LAUSR

found that crushed posaconazole DR tablets given per feeding tube at a dose of 300 mg daily produced therapeutic levels after 2 weeks of therapy in 19 of 19 patients receiving treatment for rhino-orbito-cerebral mucormycosis. Many factors can impact drug levels of crushed posaconazole DR tablets, spanning from the obvious patient factors (i.e. absorption) to terminal tube placement (e.g. J-tube versus G-tube) or the more nuanced factors (preparation and administration technique). The literature supporting this practice is evolving, but still limited. It is currently unknown how different manufacturers’ DR matrices may impact serum concentrations if crushed, or how crushed DR tablets would compare in a head-to-head comparison against the oral suspension. Our experience adds to the growing body of evidence suggesting that crushing and administering posaconazole DR tablets via enteral feeding tubes is safe and often results in therapeutic levels. Importantly, doses may likely need to be upor down-titrated when switching to or from the formulation of crushed posaconazole DR tablets, respectively. Clinicians should consider this route of administration, when necessary, in conjunction with careful dose titration and frequent TDM.