CRESEMBA® is suitable for the renally impaired – even those with ESRD¹

CRESEMBA® has no cyclodextrin in its IV formulation, which means that it has reduced potential for renal toxicity compared with other azoles.^1,5–7 

It can be used in patients with renal dysfunction, including ESRD, without dose adjustments.¹

Treatment outcomes with CRESEMBA® appear to be unaffected by kidney function.^8,9 There is no evidence of loss of efficacy or drug safety concerns in patients with renal impairment, and median hospital LOS may be reduced vs voriconazole in patients with moderate-to-severe impairment (p=0.0032).^8,9 

With liposomal amphotericin B, nephrotoxicity can be a concern, and renal adverse events are a common reason for treatment discontinuation.¹⁰

Could using CRESEMBA® in patients with renal impairment help you stay focused on their underlying condition?

CRESEMBA® may simplify treatment in patients with hepatic impairment¹

CRESEMBA® has significantly improved hepatic tolerability vs voriconazole: the frequency of drug-related hepatobiliary AEs in the SECURE trial was 9% and 16%, respectively (p=0.016).²

Unlike voriconazole, CRESEMBA® does not require dose adjustments in patients with mild or moderate hepatic dysfunction (Child-Pugh A and B).^1,5

Although elevated liver transaminases have been reported, they rarely require treatment discontinuation.¹ 

CRESEMBA® has not been studied in severe hepatic impairment; use in these patients is not recommended unless the potential benefit outweighs the risks.¹ 

With liposomal amphotericin B, hepatotoxicity remains a concern, with hepatic adverse events being a common reason for treatment discontinuation.¹⁰

Could using CRESEMBA® in patients with hepatic impairment help you stay focused on their underlying condition?

CRESEMBA® does not cause QTc prolongation¹

While voriconazole and posaconazole prolong the QTc interval, CRESEMBA® doesn’t.^1,5,6,11 This may be a valuable consideration in patients with proarrhythmic risk.

CRESEMBA® shortens the QTc interval; it is therefore contraindicated in patients with familial short QT syndrome, and should be used with caution in combination with medicines that cause QTc shortening.¹

In patients with proarrhythmic risk, could CRESEMBA® be a consideration?

CRESEMBA® has fewer and more manageable drug–drug interactions than other azoles^1,3

Compared with other azoles, CRESEMBA® can help simplify the management of patients taking certain concomitant medications.^1,3,5,6

As the table below shows, CRESEMBA® has fewer CYP450 effects vs other azoles.^1,3

Comparative inhibition of selected CYP450 isoenzymes by triazoles¹²

Adapted from reference 12.

This means CRESEMBA® can be administered with several medications without the need to dose-adjust.¹

Recommendations for the coadministration of CRESEMBA® with key medications^1,a

Adapted from reference 1.

CRESEMBA® can be used with ibrutinib

The BTK inhibitor ibrutinib is increasingly being prescribed for the treatment of B-cell malignancies such as CLL, MCL and WM.^13–15 Ibrutinib therapy has been associated with an increased incidence of invasive fungal infections, particularly invasive aspergillosis.^14–16

Unlike voriconazole, posaconazole and itraconazole, CRESEMBA® can be used with ibrutinib, and coadministration appears to be well tolerated.^13,16

a. CRESEMBA® is contraindicated in coadministration with ketoconazole, high-dose ritonavir, and strong CYP3A4/5 inducers such as rifampicin, rifabutin, carbamazepine, long-acting barbiturates, phenytoin and St. John’s wort, or with moderate CYP3A4/5 inducers such as efavirenz, nafcillin and etravirine.¹ For further details and a full list of drug interactions, please refer to Local Product Document.