Generic

Voriconazole

Indications

Voriconazole is an antifungal azole medication. It is suggested for the treatment of the following fungal infections in individuals aged 12 and up:

• Aspergillosis invasive
• Candidemia (non-tuberculous) and widespread candidiasis in the skin, abdomen, kidneys, bladder wall, and wounds
• Candida esophagitis is a kind of candidiasis that affects the eso
• Scedosporium apiospermum and Fusarium species, notably Fusarium solani, produce serious infections.
• Patients who are resistant to or intolerant of alternative treatments.

Pharmacology

Voriconazole is a triazole antifungal drug that is used to treat severe fungal infections. By inhibiting CYP450-dependent 14-alpha sterol demethylase, voriconazole binds to and inhibits ergosterol production. When 14-alpha sterol demethylase is inhibited, ergosterol in the fungal cell membrane is depleted.

Dosage & Administration

Oral-

• 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

• Inhibitors and inducers for CYP3A4, CYP2C9, and CYP2C19: Adjust the Voriconazole dosage as needed, and keep an eye out for any side effects or lack of efficacy.
• Drugs that are CYP3A4, CYP2C9, and CYP2C19 substrates may have their concentrations and activity increased by voriconazole. Reduce the doses of these other drugs and keep an eye out for side effects.
• With co-administration of Phenytoin or Efavirenz, increase the maintenance oral and intravenous dosage of Voriconazole.

Contraindications

Hypersensitivity to Voriconazole or any of the drug’s other ingredients-

• Because of the potential of major adverse effects when combined with terfenadine, astemizole, cisapride, pimozide, or quinidine, sirolimus is not recommended.
• Due to the possibility of efficacy loss, rifampin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir, rifabutin, ergot alkaloids, and St. John’s Wort should not be taken together.

Side Effects

Abdominal pain, anemia, blurred vision, headache, chest pain, nausea, and diarrhea are the most prevalent side effects.

Pregnancy & Lactation

In pregnant women, there are no sufficient and well-controlled trials. Only if the possible benefit outweighs the risk to the fetus should it be taken during pregnancy.

Precautions & Warnings

Long-term exposure (treatment or prophylaxis) of more than 180 days necessitates careful consideration of the benefit-risk ratio. Long-term voriconazole medication has been linked to squamous cell carcinoma of the skin (SCC).

Therapeutic Class

Other Antifungal preparations.

Storage Conditions

Keep out of children’s reach. Store in a cool, dry area below 25°C and out of direct sunlight. Voriconazole powder for suspension should be stored at a temperature of 2° to 8°C.

Pharmaceutical Name

General Pharmaceuticals Ltd.