Indications 

Noxafil (modified-release tablet) is a prescribed medication used for preventing invasive fungal infections in severely immunocompromised patients, particularly those at high risk due to chemotherapy or stem cell transplantation. 

Noxafil (oral suspension) is prescribed for the treatment of oral thrush, a yeast infection affecting the mouth. It can be used as the primary treatment or as an alternative option if prior attempts with itraconazole or fluconazole have been unsuccessful. 

Classified as an azole antifungal medication, Noxafil functions by inhibiting the growth of fungi responsible for causing infections. 

Uses and Dosage 

Before taking Noxafil and with each prescription refill, carefully review its medication guide and patient information leaflet. Ask your doctor or pharmacist if you have any queries or uncertainties. 

The dosage and length of treatment with Noxafil vary per individual based on their medical condition and response to the treatment. 

Typically, Noxafil tablet and oral suspension are taken twice daily on the first day, followed by once-daily dosing from the second day onward. 

Noxafil tablets should be taken with food. Swallow the tablets whole and do not break, crush, or chew them. If you are unable to swallow the tablets whole, inform your healthcare provider as an alternative medication may be necessary. 

Noxafil oral suspension should be taken either during a full meal or within 20 minutes after eating. If a full meal is not possible, each dose can be taken with a liquid nutritional supplement or an acidic carbonated beverage, such as ginger ale. 

Prior to use, shake Noxafil oral suspension thoroughly, and then utilize the provided measuring spoon to ensure accurate dosage. After each use and before storage, the spoon should be rinsed thoroughly with water. 

To achieve optimal results, maintain a consistent level of this medication in your body. Take it at regular intervals, spacing the doses evenly throughout the day and adhering to a consistent daily schedule. 

Take Noxafil tablet and oral suspension exactly as directed. Do not modify the prescribed dosage, duration, or frequency of intake without first consulting your doctor. 

In case of persistent vomiting or diarrhea, contact your doctor, as Noxafil’s efficacy may be compromised during this period. 

Side Effects 

Listed below are the potential adverse effects of Noxafil. If any of them last or worsen, promptly inform your physician. 

Common Side Effects 

• Diarrhea 
• Nausea 
• Vomiting 
• Headache 
• Fever 
• Cough 

Serious Side Effects 

• Rapid or irregular heartbeats, chest fluttering, shortness of breath, and sudden dizziness (possible fainting) 
• Swelling in an arm or leg 
• Shortness of breath 
• Symptoms of liver problems: 
  • Nausea 
  • Vomiting 
  • Itching 
  • Fatigue 
  • Jaundice (yellowing of skin or eyes) 
• Signs of electrolyte imbalance: 
  • Increased thirst or urination 
  • Constipation 
  • Muscle pain or weakness 
  • Numbness or tingling 
  • Confusion 
  • Feeling jittery 
  • Irregular heartbeats 

Inform your doctor immediately if any of the severe side effects above occur. 

Allergic Reactions 

Although rare, a severe allergic reaction to Noxafil may occur. Seek immediate medical assistance if you observe any of these symptoms: 

• Hives 
• Difficult breathing 
• Face, lips, throat, or tongue swelling 

Not all side effects of Noxafil are included in this list. Tell your physician promptly if any unlisted effects are observed. 

Cautions 

Before starting treatment with Noxafil, inform your doctor and pharmacist of any known allergies, particularly to: 

• Posaconazole 
• Other azole antifungals, such as ketoconazole 
• Other drugs 
• Any of the components of Noxafil modified-release tablet and oral suspension 

To ensure Noxafil is safe for you, disclose to your physician your medical background, especially if you have a history of liver or kidney disease. 

Inform your doctor and pharmacist about all prescription and non-prescription medications, vitamins, and herbal supplements you are currently taking or planning to take to mitigate the risk of drug interaction with Noxafil. 

The efficacy of Noxafil may be affected by other drugs that influence its elimination from the body, such as: 

• Rifamycins (e.g., rifabutin) 
• Efavirenz, 
• Anticonvulsants (e.g., phenytoin) 

The efficacy of other drugs may be impacted by Noxafil’s ability to hinder their elimination from the body. Examples of drugs that may be affected include 

• Specific alpha blockers (e.g., alfuzosin, silodosin, tamsulosin) 
• Certain benzodiazepines (e.g., midazolam) 
• Dronedarone 
• Ergot alkaloids (e.g., ergotamine, dihydroergotamine) 
• Pimozide 
• Quinidine 
• Rivaroxaban 
• Sirolimus 
• Certain “statin” drugs (e.g., lovastatin, simvastatin) 
• Venetoclax 

The use of Noxafil may result in QT prolongation, which can lead to serious and rarely fatal irregular heartbeat and other symptoms, such as severe dizziness and fainting, requiring immediate medical attention. 

Noxafil can cause dizziness, which can be worsened by alcohol. Refrain from driving, operating machinery, or engaging in activities requiring alertness until you can do so safely. Furthermore, abstain from alcohol as it can also increase the risk of severe liver problems. 

The use of Noxafil during pregnancy should only be considered if the benefits exceed the risks to the fetus. 

Consult your doctor before breastfeeding, as it is uncertain whether posaconazole is excreted in breast milk.