Voriconazole (Voriconazolum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Antifungal means

Included in the formulation
  • Biflurin
    pills inwards 
    FARMSINTEZ, PAO     Russia
  • Wikand
    pills inwards 
    OBOLENSKOE PHARMACEUTICAL ENTERPRISE, CJSC     Russia
  • Vfend®
    powder inwards 
    Pfizer Inc.     USA
  • Vfend®
    lyophilizate d / infusion 
    Pfizer Inc.     USA
  • Vfend®
    pills inwards 
    Pfizer Inc.     USA
  • VORICOZ
    pills inwards 
    Highgans Laboratories Pvt. Ltd.     India
  • Voriconazole
    lyophilizate d / infusion 
    BIOCAD, CJSC     Russia
  • Voriconazole Canon
    pills inwards 
    CANONFARMA PRODUCTION, CJSC     Russia
  • Voriconazole Sandoz®
    pills inwards 
    Sandoz d.     Slovenia
  • Voriconazole Sandoz®
    lyophilizate d / infusion 
    Sandoz d.     Slovenia
  • Voriconazole Acry
    pills inwards 
    AKRIKHIN HFK, JSC     Russia
  • Voriconazole-Teva
    pills inwards 
    Teva Pharmaceutical Enterprises Co., Ltd.     Israel
    • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

    VED

    ONLS

    АТХ:

    J.02.A. C.03   Voriconazole

    Pharmacodynamics:

    Selectively inhibits fungal cytochrome P450-dependent enzyme, involved in the process of demethylation of 14α-sterol, thereby interrupting the biosynthesis of ergosterol. As a result, lysis of the fungal cell occurs.

    Has fungicidal activity against fungi of the genus Candida spp. and has a pronounced fungistatic effect against Aspergillus spp.

    Pharmacokinetics:

    After oral administration, it is completely absorbed in the gastrointestinal tract.After intravenous administration, the bioavailability is 96%. The maximum concentration in the blood plasma is reached after 24 hours. The connection with plasma proteins is 58%.

    Penetrates through the blood-brain and placental barrier, is found in breast milk. Metabolism in the liver.

    The half-life is 6 hours. Elimination by the kidneys and with feces.

    Indications:

    It is used for the treatment of invasive aspergillosis and candidiasis, is used in severe fungal infections, in cases of refractoriness of pathogens to other medicines, and also for the prevention of fungal infections in patients at high risk: bone marrow recipients and relapses of leukemia.

    ICD-10

    I.B35-B49.B37.8   Candidiasis of other localizations

    I.B35-B49.B37.7   Candida septicemia

    I.B35-B49.B37.6   Candidiasis endocarditis (I39.8 *)

    I.B35-B49.B37.1   Pulmonary Candidiasis

    I.B35-B49.B48.7   Opportunistic fungal infections

    I.B35-B49.B44   Aspergillosis

    I.B35-B49.B48.2   Allsheroesis

    I.B35-B49.B44.0   Invasive pulmonary aspergillosis

    I.B35-B49.B44.7   Disseminated Aspergillosis

    I.B35-B49.B49   Mycosis, unspecified

    Contraindications:Individual intolerance, children under 2 years old.

    Carefully:Renal and hepatic insufficiency, hypersensitivity.
    Pregnancy and lactation:

    Recommendations for FDA - category D. Contraindicated in pregnancy and lactation.

    Dosing and Administration:

    Use in children

    Supportive dose in children aged 2 to 12 years: 4 mg / kg body weight every 12 hours.

    Adults and children over 12 years of age

    Inside and intravenously drip, the dose is selected individually, depending on the age and body weight.

    Maintenance dose: 200 mg 2 times a day.

    The highest daily dose: 3 mg / kg body weight, but not more than 400 mg.

    The highest single dose: 200 mg.

    Side effects:

    Central and peripheral nervous system: asthenia, headache, dizziness, extrapyramidal syndrome, confusion, fainting, hallucinations.

    Respiratory system: shortness of breath, distress syndrome, pulmonary edema.

    Hemopoietic system: anemia, leukopenia, thrombocytopenia, neutropenia, lymphopenia, eosinophilia.

    The cardiovascular system: phlebitis, arterial hypotension, tachycardia or bradycardia, nodal arrhythmias, rarely - ventricular fibrillation.

    Digestive system: anorexia, nausea, gastralgia, vomiting, indigestion, cholecystitis, constipation.

    Musculoskeletal system: pain in the back, rarely - arthritis.

    Dermatological reactions: itching, rash, purpura, psoriasis, rarely - discoid lupus erythematosus.

    Sense organs: a taste disorder, oculomotor crisis, nystagmus, photophobia, diplopia, atrophy of the optic nerve.

    Urinary system: hematuria, acute renal failure, rarely - necrosis of renal tubules.

    Allergic reactions.

    Overdose:

    Increased side effects.

    Treatment is symptomatic. Effective hemodialysis.

    Interaction:

    Voriconazole is metabolized with the participation of isoenzymes CYP2C19, CYP2C9 and CYP3A4. Inhibitors or inducers of these isoenzymes can cause respectively an increase or decrease in the concentrations of voriconazole in plasma.

    With simultaneous application increases the toxic effect of nifedipine, sirolimus, itraconazole.

    It is not recommended to carry out blood transfusion simultaneously with the introduction of voriconazole.

    Special instructions:

    It is not recommended to mix or inject patients simultaneously with other pharmaceutical products, with the exception of 0.9% sodium chloride solution and 5% dextrose solution.

    Monitoring of liver and kidney function, the number of blood cells.

    In the treatment it is not recommended to drive vehicles and work with moving mechanisms.

    Instructions
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