voriconazole

vor-i-KON-a-zole

Commonly used brand name(s)

In the U.S.

• Vfend

Available Dosage Forms:

• Powder for Suspension


• Tablet

Therapeutic Class: Antifungal

Chemical Class: Triazole

Uses For voriconazole

Voriconazole is used to treat serious fungal or yeast infections, such as aspergillosis (fungal infection in the lungs), candidemia (fungal infection in the blood), esophageal candidiasis (candida esophagitis), or other fungal infections (infections in the skin, stomach, kidney, bladder, or wounds). It may also be used to treat patients with serious fungal or yeast infections who cannot tolerate other types of treatment or do not respond to other types of treatment.

voriconazole is available only with your doctor's prescription.

Before Using voriconazole

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For voriconazole, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to voriconazole or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of voriconazole in children younger than 12 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of voriconazole in the elderly.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking voriconazole, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using voriconazole with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Astemizole


• Carbamazepine


• Cisapride


• Dihydroergotamine


• Dronedarone


• Ergoloid Mesylates


• Ergonovine


• Ergotamine


• Mephobarbital


• Mesoridazine


• Methylergonovine


• Methysergide


• Phenobarbital


• Pimozide


• Posaconazole


• Quinidine


• Rifabutin


• Rifampin


• Ritonavir


• Sirolimus


• Sparfloxacin


• St John's Wort


• Terfenadine


• Thioridazine

Using voriconazole with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abiraterone


• Acenocoumarol


• Alprazolam


• Amiodarone


• Amitriptyline


• Amoxapine


• Apomorphine


• Arsenic Trioxide


• Asenapine


• Azithromycin


• Boceprevir


• Bretylium


• Cabazitaxel


• Chloramphenicol


• Chloroquine


• Chlorpromazine


• Ciprofloxacin


• Citalopram


• Clarithromycin


• Clomipramine


• Clopidogrel


• Clozapine


• Crizotinib


• Cyclosporine


• Darunavir


• Dasatinib


• Delavirdine


• Desipramine


• Dicumarol


• Disopyramide


• Docetaxel


• Dofetilide


• Dolasetron


• Droperidol


• Efavirenz


• Erythromycin


• Everolimus


• Flecainide


• Fluconazole


• Fosphenytoin


• Gatifloxacin


• Gemifloxacin


• Glimepiride


• Granisetron


• Halofantrine


• Haloperidol


• Ibutilide


• Iloperidone


• Imipramine


• Ixabepilone


• Lapatinib


• Levofloxacin


• Lopinavir


• Lumefantrine


• Mefloquine


• Moxifloxacin


• Nevirapine


• Nilotinib


• Norfloxacin


• Nortriptyline


• Octreotide


• Ofloxacin


• Ondansetron


• Paliperidone


• Pazopanib


• Perflutren Lipid Microsphere


• Phenprocoumon


• Phenytoin


• Procainamide


• Prochlorperazine


• Promethazine


• Propafenone


• Protriptyline


• Quetiapine


• Quinine


• Ranolazine


• Rivaroxaban


• Romidepsin


• Ruxolitinib


• Salmeterol


• Sildenafil


• Simvastatin


• Sodium Phosphate


• Sodium Phosphate, Dibasic


• Sodium Phosphate, Monobasic


• Solifenacin


• Sorafenib


• Sotalol


• Sunitinib


• Tacrolimus


• Telaprevir


• Telavancin


• Telithromycin


• Temsirolimus


• Tetrabenazine


• Ticagrelor


• Toremifene


• Trazodone


• Triazolam


• Trifluoperazine


• Trimipramine


• Vandetanib


• Vardenafil


• Vemurafenib


• Vinblastine


• Vincristine


• Vincristine Liposome


• Vinorelbine


• Warfarin


• Ziprasidone

Using voriconazole with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfentanil


• Amprenavir


• Atorvastatin


• Cerivastatin


• Desogestrel


• Diclofenac


• Dienogest


• Drospirenone


• Estradiol Cypionate


• Estradiol Valerate


• Ethinyl Estradiol


• Ethynodiol Diacetate


• Etonogestrel


• Etravirine


• Fentanyl


• Fosamprenavir


• Glipizide


• Glyburide


• Ibuprofen


• Levonorgestrel


• Lovastatin


• Medroxyprogesterone Acetate


• Meloxicam


• Mestranol


• Methadone


• Midazolam


• Nelfinavir


• Norelgestromin


• Norethindrone


• Norgestimate


• Norgestrel


• Omeprazole


• Oxycodone


• Saquinavir


• Tolbutamide


• Tretinoin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of voriconazole. Make sure you tell your doctor if you have any other medical problems, especially:

• Cancer treatment (e.g., chemotherapy), history of or


• Heart disease, history of or


• Mineral imbalance (e.g., low potassium, magnesium, or calcium in the blood) or


• Stem cell transplant—Use with caution. These conditions may increase your risk of having serious side effects.

