Voriconazole
Generic Details
Generic Name
Voriconazole
Other Names
- VFEND
Drug Class
- Antifungal
Chemical Formula
C16H14F3N5O
Molecular Weight
349.31 g/mol
Mechanism of Action
- Voriconazole inhibits the enzyme 14-alpha-sterol demethylase, resulting in the inhibition of ergosterol synthesis in fungi.
Indications
- Invasive aspergillosis
- Esophageal candidiasis
- Serious fungal infections caused by Scedosporium apiospermum and Fusarium spp.
Common Dosage Forms
- Tablet
- Injection
- Oral suspension
Typical Dosage
- 200 mg every 12 hours on the first day, then 100-200 mg every 12 hours thereafter (oral)
- 6 mg/kg every 12 hours on day 1, then 4 mg/kg every 12 hours thereafter (IV)
Pediatric Dosage
- Dosage is weight-based and varies depending on the indication.
Geriatric Dosage
- Adjust dosage based on renal function.
Side Effects
- Visual disturbances
- Liver function abnormalities
- Skin reactions
- Headache
- Nausea
- Vomiting
Contraindications
- Hypersensitivity to voriconazole
Pregnancy Category
- D
Lactation Safety
- Limited data available; caution advised
Drug Interactions
- Contraindicated with strong CYP3A4 inducers like rifampin
- Interacts with warfarin, tacrolimus, and sirolimus among others
Overdose Symptoms
- Hallucinations
- Visual disturbances
- Confusion
Antidote for Overdose
- There is no specific antidote; manage symptoms and provide supportive care.
Storage Conditions
- Store at room temperature below 30°C (86°F)
Pharmacokinetics
- Absorption: Well absorbed orally
- Distribution: Highly distributed in tissues
- Metabolism: Metabolized in the liver
- Excretion: Primarily excreted in the urine
Precautions
- Monitor liver function tests periodically
- Monitor renal function during therapy
Warnings
- Risk of hepatotoxicity
- Avoid direct sunlight exposure due to phototoxicity risk
Others
- Before starting voriconazole therapy, patients should have baseline liver function tests and ECG.