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Manufacturer Pfizer
Distributor Zuellig
Contents Voriconazole
Indications Treatment of invasive aspergillosis; candidemia in non-neutropenic patients; serious invasive Candida infections (including C. krusei); esophageal candidiasis; serious fungal infections caused by Scedosporium & Fusarium spp; other serious fungal infections in patients intolerant of, or refractory to, other therapy. Prevention of breakthrough of fungal infections in febrile high-risk patients (allogeneic bone marrow transplants, relapsed leukemia patients).
Dosage Adult Loading dose (1st 24 hr): All indications IV 6 mg/kg 12 hrly. Tab Wt ≥40 kg 400 mg 12 hrly, wt ≤40 kg 200 mg 12 hrly. Maintenance dose (after 24 hr): Prevention of breakthrough infections IV 3 mg/kg 12 hrly. Tab Wt ≥40 kg 200 mg 12 hrly, wt ≤40 kg 100 mg 12 hrly. Serious invasive Candida infections/Invasive aspergillosis/Scedosporium & Fusarium infections/Other serious mould infections IV 4 mg/kg 12 hrly. Tab Wt ≥40 kg 200 mg 12 hrly, wt ≤40 kg 100 mg 12 hrly. Candidemia in non-neutropenic patients IV 3-4 mg/kg 12 hrly. Tab Wt ≥40 kg 200 mg 12 hrly, wt ≤40 kg 100 mg 12 hrly. Esophageal candidiasis IV No recommendation. Tab Wt ≥40 kg 200 mg 12 hrly, wt ≤40 kg 100 mg 12 hrly. Childn 2 to <12 yr No oral or IV loading dose is recommended. Maintenance dose: IV 7 mg/kg 12 hrly. Tab 200 mg 12 hrly. Max IV infusion rate: 3 mg/kg/hr.
Administration Should be taken on an empty stomach (Take at least 1 hr before or after meals.).
Contraindications Hypersensitivity to voriconazole. Co-administration w/ terfenadine, astemizole, cisapride, pimozide, quinidine, sirolimus, rifampicin, carbamazepine, long-acting barbiturates (eg phenobarb), ritonavir (400 mg 12 hrly), ergot alkaloids (ergotamine, dihydroergotamine) & St. John's wort.
Special Precautions Hypersensitivity to other azoles, potentially proarrhythmic conditions, infusion-related reactions. Monitor renal, hepatic & pancreatic function. Avoid intense or prolonged exposure to direct sunlight. Childn <2 yr. Concomitant use w/ methadone, short-acting opiates, phenytoin, rifabutin, ritonavir, efavirenz. Pregnancy & lactation. May affect ability to drive or operate machine (may cause transient & reversible changes in vision).
Adverse Drug Reactions Visual disturbances, fever, rash, vomiting, nausea, diarrhea, headache, peripheral edema, abdominal pain, sinusitis, chills, asthenia, chest pain, inj site reaction/inflammation, flu syndrome, lung edema, cheilitis, gastroenteritis, elevated liver function tests, jaundice, cholestatic jaundice, thrombocytopenia, anemia, leukopenia, pancytopenia, hypokalemia, hypoglycemia, back pain, dizziness, tremor, paresthesia, hallucinations, confusion, depression, anxiety, agitation, resp distress syndrome, face edema, pruritus, maculopapular rash, photosensitivity skin reaction, alopecia, exfoliative dermatitis, purpura, hypotension, thrombophlebitis, phlebitis, increased creatinine, acute kidney failure, hematuria.
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Drug Interactions Cyclosporine, tacrolimus, methadone, short-acting opiates, warfarin, other oral anticoagulants (eg phenprocoumon, acenocoumarol), sulfonylureas, statins, benzodiazepines, vinca alkaloids, NSAIDs, efavirenz, phenytoin, rifabutin, omeprazole, HIV-protease inhibito