Voriconazole Brand Name
VFEND
What is Voriconazole
Voriconazole is an azole antifungal agent derived from the structure of fluconazole but was designed to enhance the potency and spectrum of activity of fluconazole.
Voriconazole has been studied in a variety of fungal infections, including Aspergillosis, fluconazole-susceptible and -resistant Candida infections, and Cryptococcus neoformans.
Unlike fluconazole, voriconazole exhibits activity against molds, such as Aspergillus. Voriconazole is associated with QT prolongation, visual disturbances, and phototoxicity.
Drug interactions are numerous for voriconazole, which may pose a therapeutic challenge for the clinician.
Oral dosing, not possible with amphotericin B or caspofungin, may be an advantage to allow step down therapy for voriconazole.
Voriconazole is indicated for the treatment of invasive aspergillosis, esophageal candidiasis, candidemia in non-neutropenic patients and other deep tissue Candida infections, and as salvage therapy for Scedosporium sp. and Fusarium sp. infections.
Indications
- Acremonium sp.
- allergic bronchopulmonary aspergillosis
- aspergillosis
- aspergillosis prophylaxis
- Aspergillus flavus
- Aspergillus fumigatus
- Aspergillus nidulans
- Aspergillus niger
- Aspergillus terreus
- Aspergillus ustus
- Blastomyces dermatitidis
- blastomycosis
- bone and joint infections
- Candida albicans
- Candida glabrata
- Candida guilliermondii
- Candida krusei
- Candida lusitaniae
- Candida parapsilosis
- Candida tropicalis
- candidemia
- candidiasis
- candidiasis prophylaxis
- chorioretinitis
- Coccidioides immitis
- coccidioidomycosis
- coccidioidomycosis prophylaxis
- cryptococcosis
- Cryptococcus neoformans
- endocarditis
- endophthalmitis
- esophageal candidiasis
- febrile neutropenia
- fungal keratitis
- fusariosis
- Fusarium solani
- Fusarium sp.
- Histoplasma capsulatum
- histoplasmosis
- histoplasmosis prophylaxis
- infectious arthritis
- intraabdominal abscess
- intraabdominal infections
- meningitis
- myocarditis
- ophthalmic infection
- oropharyngeal candidiasis (thrush)
- osteomyelitis
- pericarditis
- peritonitis
- pneumonia
- Rhodotorula sp.
- scedosporiosis
- Scedosporium apiospermum
- Scedosporium sp.
- sinusitis
- skin and skin structure infections
- Talaromyces marneffei
- talaromycosis
- tracheobronchitis
Side Effects
- abdominal pain
- agitation
- agranulocytosis
- akathisia
- alopecia
- amnesia
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- anuria
- anxiety
- aplastic anemia
- arrhythmia exacerbation
- arthralgia
- ascites
- asthenia
- ataxia
- atrial fibrillation
- AV block
- azotemia
- back pain
- blepharitis
- bone pain
- bradycardia
- bundle-branch block
- cardiac arrest
- cardiomyopathy
- cerebral edema
- cheilitis
- chest pain (unspecified)
- chills
- cholecystitis
- cholelithiasis
- cholestasis
- clastogenesis
- coma
- confusion
- conjunctivitis
- constipation
- contact dermatitis
- corneal opacification
- cough
- cyanosis
- delirium
- depression
- diabetes insipidus
- diarrhea
- diplopia
- disseminated intravascular coagulation (DIC)
- dizziness
- drowsiness
- dysgeusia
- dysmenorrhea
- dyspepsia
- dysphagia
- dyspnea
- dysuria
- ecchymosis
- eczema vaccinatum
- edema
- elevated hepatic enzymes
- encephalopathy
- eosinophilia
- epididymitis
- epistaxis
- erythema multiforme
- esophageal ulceration
- esophagitis
- euphoria
- exfoliative dermatitis
- fever
- flank pain
- flatulence
- fluorosis
- flushing
- furunculosis
- GI bleeding
- GI perforation
- gingival hyperplasia
- gingivitis
- glossitis
- glycosuria
- Guillain-Barre syndrome
- hallucinations
- headache
- hearing loss
- heart failure
- hematemesis
- hematuria
