Voriconazole

Voriconazole : An Overview

Voriconazole is a prescription antifungal medication in the triazole class used to treat fungal infections, including certain invasive fungal infections, such as aspergillosis. Voriconazole was first approved by the U.S. Food and Drug Administration (FDA) in 2002 and is sold under the brand name Vfend. It is available as a sterile oral suspension and intravenous (IV) solution, as well as a powder for IV injection.

Uses for Voriconazole

Voriconazole is indicated for the treatment of the following fungal infections in adults:

Invasive Aspergillosis
Esophageal Candidiasis
Invasive Candidiasis (incl. Candida Peritonitis and Abscesses)
Serious Fungal Infections caused by Scedosporium (including S. apiospermum) and Fusarium species

Voriconazole is not indicated for the treatment of tinea infections or mucocutaneous candidiasis caused by candida species in pediatric patients.

Brand Name	Voriconazole
Type
Weight
Generic	Voriconazole
Manufacturer
Available in	English বাংলা

Mechanism of Action

Voriconazole works by inhibiting the activity of several enzymes located in the fungal cell wall, resulting in disruption of the cell membrane and death of the fungus. As a result, voriconazole is useful for treating fungal infections caused by several different species of fungi.

How Long Does It Take to Work?

Voriconazole typically takes 2 to 3 weeks to begin working, although it may take longer for serious fungal infections. Your healthcare provider will monitor you closely to determine when the medication is working. If your symptoms are not improving, your healthcare provider may recommend an alternative medication.

Absorption

Voriconazole is rapidly absorbed following oral administration. Maximum plasma concentrations are achieved in approximately 2 to 3 hours. It has also been shown to be highly bioavailable, with an extent of absorption of more than 95%.

Route of Elimination

Voriconazole is mainly eliminated by the kidneys, with a half-life of 7 to 14 hours. It is not metabolized and is more extensively eliminated in the urine than in faeces.

Dosage

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.

The recommended dosage of voriconazole varies depending on the type and severity of the fungal infection, as well as which route of administration is used (oral or intravenous). In adults, the usual dosage of oral voriconazole is 200 mg every 12 hours for serious fungal infections. For patients with renal impairment, the dosage should be adjusted as needed.

Administration

Voriconazole is available for both oral and intravenous administration. For oral administration, the tablets should be taken with food. For intravenous administration, the powder should be reconstituted with sterile water and administered as an infusion over a period of 1 to 2 hours.

Side Effects

Common side effects of voriconazole include: nausea, headache, dizziness, diarrhea, abdominal pain, rash, changes in liver function tests, and visual disturbances. Less common but potentially serious side effects include: Stevens-Johnson syndrome, toxic epidermal necrolysis, and cardiomyopathy.

Toxicity

Voriconazole can be toxic in high doses, especially when taken with other medications that interact with it. If you experience any signs of toxicity, such as severe headache, fever, confusion, or rapid heartbeat, contact your healthcare provider immediately.

Precautions

Before taking voriconazole, tell your doctor if you are pregnant, breastfeeding, or have any allergies. Also tell them about all medications you are currently taking, as well as any chronic conditions, such as kidney or liver disease. You should avoid or limit drinking alcohol while taking voriconazole, as it may increase the risk of liver damage. Keep all medications out of sight and reach of children.

Interaction

Voriconazole can interact with many other medications, including some antibiotics, anti-arrhythmics, and antifungals. It is important to tell your healthcare provider about all other medications you are taking to avoid the risk of drug interactions. Additionally, some foods and beverages such as grapefruit juice may interact with voriconazole. Be sure to check with your pharmacist or doctor before consuming any beverages with voriconazole.

Disease Interaction

Voriconazole can interact with many diseases, such as liver disease or kidney disease, as well as with other medical conditions. It is important to tell your healthcare provider about any medical conditions you have before taking voriconazole.

Drug Interaction

Voriconazole can interact with many drugs, such as certain antibiotics, antivirals, antifungals, and anticonvulsants. Be sure to tell your healthcare provider about all medications you are taking before taking voriconazole.

Food Interactions

Grapefruit juice should not be consumed while taking voriconazole, as it may increase the risk of drug interactions. Additionally, voriconazole should be taken with food to increase absorption and effectiveness of the medication.

Pregnancy Use

Voriconazole should be used with caution during pregnancy and only when the potential benefits outweigh the risks. If you are pregnant, talk to your healthcare provider before taking voriconazole.

Lactation Use

Voriconazole should be used with caution in breastfeeding women, as it is not known if the medication passes into breast milk. Talk to your healthcare provider about the risks and benefits before taking this medication while breastfeeding.

Acute Overdose

If you or someone else has taken an overdose of voriconazole, contact your local poison control center or emergency room right away. Taking too much voriconazole can cause serious side effects, including liver damage.

Contraindication

Voriconazole is contraindicated in patients with a known hypersensitivity to any of the components of voriconazole or other triazole antifungal agents.

Use Directions

Follow your healthcare professional's instructions for taking voriconazole. Take the tablets with food, and follow your healthcare provider's instructions for taking voriconazole intravenously. It is important to follow the dosing instructions exactly to ensure the medication is effective and to reduce the risk of serious side effects.

Storage Conditions

Voriconazole should be stored at room temperature, away from heat and moisture. Do not keep this medication in the bathroom, as it may become less effective over time. Keep all medications away from children and pets.

Volume of Distribution

The volume of distribution (Vd) of voriconazole is 7.7 to 9.6 liters per kilogram (L/kg). This means that voriconazole is extensively distributed throughout the body and may take some time to be eliminated.

Half-Life

The half-life of voriconazole is 6 to 17 hours, which means that it takes this long for half of the drug to be eliminated from the body.

Clearance

The clearance of voriconazole is approximately 2.5 to 5.5 liters per hour per kilogram (L/hr/kg). This means that voriconazole is rapidly cleared from the body, but that it may take some time to reach peak concentrations in the blood.

See in details version Voriconazole also Voriconazole in bangla