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Voriconazole
From WikEM
Contents
Administration
- Type: Antifungal (Candida, mycoses, Aspergillosis)
- Dosage Forms:
- Routes of Administration: IV, PO
- Common Trade Names:
Adult Dosing
- 200-400mg PO BID or 4-6mg IV BID
Pediatric Dosing
- Children >12 yo: same as adult dosing
Special Populations
- Pregnancy Rating: D
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: PO preferred, no adjustement to dose
- Hepatic dosing: mild-moderate impairment- reduce dose. Severe: avoid using
Contraindications
- Allergy to class/drug
- Concomitant use of carbamazepine or CYP3A4 substrates, ritonavir, ergots, barbiturates, rifampin, sirolimus, or St. John's Wort
Adverse Reactions
Serious
- Prolonged QT, dysrhythmias, cardiac arrest
- Erythema multiforme, SJS, TEN
- Malignant melanoma, squamous cell carcinoma
- Hepatotoxicity
- Renal failure
- Toxic encephalopathy
- Pancreatitis
- Optic neuritis
Common
- Peripheral edema
- Rash
- Nausea/vomiting, diarrhea
- Headache
- Visual disturbances
- Hallucinations
- Fever
Pharmacology
- Half-life: Dose dependant, non-linear pharmacokinetics
- Metabolism: CYP2C19, CYP2C9 and CYP3A4
- Excretion: Renal
Mechanism of Action
- Triazole antifungal: inhibits synthesis of fungal cell wall ergosterol