- hemolytic anemia
- hemoptysis
- hemorrhagic cystitis
- hepatic failure
- hepatitis
- hepatomegaly
- hyperbilirubinemia
- hypercalcemia
- hypercholesterolemia
- hyperglycemia
- hyperkalemia
- hypermagnesemia
- hypernatremia
- hypertension
- hyperthyroidism
- hypertonia
- hyperuricemia
- hypervolemia
- hypocalcemia
- hypoglycemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypophosphatemia
- hypotension
- hypothyroidism
- hypoxia
- impotence (erectile dysfunction)
- infection
- influenza
- injection site reaction
- insomnia
- jaundice
- keratitis
- keratoconjunctivitis
- leukopenia
- libido decrease
- lupus-like symptoms
- lymphadenopathy
- maculopapular rash
- megaloblastic anemia
- melena
- muscle cramps
- myalgia
- myasthenia
- mydriasis
- myocardial infarction
- myopathy
- nausea
- night blindness
- nightmares
- nystagmus
- ocular hemorrhage
- ocular pain
- oliguria
- optic atrophy
- optic neuritis
- oral ulceration
- orthostatic hypotension
- osteomalacia
- osteonecrosis
- osteoporosis
- otalgia
- palpitations
- pancreatitis
- pancytopenia
- papilledema
- paresthesias
- pelvic pain
- peptic ulcer
- peripheral edema
- peripheral neuropathy
- peripheral vasodilation
- petechiae
- pharyngitis
- phlebitis
- photophobia
- photosensitivity
- pleural effusion
- proctitis
- pruritus
- pseudomembranous colitis
- pseudoporphyria
- psoriasis
- psychosis
- pulmonary edema
- pulmonary embolism
- purpura
- QT prolongation
- rash
- renal failure (unspecified)
- renal tubular necrosis
- retinal hemorrhage
- rhinitis
- seizures
- sinus tachycardia
- sinusitis
- skin discoloration
- splenomegaly
- Stevens-Johnson syndrome
- stomatitis
- stroke
- suicidal ideation
- supraventricular tachycardia (SVT)
- syncope
- testicular swelling
- thrombocytopenia
- thrombotic thrombocytopenic purpura (TTP)
- tinnitus
- torsade de pointes
- toxic epidermal necrolysis
- tremor
- urinary incontinence
- urinary retention
- urticaria
- uveitis
- vaginal bleeding
- ventricular fibrillation
- ventricular tachycardia
- vertigo
- visual impairment
- vomiting
- xerophthalmia
- xerosis
- xerostomia
Monitoring Parameters
- LFTs
- serum bilirubin (total and direct)
- serum creatinine/BUN
- serum voriconazole concentrations
Contraindications
- alcoholism
- Asian patients
- azole antifungals hypersensitivity
- Black patients
- bradycardia
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cardiomyopathy
- Caucasian patients
- chemotherapy
- cholestasis
- contraception requirements
- coronary artery disease
- diabetes mellitus
- dialysis
- females
- galactosemia
- geriatric
- heart failure
- hepatic disease
- hepatitis
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- infusion-related reactions
- jaundice
- lactase deficiency
- long QT syndrome
- malnutrition
- melanoma
- myocardial infarction
- ocular disease
- pancreatitis
- poor metabolizers
- pregnancy
- QT prolongation
- renal disease
- renal failure
- renal impairment
- reproductive risk
- sunlight (UV) exposure
- thyroid disease
Interactions
- Abacavir; Dolutegravir; Lamivudine
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Abemaciclib
- Acalabrutinib
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Acetohexamide
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- Aliskiren; Amlodipine
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- Almotriptan
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- Amlodipine
- Amlodipine; Atorvastatin
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- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
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- Aspirin, ASA; Oxycodone
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