Voriconazole

Overview

Voriconazole injection (Vfend) is used to treat certain serious yeast or infections, such as candidemia (fungal infection in the blood), aspergillosis (fungal infection in the lungs), esophageal candidiasis, or other fungal infections, including infections in the stomach, skin, kidney, bladder, and wounds. It can also be used to treat patients with serious yeast or fungal infections who cannot tolerate other forms and types of medicine or who do not respond positively to other types of medicine. Vfend is given via injection into a vein as directed by a professional doctor, usually every twelve hours. It needs to be injected slowly over one to two hours. The dosage is based on a variety of factors including your medical condition, your weight, response to treatment, and other medications you may be taking.

Conditions treated

  • Candidiasis yeast infection that spreads throughout the body
  • Aspergillosis
  • Infection caused by the fusarium species fungus
  • Presence of candida species yeast in the blood
  • Infection caused by the fungus fusarium solani
  • Invasive aspergillosis
  • Aggressive fungal infection
  • Fungal infection of the esophagus
  • Infection caused by the fungus scedosporium apiospermum
  • Presumed infection in neutropenic patient with fever
  • Candidiasis fungal infection of the oropharynx

Type of medicene

  • Vfend I.V.- powder for solution

Side effects

Along with its intended effects, Voriconazole may cause some unwanted side effects. Although not all of these side effects may occur, if they do occur they could mean you need to seek medical attention. These are ranked below in terms of most common, common and rare.

Most common side effects

  • Difficulty seeing at night
  • Rash (however, you may not be able to tell it apart from a more 'rare' rash that could be a sign of a severe allergic reaction- see below)
  • Increased sensitivity of the eyes to sunlight
  • Vision changes

Less common side effects

  • Swelling or bloating of the arms, face, lower legs, hands, or feet
  • Chills
  • Blurred vision
  • Clay-colored stools
  • Dark urine
  • Confusion
  • Convulsions
  • Dark urine
  • Convulsions
  • Decreased urine
  • Dry mouth
  • Lightheadedness or faintness when rising suddenly from a sitting or lying position
  • Dizziness
  • Feeling of warmth
  • Increased thirst
  • Fever
  • Pounding or irregular heartbeat
  • Itching
  • Loss of appetite
  • Muscle pain or cramps
  • Nervousness
  • Muscle twitching and spasms
  • Nausea
  • Tingling or numbness in the feet, hands or lips
  • Pounding in the ears
  • Rapid weight gain
  • Rash with small raised lesions or flat lesions on the skin
  • Redness of the neck, face, arms and occasionally, the upper chest
  • Stomach pain
  • Fast or slow heartbeat
  • Sweating
  • Trembling
  • Unpleasant breath odor
  • Unusual tiredness or weakness
  • Vomiting of blood
  • Yellow skin or eyes

Rare side effects

  • Agitation, anger, irritability or hostility
  • Peeling, blistering or loosening of the skin
  • Increased sensitivity of the skin to sunlight
  • Discoloration of the skin
  • Hallucinations
  • Severe sunburn

Most of the common side effects of Voriconazole that may occur usually don't require medical attention. These side effects can disappear during treatment as your body adjusts to the solution. Also, your healthcare professional may be able to inform you of ways to reduce the intensity or prevent some of these side effects.

Dosage

As with all medications, it's important to take Voriconazole only as prescribed by a qualified physician. This means patients should avoid taking more of the medication than required, and, if instructed to stop taking the medication, ensure they do so, even if they have some medication supply remaining.

The general dosage of Voriconazole is injection, powder for reconstitution 200mg. However, the specific dosage of Voriconazole depends on a variety of factors such as what condition it is being used to treat, the age of the patient, the strength of the medicine, the number of doses required each day, and the period of time the patient is required to stay on the medication.

