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Azole antifungal

CRESEMBA (isavuconazonium sulfate) is an antifungal medicine used to treat serious fungal infections like invasive aspergillosis and invasive mucormycosis. It is available as an injection for intravenous use or as capsules for oral use.

How it worksCRESEMBA works by blocking a specific enzyme (lanosterol 14-alpha demethylase) that fungi need to grow.

Brand names:CRESEMBA

Used for
Invasive aspergillosisInvasive mucormycosis
Conditions
Invasive aspergillosisInvasive mucormycosis
Class
AntifungalAzoleAzole antifungalImmune systemRespiratory system

How to take

FormsInjection (intravenous), Capsules (oral)
RoutesIntravenous, Oral

For adults and children (1+ years) using the injection, a loading dose is given for 48 hours, followed by a once-daily maintenance dose. For adults and children (6+ years, 16kg+) using capsules, a loading dose is given for 48 hours, followed by a once-daily maintenance dose. Capsules can be taken with or without food.

The injection must be given through an in-line filter over at least one hour. For children, specific weight and age requirements apply depending on the form used.

Key warnings

  • ·Serious liver reactions may occur; liver tests should be checked regularly.
  • ·Life-threatening allergic reactions have been reported.
  • ·This drug may cause harm to an unborn baby.
  • ·The intravenous version may form tiny particles, so it must be used with an in-line filter.

Do not use if

  • ·Known allergy to isa vacuconazole.
  • ·Use of strong CYP3A4 inhibitors (e.g., ketoconazole, high-dose ritonavir).
  • ·Use of strong CYP3A4 inducers (e.g., rifampin, carbamazepine, St. John's wort, or long-acting barbiturates).

Side effects

Common

NauseaVomitingDiarrheaHeadacheAbdominal painRash

Serious

  • ·Liver problems
  • ·Severe allergic reactions (anaphylaxis)
  • ·Severe skin reactions
  • ·Infusion-related reactions during IV use

Seek help if

  • ·Signs of an allergic reaction (anaphylaxis)
  • ·Serious skin reactions
  • ·Signs of liver issues

Interactions

  • ·Do not use CRESEMBA with strong CYP3A4 inhibitors like ketoconazole or high-dose ritonavir.
  • ·Do not use CRESEMBA with strong CYP3A4 inducers like rifampin, carbamazepine, or St. John's wort.
  • ·CRESEMBA may change the levels of other drugs in your body, such as digoxin.
FoodCRESEMBA capsules can be taken either with food or without food.

Special populations

PregnancyCRESEMBA may cause harm to a fetus. It is important for pregnant women to know the risks and for women of childbearing age to use effective birth control while taking this medication.

PediatricCRESEMBA injection is for patients 1 year and older. CRESEMBA capsules are for patients 6 years and older who weigh at least 16 kg.

GeriatricNo dose adjustment is needed for elderly patients, as the drug works similarly in older adults compared to younger ones.

Talk to your doctor

Monitor

  • ·Liver function (ALT, AST)
  • ·Allergic reactions
  • ·Infusion reactions

Questions to ask

  • ·Are my liver function tests normal?
  • ·Are any of my current medications incompatible with CRESEMBA?
  • ·What should I do if I experience a skin rash or allergic reaction?

Pharmacokinetics

Half-lifeThe mean plasma half-life of isa vacuconazole is 130 hours.
MetabolismIs a sensitive substrate of CYP3A4.

Practical

OverdoseTaking more than the recommended dose of CRESEMBA can increase the risk of side effects like headache, dizziness, nausea, vomiting, and heart palpitations.

Ingredients

Inactive

black iron oxidecolloidal silicon dioxidedisodium edeatategellan gumhypromellosemagnesium citratemicrocrystalline cellulosepotassium acetatepotassium hydroxidepropylene glycolpurified waterred iron oxideshellacsodium lauryl sulfatestearic acidstrong ammonia solutiontalctitanium dioxide

Educational summary derived from FDA labeling, AI-assisted. Not medical advice — consult a healthcare professional. Updated 2026-04-25.