Voriconazole (Vfend®, Pfizer) is a triazole antifungal medication used to treat serious fungal infections. It is used to treat invasive fungal infections that are generally seen in patients who are immunocompromised. These infections include invasive candidiasis and aspergillosis.

Administration

---

Oral (in tablets or suspension) or intravenous. Voriconzole interacts with many medications, including drugs given to suppress the immune system in transplant patients (e.g. ciclosporin, etc.).

Voriconazole is available as 50mg tablets and 200mg tablets. The oral suspension contains 200mg per 5ml. The intravenous preparation comes in vials containing 200mg of powder.

Pharmacology

---

Voriconazole is well absorbed (bioavailability 96%) and it has been said that measuring voriconazole levels is unnecessary. There is increasing evidence that this is untrue: children in particular seem to clear voriconazole faster than adults. It is suggested that clinicians should aim to achieve levels above 2.05µg/ml.

Voriconazole is metabolised by the liver and the dose should be halved in patients with mild to moderate hepatic impairment (Child-Pugh score A or B). There is no data available for patients with severe hepatic impairment (Child-Pugh C).

No dose adjustment is necessary with renal impairment.

Side effects

---

Common side effects include:

• Blurred vision, increased eye sensitivity to light, or other visual changes
• Nausea, vomiting, or diarrhea
• Headache
• Swelling or water retention.

Rare but life-threatening side effects include:

• Severe liver damage
• Allergic reactions to the medication

There are numerous drug interactions and the advice of a pharmacist should always be sought.

References

---

Antifungals

Voriconazol