Generic
Voriconazole
73 brands available in the market
At a glance
Voriconazole belongs to a group of medicines called antifungals. It works by stopping the growth of fungus and is used to treat a wide range of fungal infection. It kills fungi by destroying the fungal cell membrane.
Description
Voriconazole is a triazole antifungal medication used to treat serious fungal infections. Voriconazole binds and inhibits ergosterol synthesis by inhibiting CYP450-dependent 14-alpha sterol demethylase.
Indications
- Severe fungal infections
- Invasive aspergillosis
- Candidemia
- Esophageal candidiasis
- Infections caused by Scedosporium apiospermum and Fusarium species
Therapeutic class
Other Antifungal preparations
Pharmacological class
Triazole Antifungal
Pharmacology
Voriconazole is a triazole antifungal agent which inhibits cytochrome P450-dependent enzymes thereby inhibiting ergosterol synthesis in fungal cell membranes.
Mechanism of action
Destroys the fungal cell membrane, killing and stopping the growth of fungi.
Dosage
Adult Dose (IV):
- Invasive Aspergillosis, Candidemia, Serious Fungal Infections: 6 mg/kg IV every 12 hours for first 24 hours, then 4 mg/kg IV every 12 hours or 200 mg PO every 12 hours
- Esophageal Candidiasis: 200 mg PO every 12 hours
- Hepatic impairment: Mild to moderate: standard loading dose but maintenance doses reduced by 50%
Child Dose (12 years and older) (IV):
- Invasive Aspergillosis, Candidemia, Serious Fungal Infections: 6 mg/kg IV every 12 hours for first 24 hours, then 4 mg/kg IV every 12 hours or 200 mg PO every 12 hours
Administration
- Take one hour before or one hour after a meal
- Swallow tablets whole; do not chew, crush or break
- Do not take antacids within two hours of taking Voriconazole
Missed dose
If you miss a dose, take it as soon as you remember; if almost time for next dose, skip it; do not double the dose.
Side effects
Common Side Effects:
- Abnormal liver function tests
- Hallucination
- Slow heart rate
- Altered vision
- Headache
- Nausea
- Rash
- Vomiting
Precautions & warnings
- May cause side effects which could affect your ability to drive
- May cause blurring of vision or uncomfortable sensitivity to light
- Liver function will be checked before and regularly during treatment
- Inform doctor if yellowing of eyes or skin, dark urine, or stomach pain occurs
- Consult doctor if pregnant, planning pregnancy or breastfeeding
Contraindications
- Hypersensitivity
- Co-administration with CYP3A4 substrates, terfenadine, astemizole, cisapride, pimozide, quinidine, rifampicin, carbamazepine, long-acting barbiturates, ergot alkaloids, efavirenz, ritonavir, sirolimus, rifabutin, St John's wort
Drug interactions
- Oral anticoagulants: increased prothrombin time
- Ciclosporin and tacrolimus: may increase plasma concentrations
- Phenytoin: decreased voriconazole plasma concentration and increased phenytoin plasma concentrations
- Astemizole, cisapride, pimozide, quinidine and terfenadine: may increase risk of QT prolongation or torsades de pointes (potentially fatal)
- Ergot alkaloids: may increase risk of ergotism (potentially fatal)
- Sirolimus: may significantly increase plasma concentrations (potentially fatal)
- Rifampicin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir: decreased plasma concentrations (potentially fatal)
Food interactions
It is unsafe to consume alcohol with Voriconazole.
Use in pregnancy
Use in Pregnancy: Unsafe; definite evidence of risk to the developing baby; consult your doctor.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe; may pass into breast milk and harm the baby; consult your doctor.
Pediatric use
Efficacy not established in children under 12 years of age
Geriatric use
Caution required in elderly patients
Renal / hepatic impairment
Renal Impairment: Safe; no dose adjustment recommended
Hepatic Impairment: Caution needed; dose adjustment may be needed; regular LFT monitoring advised
Overdose effects
Symptoms: No data found.
Treatment: Supportive care.
Storage conditions
Keep out of reach of children. Store in a dry place, below 25°C temperature and protected from light. Store Voriconazole powder for suspension between 2° to 8°C temperature.