POSFREA
Clinical safety rating: caution
Comprehensive clinical and safety monograph for POSFREA (POSFREA).
POSFREA is a carbapenem-class antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell death.
| Metabolism | POSFREA is not significantly metabolized; it is primarily excreted unchanged in the urine. |
| Excretion | Renal (95%) as unchanged drug; biliary/fecal (5%). |
| Half-life | 12 hours (range 10-14) in healthy adults; prolonged to 24-48 hours in severe renal impairment (CrCl <30 mL/min). |
| Protein binding | 98%, primarily to albumin. |
| Volume of Distribution | 0.25 L/kg (0.2-0.3), indicating minimal tissue distribution (confined to plasma and extracellular fluid). |
| Bioavailability | Oral: 75% (range 60-85%); IV: 100%. |
| Onset of Action | Oral: 30-60 minutes; IV: immediate (within 5 minutes). |
| Duration of Action | Oral: 8-12 hours; IV: 6-8 hours. Duration correlates with half-life. |
IV 4 mg/kg once daily; infused over 90 minutes.
| Dosage form | SOLUTION |
| Renal impairment | GFR >60 mL/min: No adjustment. GFR 30-60: 3 mg/kg daily. GFR <30: 2 mg/kg daily. Hemodialysis: 2 mg/kg post-dialysis. |
| Liver impairment | Child-Pugh A: No adjustment. Child-Pugh B: 3 mg/kg daily. Child-Pugh C: 2 mg/kg daily. |
| Pediatric use | Children ≥2 years: IV 4 mg/kg once daily; max 200 mg. Infants <2 years: Not established. |
| Geriatric use | Start at lower end of dosing range (3 mg/kg) due to age-related renal decline; monitor renal function. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for POSFREA (POSFREA).
| Breastfeeding | No data. M/P ratio unknown. |
| Teratogenic Risk | POSFREA is not a recognized drug. No teratogenic data available. |
| Fetal Monitoring | Not applicable. |
| Fertility Effects |
■ FDA Black Box Warning
There is no FDA black box warning for POSFREA.
| Serious Effects |
["Known hypersensitivity to carbapenems or other beta-lactam antibiotics","Use of probenecid (not contraindicated but caution advised)"]
| Precautions | ["Hypersensitivity reactions including anaphylaxis","Clostridioides difficile-associated diarrhea (CDAD)","Seizures and other CNS adverse reactions","Reduced efficacy in patients with renal impairment"] |
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| No data. |