The manufacturers have provided some dosage guidance, but it should be noted that this can change due to the various factors mentioned above. The factors discussed with both physical and patient will be the final factor in deciding a specific dosage. Voriconazole Vfend I.V. is single-dose, unpreserved product. Vials contain 200 mg of lyophilized Voriconazole which is intended for combination with water for injection to produce a solution containing 10 mg/mL Vfend and 160 mg/mL of other solution. Vfend I.V. for injection requires reconstitution to 10 mg/mL then the following dilution to 5 mg/mL or less before the drug is given via injection. The maximum rate is 3 mg/kg per hour of Vfend over one to two hours.

Major drug interactions

Drug interactions can alter how your medications work or increase your risk of serious side effects. Keep a list of all the products you use (including herbal products and prescription/nonprescription drugs) and share it with your physician. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Voriconazole can slow down the removal of other medications from your body, which can affect their ability to work. Examples of affected drugs include ergot alkaloids (such as dihydroergotamine, ergotamine), eletriptan, certain drugs to treat irregular heartbeat (such dronedarone or disopyramide), lurasidone, pimozide, ranolazine, sirolimus, certain "statin" cholesterol drugs among others.

Other medications you use can affect the removal of Voriconazole from your body, which can, in turn, affect how Voriconazole works. Examples include certain drugs to treat seizures, efavirenz, rifamycins (such as rifabutin, rifampin) and St. John's wort, among others.

There is a variety of medication that should not be mixed with voriconazole under any circumstances. Tell your doctor if you are taking any of these drugs: Carbamazepine, dihydroergotamine, astemizole, cisapride, efavirenz, everolimus, fluconazole, ergonovine, phenobarbital, ergotamine, or other drugs like it such as pimozide, quinidine, rifabutin, sirolimus, rifampin, ritonavir, terfenadine. methylergonovine, or St John's wort.

Voriconazole can also interact with the presence of other medical problems which can reduce its ability to perform. These include:

  • Problems with the pancreas
  • Kidney disease
  • Liver disease
  • Heart rhythm problems
  • Heart disease
  • Stem cell transplant
  • Mineral imbalance
  • Cancer treatment

Warnings

Voriconazole may cause a condition that affects the heart rhythm. This is known as QT prolongation. This can sometimes cause serious (rarely fatal) irregular/fast heartbeat and other symptoms (such as fainting, severe dizziness) that need urgent medical attention.

The risk of QT prolongation can be increased if you are taking other drugs that can cause QT prolongation or have certain medical conditions. Before using Voriconazole, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: heart problems such as QT prolongation in the EKG, slow heartbeat, heart failure, family history of certain heart problems, such as sudden cardiac death.

This medicine may cause some people to have changes in vision, such as seeing wavy lines or bright spots or blurred vision. Ensure you know how you react to this medicine before you use machines, drive (especially at night) or do anything else that could be dangerous or obstructed if your vision is impaired.

Using this medicine while you're pregnant can harm your unborn baby. Use an effective form of birth control to prevent pregnancy. If you think you are pregnant while using the medicine, tell your doctor right away. You may need to avoid breastfeeding and take up alternative feeding for the duration you are on the medication. Discuss with your doctor. Be aware of the use of this medication in children. Significant studies have not been performed on the relationship of age to the effects of Voriconazole injection in children who are younger than 12 years old. Efficacy and safety have not been established.

Storage

Vfend I.V. for injection unreconstituted vials need to be stored at 59° -86°F. Freezing temperatures should be avoided at all times. As it is a single dose medication, if it not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and should be no longer than 24 hours at 36° to 46°F. Once the treatment using Vfend I.V is completed, you should consult your local pharmacy or physician to discuss the best way to discard of any remaining medication safely.

Summary

While the consumption of Voriconazole Vfend I.V injection is highly beneficial, there are some notable risks if you are taking other medications or currently have any other health issues. It's therefore important to weigh up the pros and cons before taking such a medication, especially if you fall pregnant or have just given birth with regards to breastfeeding. As the drug can also impair your basic vision and day-to-day function, it's highly important you discuss with your doctor your current health situation and drug usage in high detail. When taken correctly, this solution is highly effective in treating fungal infections and associated problems and any negatives or common side effects outweigh the positives of the drug and its ability to treat fungal infections both promptly and effectively.

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Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017
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