VORICONAZOLE

Indications & Dose:

To treat invasive aspergillosis to treat serious fungal infection caused by Scedosporium apiospermum and Fusarium species including Fusarium solani in papients intolerant of or refractory to other therapy.

• BY MOUTH

Adult and Children over 12 years old overin g 40kg.: 200mg every 12 hours, increased to 300mg every 12 hours as needed and taken at least 1 hour bbefore or after meal.

]To treat Candidemia in nonneuropenic patients and other deep tissue disseminated  Candia infections involving the abdomen kidney baldder wall, skin or a wound.

Adult ( Maintainance).: 200mg every 12 hours, every 12 hours taken at least 1 hour bbefore or after meal.

To treat iOesophageal candidiasis.

Adult.: 200mg every 12 hours, every 12 hours taken at least 1 hour bbefore or after meal for at least 14 days after signs and symptoms resolve. 

Contraindications:

Coadministration with long-acting barbiturates, carbamazepine, CYP3A4 substrates (astemizole, cisapride, pimozide, quinidine, or terfenadine), efavirenz, ergot alkaloids, rifabutin, rifampin, ritonavir, sirolimus, or St. John’s wort; hypersensitivity to voriconazole or its components; galactose intolerance, glucose-galactose malabsorption, or Lapp lactase deficiency (oral form only contains lactose) 

Side Effects:

Cautions:

Precautions:

Interaction:

DRUGS
alfentanil: Increased plasma alfentanil level and increased risk of adverse reactions benzodiazepines: Possibly prolonged sedative effect of benzodiazepines calcium channel blackers; HMG-CoA reduc-tase inhibitors, such as lovastatin; omepra-zole; sirolimus: Possibly increased plasma levels of these drugs, leading to increased risk of adverse reactions and toxicity carbamazepine, longacting barbiturates, phenytoin, rifampin: Decreased plasma voriconazole concentration coumarin,
warfarin: Possibly increased PTT cyclosporine, sirolimus, tacrolimus: Increased serum concentrations of these drugs and risk of toxicity, especially nephrotoxicity CYP3A4 substrates (astemizole, cisapride, pimozide, quinidine, terfenadine): Increased plasma levels of these drugs, which may lead to prolonged QT interval and, rarely, torsades de pointes

ergot alkaloids (ergotamine, dihydroergota-mine): May increase plasma level of ergot alkaloids, leading to ergotism fluconazole, oral contraceptives: Increased plasma voriconazole level and risk of toxicity HIVprotease inhibitors (amprenavir, nelfinavir, ritonavir, saquinavir), non-nucleoside reverse transcriptase inhibitors (delavirdine, efavirenz): Possibly inhibited metabolism of these drugs and voriconazole methadone: Increased plasma level of methadone, possibly leading to toxicity, including QT-interval prolongation oral
contraceptives: Increased plasma voriconazole level and risk of toxicity rifabutin: Increased rifabutin plasma level; decreased voriconazole plasma level St. John’s  wort: Decreased plasma voriconazole level sulfonylureas: Possibly increased plasma level of sulfonylureas and increased risk of hypoglycemia

vinca alkaloids: Possibly increased risk of neurotoxicity 

Warnings:

Adverse Effects:

CNS: Chills, dizziness, fever, hallucinations, headache

CV: Chest pain, hypertension, hypotension, peripheral edema, tachycardia, vasodilation

EENT: Abnormal or blurred vision, altered or enhanced visual perception, change in color perception, chromatopsia, dry mouth, eye hemorrhage, photophobia, visual disturbances

GI: Abdominal pain, diarrhea, elevated liver function test results, nausea, pancreatitis, vomiting

GU: Abnormal kidney function, acute renal failure, elevated serum creatinine level

HEME: Anemia, leukopenia, pancytopenia, thrombocytopenia

MS: Fluorosis, periostitis, skeletal pain

RESP: Respiratory disorders

SKIN: Cholestatic jaundice, erythema multiforme, jaundice, maculopapular rash, photosensitivity, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis
Other: Anaphylaxis (I.V. form), elevated alkaline phosphatase, hypokalemia, hypomagnesemia, sepsis 

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: