Voriconazole
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| Pronunciation | /vɒrɪˈkɒnəzoʊl/ vorr-i-KON-ə-zohl |
| Trade names | Vfend, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a605022 |
| License data |
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| Routes of administration | Intravenous, by mouth |
| ATC code | |
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| Pharmacokinetic data | |
| Bioavailability | 96% (oral) |
| Protein binding | 58% |
| Metabolism | Liver: CYP2C19 (significant involvement), also CYP2C9, CYP3A4 |
| Metabolites | Voriconazole N-oxide (major; minimal antifungal activity) |
| Elimination half-life | Dose-dependent |
| Excretion | Urine (80–83%)[2] |
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Voriconazole, sold under the brand name Vfend among others, is an
Common side effects include vision problems, nausea, abdominal pain, rash, headache, and
Voriconazole was patented in 1990 and approved for medical use in the United States in 2002.[4][5] It is on the World Health Organization's List of Essential Medicines.[6]
Medical uses
Voriconazole is used to treat invasive
It is also used to prevent fungal infection in people as they undergo BMT.[9][7]
It is also the recommended treatment for the CNS fungal infections transmitted by epidural injection of contaminated steroids.[11]
It can be taken by mouth or given in a doctor's office or clinic by intravenous infusion.[7]
Contraindications
It is toxic to the fetus; pregnant women should not take it and women taking it should not become pregnant.[2]
People who have hereditary intolerance for galactose, Lapp lactase deficiency, or glucose-galactose malabsorption should not take this drug. It should be used with caution in people with arrhythmias or long QT.[2]
No dose adjustment is necessary for renal impairment or advanced age, but children seem to clear voriconazole faster than adults and drug levels may need monitoring.[12]
Side effects
The labels carry several warnings of the risk of
Additionally, very common adverse effects, occurring in more than 10% of people, include peripheral edema, headaches, trouble breathing, diarrhea, vomiting, abdominal pain, nausea, rashes, and fever.[7]
Common adverse effects, occurring in between 1 and 10% of people, include sinus infections, low numbers of white and red blood cells (agranulocytosis, pancytopenia, thrombocytopenia, leukopenia, and anemia), low blood sugar, reduced amount of potassium and sodium, depression, hallucinations, anxiety, insomnia, agitation, confusion, convulsions, fainting, tremor, weakness, tingling, sleepiness, dizziness, bleeding retina, irregular heart beats, slow or fast heart beats, low blood pressure, inflamed veins, acute respiratory distress syndrome, pulmonary edema, inflamed lips, swollen face, stomach upset, constipation, gingivitis, jaundice, hair loss, flaky skin, itchiness, red skin, back pain, chest pain, and chills.[7]
Interactions
Being metabolized by hepatic cytochrome P450, voriconazole interacts with many drugs.[2][7] Voriconazole should not be used in conjunction with many drugs (including sirolimus, rifampicin, rifabutin, carbamazepine, quinidine and ergot alkaloids) and dose adjustments and/or monitoring should be done when coadministered with others (including fluconazole, warfarin, ciclosporin, tacrolimus, omeprazole, and phenytoin). Voriconazole may be safely administered with cimetidine, ranitidine, indinavir, macrolide antibiotics, mycophenolate, digoxin and prednisolone.[2]
Pharmacology
Pharmacokinetics
Voriconazole is well absorbed orally with a bioavailability of 96%, allowing patients to be switched between intravenous and oral administration.[citation needed]
History
Pfizer brought the drug to market as Vfend. A generic version of the tablet form of voriconazole was introduced in the US in 2011 after Pfizer and Mylan settled litigation under the
Society and culture
Brand names
As of July 2017, the medication is marketed under the following names worldwide: Cantex, Pinup, Vedilozin, Vfend, Vodask, Volric, Voramol, Voriconazol, Voriconazole, Voriconazolum, Voricostad, Vorikonazol, Voritek, Voriz, Vornal, and Vosicaz.[16]
References
- ^ "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Retrieved 30 March 2024.
- ^ a b c d e f "Vfend- voriconazole tablet, film coated Vfend- voriconazole injection, powder, lyophilized, for solution Vfend- voriconazole powder, for suspension". DailyMed. 16 September 2020. Retrieved 15 October 2020.
- ^ a b c d e f g "Voriconazole". The American Society of Health-System Pharmacists. Retrieved 8 December 2017.
- ISBN 978-1437719840.
- ISBN 9783527607495.
- hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ^ a b c d e f g "Vfend tablet and powder". UK Electronic Medicines Compendium. January 2017. Retrieved 30 July 2017.
- PMID 27365388.
- ^ PMID 28636889.
- PMID 12167683.
- ^ "Interim Treatment Guidance for Central Nervous System and Parameningeal Infections Associated with Injection of Contaminated Steroid Products". Centers for Disease Control and Prevention. Retrieved 6 November 2016.
- PMID 16569888.
- PMID 36189133.
- PMID 34631468.
- ^ "Vfend loses its paediatric protection" (PDF). IMS Health Generics Bulletin. 22 July 2016.
- ^ "Voriconazole international brand names". Drugs.com. Retrieved 30 July 2017.
Further reading
- Dean L (December 2019). "Voriconazole Therapy and CYP2C19 Genotype". In Pratt VM, McLeod HL, Rubinstein WS, et al. (eds.). Medical Genetics Summaries. PMID 31886997.
