan®), voriconazole (Vfend®), ketoconazole (Nizoral®) or any other substances such as foods, preservatives or dyes.
2. you have or have ever had any other health problems/ medical conditions including:
any kidney problems
any liver problems
any heart problems
any problems with potassium, magnesium or calcium levels in your blood.
Follow your doctor's advice if any blood tests to check on your kidney or liver are recommended.
3. are taking midazolam, a hypnotic and sedative medicine.
4. you are pregnant or plan to become pregnant
NOXAFIL should not be used during pregnancy unless indicated by your doctor. Women who are of childbearing potential should
use effective contraception while being given NOXAFIL and for 2 weeks after completing treatment. Your doctor will discuss
the possible risks and benefits to you and your unborn baby.
NOXAFIL should not be given to breastfeeding women. It is possible that the active ingredient, posaconazole, may be passed
into the breast milk. Your doctor can discuss the risks and benefits involved.
If you have not told your doctor, pharmacist or nurse about any of the above, tell them before you are given NOXAFIL.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including medicines you buy without a prescription from
a pharmacy, supermarket or health food shop.
Some medicines may increase the risk of side effects of NOXAFIL by increasing the amount of posaconazole in the blood. Similarly,
some medicines may decrease the effectiveness of NOXAFIL by decreasing the amount of posaconazole in the blood.
Medicines that can decrease the effectiveness of NOXAFIL are:
rifabutin, used to treat tuberculosis
phenytoin, used to treat fits or convulsions
efavirenz and fosamprenavir, used to treat HIV infection
medicines used to decrease stomach acid such as cimetidine, ranitidine and omeprazole
NOXAFIL may possibly increase the risk of side effects of some medicines by increasing the amount of these medicines in the
blood. These are:
vincristine, vinblastine and other vinca alkaloids, used to treat cancer
cyclosporine, tacrolimus and sirolimus, used to treat certain immune system problems or to prevent organ transplant rejection
rifabutin, used to treat certain infections
midazolam and other benzodiazepine medicines used as sedatives or muscle relaxants
calcium channel blockers, such as diltiazem, nifedipine and verapamil, used in certain heart conditions and to treat high
sulfonylureas such as glipizide (used to treat diabetes)
medicines used to treat HIV called protease inhibitors (including atazanavir which is given with ritonavir) and non- nucleoside
reverse transcriptase inhibitors
These medicines may be affected by NOXAFIL or may affect how well it works. You may need different amounts of these medicines
or you may need to take different medicines. Your doctor or pharmacist will advise you.
How NOXAFIL is given
NOXAFIL concentrated injection will be diluted to the correct concentration by your pharmacist or nurse.
How much is given
The usual dose is 300 mg twice a day on the first day, then 300 mg once a day, thereafter.
How is it given
NOXAFIL is usually diluted and given as a slow infusion or "drip" injection into your vein (intravenously).
How long to take it
The length of treatment will depend on the type of infection you have and will be individually adapted for you by your doctor.
While you are given NOXAFIL
Things you must do
Always follow your doctor's instructions carefully.
If you are a woman of childbearing age, talk to your doctor about the need for effective contraception. Once you have finished
taking NOXAFIL, continue using contraception until your next period.
If you are about to start any other new medicine, tell your doctor that you are taking NOXAFIL.
If you need to have any blood tests, tell your doctor you are taking NOXAFIL. NOXAFIL may affect the results of some laboratory
Tell all doctors, dentists and pharmacists who are treating you that you have been given NOXAFIL.
Tell your doctor, pharmacist or nurse as soon as possible if you do not feel well while you are being given NOXAFIL or after
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment
if you get some of the side effects.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
Ask your doctor, pharmacist or nurse to answer any questions you may have.
Tell your doctor or nurse if you experience any of the following:
Feeling confused or weak
Abnormal skin sensations, such as numbness, tingling, itching, creeping prickling or burning
Swelling, redness and tenderness along the vein in which NOXAFIL was given
Loss of appetite
Stomach pain or upset stomach, passing wind, dry mouth, changes in your taste
Feeling weak, dizzy, tired or sleepy
Constipation, rectal discomfort
These are common side effects.
Tell your doctor or nurse or pharmacist immediately if you notice any of the following:
rash, itchiness, hives
swelling of the face, lips, mouth, throat or neck which may cause difficulty swallowing or breathing
nausea or vomiting, diarrhoea
yellowing of your skin or whites of eyes, unusually dark urine or pale faeces, feeling sick for no reason, stomach problems,
loss of appetite or unusual tiredness or weakness (signs of liver problems)
These are very serious side effects. You may need urgent medical attention.
Other side effects not listed above may also occur in some patients. Tell your doctor, pharmacist or nurse if you notice anything
else that is making you feel unwell.
NOXAFIL concentrated injection is stored in a refrigerator (2 to 8 degrees Celsius) in the pharmacy or on the ward in a hospital.
Once prepared, the product should be used immediately. If not used immediately it can be stored for up to 24 hours at 2 to
8 degrees Celsius (in a refrigerator).
NOXAFIL is for single use only and any unused solution should be discarded.
What it looks like
NOXAFIL concentrated injection is a clear, colourless to yellow liquid.
It is supplied as a single use vial closed with a bromobutyl rubber stopper and aluminium seal.
posaconazole 300 mg/16.7 mL.
Other ingredients are:
sulfobutyl betadex sodium (SBECD)
hydrochloric acid and sodium hydroxide for pH adjustment
Water for Injections.
Merck Sharp & Dohme (Australia) Pty Limited
Level 1, Building A,
26 Talavera Road
Macquarie Park NSW 2113
Australian Registration Number: AUST R 218702
This leaflet was prepared in