About

Voriconazole is a potent, broad-spectrum triazole antifungal agent administered intravenously for the treatment of severe and life-threatening fungal infections. Its mechanism of action involves the inhibition of fungal cytochrome P450-dependent 14-alpha-demethylase, an enzyme critical for the biosynthesis of ergosterol, a key component of the fungal cell membrane. This disruption compromises the integrity and function of the fungal cell membrane, leading to fungistatic or fungicidal effects.

The injectable form is particularly vital for patients who cannot tolerate oral medication or require rapid attainment of therapeutic drug levels, especially in critical care settings. It is highly effective against a broad spectrum of fungi, including various Candida and Aspergillus species, and certain other rare molds. Due to its complex pharmacokinetics and potential for drug interactions, therapeutic drug monitoring is often recommended to ensure optimal efficacy and minimize the risk of toxicity, particularly with the intravenous formulation.

Uses

Treatment of invasive aspergillosis.
Treatment of candidemia in non-neutropenic patients.
Treatment of serious fungal infections caused by Scedosporium apiospermum.
Treatment of serious fungal infections caused by Fusarium species.

Directions For Use

Administer intravenously as a slow infusion over 1-2 hours, strictly as prescribed by a healthcare professional.

Benefits

Rapid attainment of therapeutic drug levels.
Crucial for critically ill patients unable to take oral medication.
Broad-spectrum activity against various severe fungal pathogens.
Effective against resistant Candida and Aspergillus species.
Penetrates well into various body tissues and fluids.
Improved outcomes in life-threatening fungal infections.

Side Effects

Visual disturbances (blurred vision, photophobia)
Infusion-related reactions (fever, chills)
Nausea
Vomiting
Diarrhea
Headache
Rash
Elevated liver enzymes
Photosensitivity
Peripheral edema
Hallucinations
Acute kidney injury (due to cyclodextrin excipient)

Safety Measures

Alcohol - Avoid alcohol as it can increase the risk of liver toxicity, a significant side effect of voriconazole.
Pregnancy - Voriconazole is contraindicated in pregnancy due to potential for fetal harm. Effective contraception must be used by women of childbearing potential.
Breastfeeding - It is unknown if voriconazole is excreted in human milk. Due to potential for serious adverse reactions in infants, breastfeeding is not recommended.
Liver - Use with caution in patients with hepatic impairment. Dose reduction is necessary in mild to moderate impairment, and it is contraindicated in severe impairment.
Kidney - The intravenous formulation contains cyclodextrin, which can accumulate in severe renal impairment. Oral voriconazole is preferred in such cases.
Lung - Rare cases of pulmonary toxicity, including interstitial pneumonia, have been reported. Monitor for new or worsening respiratory symptoms.

Disclaimer

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