Voriconazole

Voriconazole is a triazole antifungal medicine. It is available in Bangladesh under many brand names. Below are its uses, side effects and precautions, and every brand with its current price.

• Treatment of invasive aspergillosis.
• Treatment of candidemia in non-neutropenic patients and other serious Candida infections, including infections caused by Candida krusei.
• Treatment of esophageal candidiasis.
• Treatment of serious fungal infections caused by Scedosporium apiospermum and Fusarium species when other therapy is not suitable or has failed.

• Common side effects include nausea, vomiting, diarrhea, headache, fever, rash, and abdominal discomfort.
• Temporary visual changes, blurred vision, altered color vision, and sensitivity to light may occur.
• Liver enzyme elevation and liver inflammation can occur and may be serious.
• Serious reactions may include severe skin reactions, photosensitivity, irregular heartbeat or QT prolongation, hallucinations or confusion, and severe allergic reactions.
• Long-term use has been associated with skin damage from sunlight and, rarely, skin cancer or bone pain due to periostitis.

Use Voriconazole with caution in people with liver disease, abnormal heart rhythm, prolonged QT interval, low potassium or magnesium, kidney impairment when receiving the injection, or a history of severe skin reactions. Liver function, electrolytes, and sometimes blood drug levels may need monitoring.

Avoid strong sunlight and use protective clothing and sunscreen. This medicine may cause visual disturbance or dizziness, so avoid driving or hazardous work if affected. Use only under the guidance of a registered doctor or pharmacist.

• Voriconazole has many important interactions because it affects CYP liver enzymes.
• Do not combine with strong enzyme inducers such as rifampicin, carbamazepine, phenobarbital, or St John's wort, as they can make treatment ineffective.
• Serious interactions may occur with sirolimus, ergot alkaloids, pimozide, quinidine, and some antiviral medicines; specialist advice is required.
• It can increase the effects or toxicity of medicines such as warfarin, tacrolimus, cyclosporine, some statins, sulfonylureas, benzodiazepines, and some calcium-channel blockers.
• Phenytoin, rifabutin, efavirenz, and ritonavir may require avoidance, dose adjustment, or close monitoring.
• Food can reduce oral absorption; take tablets or suspension exactly as instructed by the doctor or product label.

• Known hypersensitivity to voriconazole or any component of the formulation.
• Concomitant use with rifampicin, carbamazepine, long-acting barbiturates such as phenobarbital, or St John's wort.
• Concomitant use with sirolimus, ergot alkaloids, pimozide, or quinidine due to risk of serious toxicity.
• Concomitant use with certain doses of ritonavir or efavirenz may be contraindicated; the prescriber must check the full medicine list.

Voriconazole should generally be avoided during pregnancy unless the doctor decides that the potential benefit outweighs the risk, as fetal harm is possible. Women who can become pregnant should use effective contraception during treatment. It is not known whether voriconazole passes into breast milk; breastfeeding should be discussed with the doctor, and an alternative medicine or temporary interruption of breastfeeding may be considered.

Store tablets, powder for suspension, and injection vials as directed on the product label, generally at room temperature away from excess heat, moisture, and direct light. Keep out of reach of children. After reconstitution, oral suspension or injection should be used within the time recommended by the manufacturer or pharmacist and any unused portion discarded safely.