MedPath
EMA Approval

Posaconazole AHCL

J02AC04

posaconazole

Antimycotics for systemic use

Basic Information

J02AC04

posaconazole

Antimycotics for systemic use

Therapeutic indication

Posaconazole AHCL oral suspension is indicated for use in the treatment of the following fungal infections in adults:

  • Invasive aspergillosis in patients with disease that is refractory to amphotericin B or itraconazole or in patients who are intolerant of these medicinal products;
  • Fusariosis in patients with disease that is refractory to amphotericin B or in patients who are intolerant of amphotericin B;
  • Chromoblastomycosis and mycetoma in patients with disease that is refractory to itraconazole or in patients who are intolerant of itraconazole;
  • Coccidioidomycosis in patients with disease that is refractory to amphotericin B, itraconazole or fluconazole or in patients who are intolerant of these medicinal products.
  • Oropharyngeal candidiasis: as first-line therapy in patients who have severe disease or are immunocompromised, in whom response to topical therapy is expected to be poor.

Refractoriness is defined as progression of infection or failure to improve after a minimum of 7 days of prior therapeutic doses of effective antifungal therapy.

Posaconazole AHCL oral suspension is also indicated for prophylaxis of invasive fungal infections in the following patients:

  • Patients receiving remission-induction chemotherapy for acute myelogenous leukemia (AML) or myelodysplastic syndromes (MDS) expected to result in prolonged neutropenia and who are at high risk of developing invasive fungal infections;
  • Hematopoietic stem cell transplant (HSCT) recipients who are undergoing high-dose immunosuppressive therapy for graft versus host disease and who are at high risk of developing invasive fungal infections.

Overview Summary

Posaconazole AHCL is an antifungal medicine used to treat adults with the following fungal diseases, when treatments with other antifungal medicines (amphotericin B, itraconazole or fluconazole) cannot be tolerated or have failed:

  • invasive aspergillosis (fungal infection caused by Aspergillus),
  • fusariosis (fungal infection caused by Fusarium),
  • chromoblastomycosis and mycetoma (long-term fungal infections of the skin or the tissue just below the skin, usually caused by fungal spores infecting wounds due to thorns or splinters),
  • coccidioidomycosis (fungal infection of the lungs caused by breathing in spores).

Posaconazole AHCL is also used as a first-line treatment for ‘thrush’, a fungal infection of the mouth and throat due to Candida. It is used in patients whose infection is severe or in patients with weakened immune systems, when medicines applied topically (directly on the thrush) are unlikely to work.

Posaconazole AHCL is also used to prevent invasive fungal infections in patients whose immune system is weakened because of treatments they are receiving for blood or bone marrow cancers or medicines used in haematopoietic stem cell transplantation (a procedure where the patient’s bone marrow is replaced by stem cells from a donor to form new bone marrow).

Posaconazole AHCL contains the active substance posaconazole and is a ‘generic medicine’. This means that Posaconazole AHCL contains the same active substance and works in the same way as a ‘reference medicine’ already authorised in the EU called Noxafil.

Authorisations (1)

EMEA/H/C/005028

Accord Healthcare S.L.U.,Edificio Este Planta 6a,World Trade Center,Moll De Barcelona S/n,08039 Barcelona,SPAIN

Authorised

July 25, 2019

Active Substances (2)

posaconazole

posaconazole

Documents (10)

Posaconazole AHCL : EPAR - Public assessment report

August 27, 2019

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Posaconazole AHCL : EPAR - All authorised presentations

August 27, 2019

AUTHORISED_PRESENTATIONS

Posaconazole AHCL : EPAR - Procedural steps taken and scientific information after authorisation

January 21, 2025

CHANGES_SINCE_INITIAL_AUTHORISATION

CHMP summary of positive opinion for Posaconazole AHCL

May 29, 2019

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Posaconazole AHCL : EPAR - Medicine overview

August 27, 2019

OVERVIEW_DOCUMENT

Posaconazole AHCL : EPAR - Risk-management-plan summary

August 19, 2022

RISK_MANAGEMENT_PLAN_SUMMARY

Posaconazole AHCL : EPAR - Procedural steps taken and scientific information after authorisation (archive)

September 8, 2021

CHANGES_SINCE_INITIAL_AUTHORISATION

Posaconazole AHCL : EPAR - Public assessment report

August 27, 2019

CHANGES_SINCE_INITIAL_AUTHORISATION

CHMP summary of positive opinion for Posaconazole AHCL

May 29, 2019

CHANGES_SINCE_INITIAL_AUTHORISATION

Posaconazole AHCL : EPAR - Product information

August 27, 2019

DRUG_PRODUCT_INFORMATION

Overview Q&A (7)

Question

Other information about Posaconazole AHCL

Answer

Posaconazole AHCL received a marketing authorisation valid throughout the EU on 25 July 2019.

Question

How is Posaconazole AHCL used?

Answer

Posaconazole AHCL can only be obtained with a prescription and treatment should be started by a doctor who has experience in managing fungal infections or in treating patients at high risk of invasive fungal infections.

Posaconazole AHCL is available as an oral suspension (40 mg/ml) which is taken with a meal or nutritional supplement.

For the treatment of fungal infections, with the exception of thrush, Posaconazole AHCL is taken at a dose of 400 mg (10 ml) twice a day, or 200 mg (5 ml) four times a day in patients who are not eating. The duration of treatment depends on the severity of the disease and the patient’s response. For thrush, Posaconazole AHCL is taken as 200 mg (5 ml) on the first day followed by 100 mg (2.5 ml) once a day for the following 13 days. For the prevention of invasive fungal infections, Posaconazole AHCL is taken at a dose of 200 mg (5 ml) three times a day. The duration of treatment depends on the patient’s condition.

For more information about using Posaconazole AHCL, see the package leaflet or contact your doctor or pharmacist.

Question

How does Posaconazole AHCL work?

Answer

The active substance in Posaconazole AHCL, posaconazole, is an antifungal medicine that belongs to the triazole group. It works by preventing the formation of ergosterol, which is an important part of fungal cell walls. Without ergosterol, the fungus dies or is prevented from spreading. The list of fungi posaconazole is active against can be found in the summary of product characteristics.

Question

Why is Posaconazole AHCL authorised in the EU?

Answer

The European Medicines Agency concluded that, in accordance with EU requirements, Posaconazole AHCL has been shown to have comparable quality and to be bioequivalent to Noxafil. Therefore, the Agency’s view was that, as for Noxafil, the benefit of Posaconazole AHCL outweighs the identified risk and it can be authorised for use in the EU.

Question

What measures are being taken to ensure the safe and effective use of Posaconazole AHCL?

Answer

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Posaconazole AHCL have been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Posaconazole AHCL are continuously monitored. Side effects reported with Posaconazole AHCL are carefully evaluated and any necessary action taken to protect patients.

Question

What are the benefits and risks of Posaconazole AHCL?

Answer

Because Posaconazole AHCL is a generic medicine and is bioequivalent to the reference medicine, its benefits and risks are taken as being the same as the reference medicine’s.

Question

How has Posaconazole AHCL been studied?

Answer

Studies on the benefits and risks of the active substance in the authorised uses have already been carried out with the reference medicine, Noxafil, and do not need to be repeated for Posaconazole AHCL.

As for every medicine, the company provided studies on the quality of Posaconazole AHCL. The company also carried out a study that showed that it is ‘bioequivalent’ to the reference medicine. Two medicines are bioequivalent when they produce the same levels of the active substance in the body and are therefore expected to have the same effect.

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