Indications
Voriconazole is an azole antifungal medicine. It is indicated for use in patients 12 years of age and older in the treatment of following fungal infections-
- Invasive aspergillosis
- Candidemia (nonneutropenic) and disseminated candidiasis in skin, abdomen, kidney, bladder wall and wounds
- Esophageal candidiasis
- Serious infections caused by Scedosporium apiospermum and Fusarium Species including Fusarium solani
- Patients intolerant of, or refractory to other therapy.
Pharmacology
Dosage & Administration
Voriconazole tablet and powder for suspension are to be taken at least one hour before or one hour following a meal
- At or over 40 kg body weight: Loading dose regimen is 400 mg or 10 ml every 12 hours (for the first 24 hours) and maintenance dose (after first 24 hours) is 200 mg or 5 ml twice daily.
- Below 40 Kg body weight: Loading dose regimen is 200 mg or 5 ml every 12 hours (for the first 24 hours) and maintenance dose (after first 24 hours) is 100 mg or 2.5 ml twice daily. Or, as directed by the registered physician.
Injection-
Invasive Aspergillosisd :
- Loading dose: 6 mg/kg 12 hourly for the first 24 hours.
- Maintenance Dose: 4 mg/kg 12 hourly.
Candidemia in nonneutropenic patients and other deep tissue Candida infections:
- Loading dose: 6 mg/kg 12 hourly for the first 24 hours.
- Maintenance Dose: 3-4 mg/kg 12 hourly.
Scedosporiosis and Fusariosis:
- Loading dose: 6 mg/kg 12 hourly for the first 24 hours.
- Maintenance Dose: 4 mg/kg 12 hourly.
Interaction
- CYP3A4, CYP2C9 and CYP2C19 inhibitors and inducers: Adjust Voriconazole dosage and monitor for adverse reactions or lack of efficacy
- Voriconazole may increase the concentrations and activity of drugs that are CYP3A4, CYP2C9 and CYP2C19 substrates. Reduce doses of these other drugs and monitor for adverse reactions
- Increase maintenance oral and intravenous dosage of Voriconazole with co-administration of Phenytoin or Efavirenz
Contraindications
Known hypersensitivity to Voriconazole or any other components of this drug-
- Co-administration with terfenadine, astemizole, cisapride, pimozide or quinidine, sirolimus due to risk of serious adverse reactions
- Co-administration with rifampin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir, rifabutin, ergot alkaloids and St. John’s Wort due to risk of loss of efficacy
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