• Fructose intolerance (rare hereditary problem) or


• Galactose intolerance (rare hereditary problem) or


• Glucose-galactose malabsorption (rare hereditary problem) or


• Lapp lactase deficiency (rare hereditary problem) or


• Sucrase-isomaltase deficiency (rare hereditary problem) or


• Any condition that makes it hard for you to digest sugars or dairy products—Use with caution. The tablet form of voriconazole contains lactose (milk sugar) and the oral liquid contains sucrose (table sugar), which can make these conditions worse.

• Heart rhythm problems (e.g., QT prolongation) or


• Kidney disease or


• Liver disease (including cirrhosis) or


• Pancreas problems—Use with caution. May make these conditions worse.

Proper Use of voriconazole

Take voriconazole exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

voriconazole comes with a patient information leaflet. Read and follow the instructions carefully. Talk with your doctor if you have any questions.

Keep using voriconazole for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

It is best to take voriconazole at least 1 hour before or 1 hour after a meal.

Shake the oral liquid well before each use. Use the oral dispenser that comes with the package to measure the dose. Rinse the oral dispenser with water after each use.

Dosing

The dose of voriconazole will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of voriconazole. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage forms (suspension or tablets):
  
  • For fungal infections:
    
    • Adults and children older than 12 years of age—At first, a loading dose of voriconazole injection is given by your doctor on the first 24 hours of treatment. Then, your doctor may switch you to an oral maintenance dose of 200 milligrams (mg) taken every 12 hours.
    
    
    • Children younger than 12 years of age—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

If you miss a dose of voriconazole, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not refrigerate or freeze the mixed suspension. The mixed suspension should be kept at room temperature and used within 14 days. Throw away any unused medicine for more than 14 days. Ask your doctor if you need a new prescription.

Precautions While Using voriconazole

It is very important that your doctor check the progress of you or your child at regular visits to make sure that voriconazole is working properly. Blood tests will be needed to check for unwanted effects.

If your symptoms do not improve, or if they become worse, check with your doctor. You may need to take voriconazole for several months before your infection gets better.

Using voriconazole while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

You or your child should not use astemizole (Hismanal®), barbiturates (such as mephobarbital, phenobarbital, or Luminal®), carbamazepine (Tegretol®), cisapride (Propulsid®), ergot medicines (such as dihydroergotamine, ergotamine, Cafergot®, Ergomar®, or Wigraine®), pimozide (Orap®), quinidine (Quinaglute®), rifabutin (Mycobutin®), rifampin (Rifadin®, Rimactane®), ritonavir (Norvir®), sirolimus (Rapamune®), St. John's wort, or terfenadine (Seldane®). Using any of them together with voriconazole may increase the chance of unwanted effects.

voriconazole may cause vision problems. Avoid driving (especially at night), using machines, or doing anything else that could be dangerous if you cannot see well. Call your doctor if you or your child have any vision changes or if bright lights bother your eyes.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.

voriconazole may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Serious skin reactions can occur during treatment with voriconazole. Stop using voriconazole and check with your doctor right away if you or your child have any of the following symptoms while you are using voriconazole: blistering, peeling, loosening of the skin; chills; cough; diarrhea; fever; itching; joint or muscle pain; red skin lesions; sore throat; sores, ulcers, or white spots in the mouth or on the lips; or unusual tiredness or weakness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

voriconazole Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Difficulty seeing at night


• increased sensitivity of the eyes to sunlight


• rash


• vision changes

Less common

• Abdominal or stomach pain


• bloating or swelling of the face, arms, hands, lower legs, or feet


• blurred vision


• chills


• clay-colored stools


• confusion


• convulsions


• dark urine


• decreased urine


• dizziness


• dry mouth


• faintness or lightheadedness when getting up suddenly from a lying or sitting position


• fever


• flushing


• increased thirst


• irregular or pounding heartbeat


• itching


• loss of appetite


• mood or mental changes


• muscle pain or cramps


• muscle spasms or twitching


• nausea


• nervousness


• numbness or tingling in the hands, feet, or lips


• pounding in the ears


• rapid weight gain


• rash with flat lesions or small raised lesions on the skin


• shortness of breath


• slow or fast heartbeat


• sweating


• trembling


• unpleasant breath odor


• unusual tiredness or weakness


• vomiting of blood


• yellow eyes or skin

Rare

• Agitation


• blistering, peeling, or loosening of the skin


• hostility or anger


• increased sensitivity of the skin to sunlight


• irritability


• redness or other discoloration of the skin


• seeing things that are not there


• severe sunburn

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Diarrhea


• headache


• nausea


• vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: voriconazole side effects (in more detail)

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More voriconazole resources

• Voriconazole Side Effects (in more detail)
• Voriconazole Use in Pregnancy & Breastfeeding
• Drug Images
• Voriconazole Drug Interactions
• Voriconazole Support Group
• 1 Review for Voriconazole - Add your own review/rating

• Voriconazole Prescribing Information (FDA)


• Voriconazole Professional Patient Advice (Wolters Kluwer)


• Voriconazole Monograph (AHFS DI)


• Voriconazole MedFacts Consumer Leaflet (Wolters Kluwer)


• Vfend Prescribing Information (FDA)


• Vfend Consumer Overview

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