For patients and carers managing aspergillosis treatment

Why this matters

Treatment for aspergillosis is often long-term and involves medications that can affect people in different ways. It’s important to know that you don’t have to suffer in silence. Recognising side effects early and reporting them can help you stay well and improve your quality of life.

Medications commonly used in aspergillosis

Antifungals
Voriconazole, Posaconazole, Itraconazole, Isavuconazole

Steroids
Prednisolone (oral), Inhaled corticosteroids

Biologic therapies
Omalizumab (anti-IgE), Mepolizumab/Benralizumab (anti-IL-5), Dupilumab (anti-IL-4/IL-13)

What to watch for

Note: These side effects range from common to rare. Most people do not experience all of them, but it’s important to be aware of what might occur. If you’re unsure whether a symptom is related to your medication, always ask.

Cardiac side effects (uncommon to rare, but important to report)

  • Palpitations (racing or irregular heartbeat)
  • Dizziness or fainting
  • Swelling in the legs or ankles
  • Chest pain or tightness
  • Changes in blood pressure or heart rhythm (QT prolongation) (can occur with antifungals or steroids)
  • Palpitations (racing or irregular heartbeat)
  • Dizziness or fainting
  • Swelling in the legs or ankles
  • Chest pain or tightness
  • Changes in blood pressure or heart rhythm (QT prolongation)

Let your healthcare team know if you have a history of heart conditions, or experience any of these symptoms during treatment.

Antifungal side effects (common to occasional)

  • Skin rash, burning, or sun sensitivity, even indoors (through windows or from reflected light)
  • Visual changes (blurred vision, colour distortion, photophobia)
  • Liver enzyme abnormalities (can show up on blood tests)
  • Nausea, abdominal discomfort, or taste changes
  • Hallucinations, anxiety, or confusion (rare but serious — seek help immediately)

Steroid side effects (common with long-term use)

  • Mood swings, anxiety, or irritability
  • Insomnia or restlessness
  • Increased appetite or weight gain
  • High blood sugar, especially if diabetic
  • Bone thinning (osteoporosis) over time
  • Skin thinning, easy bruising, or delayed healing
  • Eye pressure/glaucoma or cataracts (with long-term use)

Biologic side effects (generally well-tolerated; uncommon side effects listed below)

  • Localised reactions at the injection site (pain, swelling, redness)
  • Headache, fatigue, or low-grade fever
  • Worsening eye symptoms, especially with dupilumab (e.g. dry eyes, redness)
  • Rare: allergic reactions or increased infection risk (let your team know if you’re feeling unwell after a dose)

When to get in touch

You should contact your care team if:

  • A side effect is persistent, worsening, or interfering with your daily life
  • You notice any mental health changes (anxiety, low mood, agitation)
  • You feel dizzy, unwell, or unable to tolerate food or fluids
  • There are signs of infection (e.g. fever, cough, chills, pain)
  • You are unsure whether what you’re feeling is a side effect or something else

You’re not being a nuisance

Asking questions or raising concerns is part of staying safe. Medications can usually be adjusted, paused, or switched — but your team needs to know how you’re feeling to make those decisions. You are an expert in your own experience.

Tip: Keep a side effect diary

  • Note any changes in sleep, mood, appetite, skin, or digestion
  • Bring this with you to appointments
  • If helpful, ask a family member or friend to help observe changes

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