Drug information of Voriconazole

Mechanism of effect

Voriconazole binds and inhibits ergosterol synthesis by inhibiting CYP450-dependent 14-alpha sterol demethylase. The inhibition of 14-alpha sterol demethylase results in a depletion of ergosterol in fungal cell membrane.

Pharmacodynamic

Voriconazole is a triazole antifungal agent indicated for use in the treatment of fungal infections

Pharmacokinetics

The oral bioavailability is estimated to be 96% Protein binding:58% Metabolism:Hepatic. Voriconazole is eliminated via hepatic metabolism with less than 2% of the dose excreted unchanged in the urine.

Drug indications

fungal infections

Dosage

Usual Adult Dose for Aspergillosis - Invasive
Loading Dose: 6 mg/kg IV every 12 hours for 2 doses
Maintenance Dose:
IV:
Invasive aspergillosis and serious fungal infections due to Fusarium species and Scedosporium apiospermum: 4 mg/kg IV every 12 hours
Oral:
Less than 40 kg: 100 mg orally every 12 hours
40 kg or more: 200 mg orally every 12 hours
Usual Pediatric Dose for Aspergillosis - Invasive
2 to 11 years:
American Academy of Pediatrics recommendations: 9 mg/kg IV or orally every 12 hours
Maximum dose: 350 mg/dose
12 years or older:
Loading Dose: 6 mg/kg IV every 12 hours for 2 doses
Maintenance Dose:
IV:
Invasive aspergillosis and serious fungal infections due to Fusarium species and S apiospermum: 4 mg/kg IV every 12 hours Oral:
Less than 40 kg: 100 mg orally every 12 hours
40 kg or more: 200 mg orally every 12 hours

Drug contraindications

hypersensitivity to drug or its components. , patients with porphyria

Side effects

nausea , Headache , Tachycardia , vomiting , rash , Chills , fever , Kidney function abnormal , Hypokalemia , Creatinine increased , Phosphate Alkaline increased , Increased ALT , Increased AST , Hyperbilirubinemia , liver failure , jaundice , Photosensitivity , hallucinations , Visual abnormalities

Interactions

Erlotinib , Esomeprazole , Everolimus , Octreotide acetate , Ibuprofen , Ipratropium bromide , Irinotecan , isosorbide dinitrate , Ifosfamide , Imatinib , Budesonide , Bortezomib , Pantoprazole , Paclitaxel , Piroxicam , Pimozide , Tamsulosin , Trazodone , Tolterodine , Docetaxel , Rabeprazole , Rifampin , Zolpidem , Zonisamide , Sunitinib , Sotalol , Sirolimus , Sildenafil , Cilostazol , Simvastatin , Cyclosporine , Fluticasone propinate , Fluoxetine , Glibenclamide , Lapatinib , Lovastatin , Moxifloxacin , Midazolam , Nitrazepam , Nilotinib , Nimodipine , Vardenafil , Venlafaxine , Vincristin , Vinorelbine , Capecitabine , Carbamazepine , Disulfiram , Bisoprolol , fentanyl , Rifabutin , Ranolazine , Axitinib , ritonavir , nelfinavir , Dolasetron , vandetanib , sparfloxacin , Indinavir , Procainamide , Mefloquine , Indapamide , Dofetilide , Inotuzumab‎ , chlorpropamide , Butalbital and Acetaminophen , brigatinib , Abiraterone , Peginterferon alfa-2b , Arsenic trioxide , Efavirenz , Copanlisib , Tipranavir , Simeprevir , Etravirine , Dabrafenib , Acalabrutinib , Cabazitaxel , Maraviroc , Halofantrine , Grepafloxacin , aminolevulinic acid oral , Aminolevulinic acid topical , Acetohexamide , Terfenadine , Fesoterodine , Alfuzosin , Ergoloid Mesylate , Pazopanib , Palbociclib , Butabarbital , Ixazomib , Pimavanserin , Tasimelteon , Doravirine , trabectedine , Duvelisib , elagolix , Sonidegib , Flibanserin , Avanafil , Estazolam , Entrectinib , Levomilnacipran , ELBASVIR/GRAZOPREVIR , Larotrectinib , gilteritinib , glasdegib , Abemaciclib , Eliglustat , Suvorexant , Ruxolitinib , riociguat , Methyl aminolevulinate , tolvaptan , Bepridil , bedaquiline , Gefitinib , Dasatinib , Gemtuzumab , Cannabidiol , vemurafenib , voxelotor , Capmatinib

Alerts

1-Measure serum transaminase levels and bilirubin at the initiation of Voriconazole therapy and monitor at least weekly for the first month of treatment.
2- If treatment continues beyond 28 days, visual function including visual acuity, visual field and color perception should be monitored
3-Some azoles, including Voriconazole, have been associated with prolongation of the QT interval on the electrocardiogram Voriconazole should be administered with caution to patients with potentially proarrhythmic conditions

Points of recommendation

Voriconazole tablets should be taken at least one hour before or after a meal.

Pregnancy level

D

Related drugs

Itraconazole , Posaconazole , Fluconazole , Ketoconazole , miconazol , Isavuconazonium