Medication for aspergillosis

Aspergillosis Patient Support

Formerly Aspergillus Trust and
Aspergillus Website for Patients

...funded by the Fungal Research Trust

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Medication

Absorption
Some of the antifungal drugs (e.g. itraconazole) are taken orally and can be difficult to absorb, particularly if you are antacid medication (medicine used to treat indigestion, stomach ulcers or heartburn). This is because some acid in the stomach is needed to dissolve the capsules and allow absorption.

In the case of itraconazole the standard advice is to ensure that there is plenty of acid in the stomach by taking a fizzy drink such as cola with the medication (the carbon dioxide that causes the fizz also makes the drink quite acidic). Some people dislike fizzy drinks so substitute a fruit juice e.g. orange juice however this is now NOT recommended (N.B. see note on the right about fruit juices).

Itraconazole capsules are taken after a meal and 2 hours before taking antacids. Itraconazole solution is taken one hour before a meal as it is more easily absorbed.

It is well worth reading the Patient Information Leaflet packed with your medication as this gives you all the information you need to store and use it. We provide a list of the commonest medications on the right of this page and links to their respective PILs.

Even after following all the manufacturers' instructions absorbance of some drugs is often unpredictable. You may find that your doctor will take blood samples to check how well your body is absorbing an antifungal.

Side Effects
All drugs have side effects ('adverse effects') and drug manufacturers are required to list them in the Patient Information Leaflet (PIL). The majority are minor but all are worthwhile mentioning to your doctor at your next visit. Side effects can be very diverse and often completely unexpected. If you are feeling unwell it is always worth checking the list of side effects on the PIL as it may be that the drug you are taking is causing a problem. If in doubt always seek your doctor's advice.

Steroids are particularly prone to causing many unpleasant side effects. There is information that is specific to steroid side effects and how to best take steroids here.

Patients experiencing side effects are given a range of advice - it may be that persevering in taking the drug causes the problem to eventually disappear, or it may be that the patient should be stopped from taking the drug. Occasionally another drug will be prescribed to counteract the side effect.

Except in the most severe cases it is not advisable for the patient to stop taking a drug without consulting their doctor.

Further information

The most common drugs prescribed for long term use for people with aspergillosis are listed with detailed information below. There is also a listing of simplified information for most of these drugs here.

It is well worth reading the patient information leaflets (PIL) for the medication you are about to start taking and noting any warnings, side effects and the list of incompatible medicines. This is also a great place to read specific guidance on how to take your medication. We supply up-to-date copies below:

(PIL - Patient Information Leaflet)
(VIPIL - for visually impaired):

Steroids:
- Prednisolone
  - 25mg (PIL)(VIPIL)
  - 2.5mg (PIL) (VIPIL)
  - 1mg (PIL)(VIPIL)
Antifungals:
- Itraconazole (Sporanox)
  - Solution (PIL)(VIPIL)
  - IV (PIL)(VIPIL)
  - Capsule (PIL)(VIPIL)
  - Pulse (PIL)(VIPIL)
- Amphotericin
  - Abelcet (PIL)(VIPIL)
  - Ambisome (PIL)(VIPIL)
  - Amphocil (PIL)(VIPIL)
  - Fungizone (PIL)(VIPIL)
- Voriconazole (VFEND)
  - 200mg powder (PIL)(VIPIL)
  - 40mg/ml oral (PIL)(VIPIL)
  - 50 & 200mg tablets (PIL)(VIPIL)
- Caspofungin (CANCIDAS)
  - 50mg (PIL)(VIPIL)
  - 70mg (PIL)(VIPIL)
- Posaconazole (Noxafil)(PIL)
- Flucytosine (Acontil) (PIL)(VIPIL)

Fruit juice
Grapefruit,juice is known to increase the blood levels of several drugs including itraconazole. In some cases (not with itraconazole) that has lead to potentially dangerous overdosing - for example in blood pressure drugs which are harmful if overdone.

There has also now been a second report that several fruit juices can block absorption of some antifungal drugs (and others), potentially leading to a lowering of blood drug levels.

All taken together it is probably best to take your itraconazole with a cola drink, avoiding fruit juices altogether.

New side effects
Patientsville offers listings of many drugs and side effects that are currently being reported by patients themselves. Some of these might be new but the quality of the information is not controlled so there is always a chance that the side effect reported is unrelated to the drug being used. Read with caution.