Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Isavuconazonium sulfate
Drug ID BADD_D01201
Description Isavuconazole is an triazole antifungal with broad spectrum of activity and good safety profile [A32026]. It is approved by the FDA and EMA for the treatment of invasive aspergillosis and mucormycosis. It works by inhibiting fungal cell membrane synthesis. Invasive fungal infections pose significant clinical challenges for patients, especially those who are immunocompromised. In vitro, most of the _Candida_ species, most _Aspergillus_ species, Mucorales, _Cryptococcus_ spp., _Fusarium_ species, dermatophytes and dimorphic fungi displayed susceptibility to isavuconzaole [A32029]. Resistance to isavuconazole has been associated with the mutation in the target gene CYP51 [FDA Label]. Cross-resistance between isavuconazole and other azoles was also proposed although the clinical relevance is unclear [FDA Label]. As isavuconazole displays low water solubility, it is found as an active ingredient of its prodrug, [DB06636]. The prodrug formulation of isavuconazole is FDA- and EMA-approved and is marketed under the trade name Cresemba for the treatment of invasive aspergillosis and mucormycosis as oral or intravenous administration. The intravenous formulation is cyclodextrin-free which gives isavuconazole an advantage over other azole antifungals that requires cyclodextrin for facilitating drug solubility; this is because cyclodextrin has a potential for nephrotoxicity [A32029]. It is proposed that the intravenous and oral dosing can be used interchangeably [L1482], without the need for a repeat loading dose when transitioning from an IV to an oral formulation [A32026]. Isavuconazonium displays excellent water solubility for intravenous formulations, good absorption, and enhanced oral bioavailability [A32026]. Following administration, isavuconazonium undergoes biotransformation to form the active moiety, isavuconazole, for the antifungal actions.
Indications and Usage Indicated in the treatment of invasive aspergillosis and invasive mucormycosis.
Marketing Status Prescription
ATC Code J02AC05
DrugBank ID DB11633
KEGG ID D10750
MeSH ID C508735
PubChem ID 72196309
TTD Drug ID D0DD4P
NDC Product Code 0469-0520; 0469-0420; 0469-1020; 50909-1703
Synonyms isavuconazole | BAL 8557 | BAL8557 | BAL-8557 | isavuconazonium sulfate | Cresemba
Chemical Information
Molecular Formula C35H36F2N8O9S2
CAS Registry Number 946075-13-4
SMILES CC(C1=NC(=CS1)C2=CC=C(C=C2)C#N)C(CN3C=[N+](C=N3)C(C)OC(=O)N(C)C4=C(C=CC=N4)COC(= O)CNC)(C5=C(C=CC(=C5)F)F)O.OS(=O)(=O)[O-]
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Abdominal distension07.01.04.001--
Abdominal pain07.01.05.002--
Acute respiratory failure22.02.06.001; 14.01.04.004--Not Available
Agitation19.06.02.001; 17.02.05.012--
Agranulocytosis01.02.03.001--Not Available
Alanine aminotransferase increased13.03.01.003--
Alopecia23.02.02.001--
Anaphylactic reaction24.06.03.006; 10.01.07.001--
Anxiety19.06.02.002--
Aspartate aminotransferase13.03.01.032--Not Available
Back pain15.03.04.005--
Blood alkaline phosphatase13.04.02.010--Not Available
Blood bilirubin13.03.01.040--Not Available
Bone pain15.02.01.001--
Bronchospasm22.03.01.004; 10.01.03.012--
Chest pain22.02.08.003; 08.01.08.002; 02.02.02.011--Not Available
Chills15.05.03.016; 08.01.09.001--
Cholecystitis09.03.01.001--
Cholelithiasis09.03.01.002--Not Available
Confusional state19.13.01.001; 17.02.03.005--
Constipation07.02.02.001--
Delirium19.13.02.001--
Depression19.15.01.001--
Dermatitis23.03.04.002--Not Available
Dermatitis exfoliative23.03.07.001; 10.01.01.004--
Diarrhoea07.02.01.001--
Disorientation19.13.01.002; 17.02.05.015--Not Available
Dysgeusia17.02.07.003; 07.14.03.001--
Dyspepsia07.01.02.001--
Dyspnoea22.02.01.004; 02.01.03.002--
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