Voriconazole

Voriconazole is a drug used to treat serious yeast infections that affect the inside of the body. Some diseases caused by fungal infections that can be treated with this drug are invasive aspergillosis, esophageal candidiasis, and candidemia.

Voriconazole belongs to the azole class of antifungals which work by inhibiting the formation of fungal cell membranes. That way, the growth of the fungus can be stopped. This medication is generally used only when other antifungal medications are less effective.

Variconazole trademarks: Vfend, Vorica, Vorigen

What is Voriconazole

 Warning Before Using Voriconazole

Voriconazole should only be used with a doctor's prescription. Before using voriconazole, you need to pay attention to the following points:

• Do not use voriconazole if you are allergic to it or to other azole antifungals, such as fluconazole or itraconazole . Tell your doctor about any allergies you have.
• Avoid consuming alcoholic beverages while undergoing treatment with voriconazole, because it can increase the risk of liver disorders.
• Tell your doctor if you have heart failure, electrolyte disturbances , liver disease, kidney disease, or digestive disorders that are consistently caused by consumption of sugar, milk, or dairy products.
• Inform your doctor if you or your family have a history of heart rhythm disturbances, abnormal EKG results, or sudden cardiac arrest at a young age.
• Tell your doctor that you are taking voriconazole if you are having surgery, including dental surgery.
• Tell your doctor if you are pregnant, nursing, may become pregnant, or planning a pregnancy before using voriconazole.
• Use contraception to prevent pregnancy while using voriconazole. Consult your doctor about the most effective contraceptive for you.
• Tell your doctor if you are taking other medications, including supplements and herbal products, to prevent drug interactions.
• Do not immediately drive a vehicle or do other activities that require alertness while on treatment with voriconazole, because this drug can cause temporary vision problems.
• Do not be exposed to the sun for too long while undergoing treatment with voriconazole, because this drug can make your skin more sensitive to sunlight. Use sunscreen before going outside during the day.
• Immediately see a doctor if you experience a drug allergic reaction , serious side effects, or an overdose after using voriconazole.

Dosage and Rules for Use Voriconazole

The doctor will give the dose and determine the duration of treatment according to the patient's condition. The following is the distribution of voriconazole tablet doses based on the patient's condition, body weight (BB), and age:

Conditions: Invasive aspergillosis , esophageal candidiasis , candidaemia (candida infection in the blood), candida infections in deep tissue, and scedosporiosis or fusariosis

• Adults ≥40 kg: 400 mg every 12 hours for the first 24 hours, followed by 200 mg every 12 hours. Dosage may be increased up to 300 mg every 12 hours or reduced by 50 mg if needed. The dosage is adjusted according to the patient's condition and response to treatment.
• Adults <40 kg: 200 mg every 12 hours for the first 24 hours, followed by 100 mg every 12 hours. Dosage may be increased to 150 mg every 12 hours or reduced by 50 mg if needed. Dosage is adjusted based on the patient's condition and response to treatment.
• Children aged 2–14 years <50 kg: 9 mg/kg every 12 hours. Maximum dose of 350 mg.

For the treatment of esophageal candidiasis , treatment is continued for at least 14 days and continued for 7 days after symptoms resolve.

Voriconazole is also available as an infusion. For this dosage form, the dosage in adults and children is based on body weight.

The maximum duration of voriconazole infusion is 6 months. Medicine can be diverted to drinking tablets when the patient is ready.

How to Use Voriconazole Properly

Voriconazole infusion will be given by a doctor or medical officer under the supervision of a doctor at the hospital.

If you are prescribed voriconazole to be taken independently, follow the doctor 's instructions or the information listed on the drug packaging when using voriconazole tablets. Use this drug according to the recommended dosage and do not increase the dose without consulting your doctor first.

Voriconazole tablets can be taken 1 hour before eating or 1–2 hours after eating. Use plain water to swallow voriconazole tablets. Do not stop taking the drug before the appointed time even if you feel better.

Take voriconazole at around the same times each day. If you forget to take voriconazole, use this drug immediately if it is not near the next schedule. If it is close, ignore the missed dose and do not double the next dose.

Check with your doctor regularly. You may be asked to have blood tests to check your condition and your body's response to treatment.

Store voriconazole tablets in a place that is protected from direct sunlight. Keep medicine out of reach of children.

Voriconazole Interactions with Other Drugs

There are several drug interaction effects that can occur if voriconazole is used together with other medicines, namely:

• Increased risk of fatal heart rhythm disturbances ( arrhythmias ), such as torsade de pointes , when used with astemizole, cisapride , quinidine, pimozide, or terfenadine
• Increased risk of fatal side effects, such as heart attack, stroke, or tissue death ( gangrene ), if used with ergot alkaloids, for example dihydroergotamine or ergotamine
• Increased sirolimus side effects
• Decreased voriconazole levels or increased blood levels of phenytoin or rifabutin when used together
• Decreased blood levels of voriconazole when used with carbamazepine , phenobarbital , rifampicin , ritonavir or the herbs John's wort
• Increased risk of side effects from ciclosporin , omeprazole, tacrolimus , methadone, oxycodone, or nonsteroidal anti-inflammatory drugs , such as ibuprofen or diclofenac
• Increased risk of side effects from voriconazole when used with birth control pills
• Increased risk of bleeding when used with anticoagulant drugs , such as warfarin

Voriconazole Side Effects and Dangers

There are side effects that can occur after using voriconazole, including:

• Diarrhea
• Nauseous
• Vomit
• Headache
• Dizzy
• Dry mouth
• Reddened or hot face and skin ( hot flashes )

Check with your doctor if the side effects above don't go away or get worse. Immediately see a doctor if you experience an allergic drug reaction or more serious side effects, such as:

• Rapid heartbeat or palpitations, shortness of breath, and dizziness as if you feel like you are going to pass out
• Visual disturbances, such as difficulty seeing colors
• Sunburn , which can be characterized by reddened skin that feels hot to the touch, or blisters filled with fluid that can burst
• Unusual bleeding or bruising
• Slow heart rate, weak pulse, fainting and slow breathing
• Kidney problems, which can be marked by reduced urine volume or no urination at all, shortness of breath, or swelling of the feet or ankles
• Liver disorders, which can be characterized by nausea, vomiting, itchy skin, and yellowing of the skin or eyes (jaundice)
• Symptoms of electrolyte disturbances, such as dizziness, numbness or tingling, constipation, feeling very thirsty, increased urination, irregular heartbeat, leg cramps, muscle spasms, muscle weakness, coughing or feeling like choking