Description

Voriconazole 200 mg injection is used to treat serious fungal infections in the body, including:

• Invasive aspergillosis – a type of lung infection caused by Aspergillus fungi
• Candidemia in non-neutropenic patients and other deep tissue Candida infections
• Serious infections due to Fusarium species and Scedosporium apiospermum

The recommended dosing for voriconazole 200 mg injection is:

• Loading dose: 6 mg/kg IV every 12 hours on Day 1
• Maintenance dose: 4 mg/kg IV every 12 hours

IV therapy should continue for at least 7 days. Once the patient improves clinically and can tolerate oral medication, the oral tablet or suspension formulation may be used to complete treatment.Voriconazole is contraindicated in patients with known hypersensitivity to the drug or its ingredients. It also interacts with certain medications like rifampin, carbamazepine, long-acting barbiturates, and St. John’s wort, so concomitant use should be avoided.Patients should be monitored for development of abnormal renal function, as voriconazole can cause acute renal failure in some cases. Serum creatinine levels should be closely monitored, especially in those with moderate to severe renal impairment (creatinine clearance <50 mL/min).                                                                                                                                         

Mechanism of Action of Voriconazole

The primary mode of action of voriconazole is the inhibition of fungal cytochrome P-450-mediated 14α-lanosterol demethylation, an essential step in ergosterol biosynthesis.Voriconazole is more selective than some other azole drugs for fungal cytochrome P-450 enzyme systems compared to various mammalian cytochrome P-450 enzyme systems.The subsequent loss of normal sterols correlates with the accumulation of 14α-methyl sterols in fungi, which may be responsible for voriconazole’s fungistatic and fungicidal activity.In vitro, voriconazole displays broad-spectrum antifungal activity with high potency against Candida species (including fluconazole-resistant strains) and fungicidal activity against Aspergillus species. It also shows activity against emerging fungal pathogens like Scedosporium and Fusarium.                                                                                           

Voriconazole

Antifungal medication

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Usage

Treats fungal infections such as aspergillosis, candidiasis, coccidioidomycosis, and others

Administration

Can be taken orally or injected into a vein

Common Side Effects

Vision problems, nausea, abdominal pain, rash, headache, hallucinations

The chemical structure of voriconazole is:(2R,3S)-2-(2,4-Difluorophenyl)-3-(5-fluoro-4-pyrimidinyl)-1-(1H-1,2,4-triazol-1-yl)-2-butanolIts molecular formula is C16H14F3N5O and its relative molecular mass is 349.31.The structural formula is:CC@@HC@(c3ccc(cc3F)F)OInChI=1S/C16H14F3N5O/c1-10(15-14(19)5-20-7-22-15)16(25,6-24-9-21-8-23-24)12-3-2-11(17)4-13(12)18/h2-5,7-10,25H,6H2,1H3/t10-,16+/m0/s1BCEHBSKCWLPMDN-MGPLVRAMSA-N

Dosage in Adults

• Loading dose: 6 mg/kg IV every 12 hours for the first 24 hours
• Maintenance dose: 4 mg/kg IV every 12 hours or 200 mg orally every 12 hours
• Oral dose for patients <40 kg: 100 mg or 150 mg every 12 hours

Dosage in Pediatric Patients 2 to <12 years

• Loading dose: 9 mg/kg IV every 12 hours for the first 24 hours
• Maintenance dose: 8 mg/kg IV every 12 hours or 9 mg/kg (max 350 mg) orally every 12 hours

Administration

• Reconstitute voriconazole injection to 10 mg/mL and further dilute to ≤5 mg/mL before IV infusion over 1-3 hours
• Avoid IV administration in moderate to severe renal impairment (CrCl <50 mL/min)

Storage

• Store voriconazole powder for injection at 20-25°C (68-77°F)
• Reconstituted solution is stable for 24 hours at 2-8°C

Reviews

Voriconazole is generally well-tolerated, with the most common adverse effects being visual disturbances, fever, rash, vomiting, nausea, diarrhea, headache, and liver function test abnormalities. Careful monitoring of renal and hepatic function is recommended during treatment.