Table 1 Antifungal pharmacotherapy of mucormycosis [30,31,32,33,34]

First line

Amphotericin B lipid complex or liposomal amphotericin B

Infusion-related reactions, nephrotoxicity, electrolyte imbalance (hypomagnesemia, hypophosphatemia, hypokalemia, hypocalcemia), transaminitis

Renal function (SCr, BUN, urine output/input), electrolytes (potassium, magnesium, phosphorus), LFT, CBC, temperature

Salvage therapy

Posaconazole 300 mg IV/PO DR tablet every 12 h for the first day, then 300 mg IV/PO daily.

IR oral suspension^a Posaconazole 200 mg PO q6h or 400 mg PO q12h

Diarrhea, nausea, vomiting, QTc prolongation, transaminitis

LFT, QTc, CBC, Posaconazole trough concentrations

DR tablet can be taken with or without food; do not chew, divide, crush, or dissolve DR tablet

^aIR suspension should be taken with a full meal and should be avoided with concurrent proton pump inhibitors

Isavuconazonium sulfate 372 mg (isavuconazole 200 mg) IV/PO q8h × 6 doses, followed by 372 mg IV/PO or PO q24h thereafter

Nausea, vomiting, diarrhea, transaminitis, peripheral edema, back pain, QTc shortening

LFTs, QTc, isavuconazole trough concentration monitoring is not recommended except when concerned for impaired drug absorption, therapeutic failure, and toxicity