Adult Dosing
Invasive Aspergillosis
- Loading dose: 6 mg/kg IV q12 hrs for 2 doses
- Maintenance dose: 200 mg PO q12 hrs if > 40 kgs or 100 mg PO q12 hrs if < 40 kgs
- Max: 600 mg/day if > 40 kgs or 300 mg/day if < 40 kgs
- Note: Give 1 hr before or after meal
Serious fungal infections
- Loading dose: 6 mg/kg IV q12 hrs for 2 doses
- Maintenance dose: 200 mg PO q12 hrs if > 40 kgs or 100 mg PO q12 hrs if < 40 kgs
- Max: 600 mg/day if > 40 kgs or 300 mg/day if < 40 kgs
- Note: Give 1 hr before or after meal
Candidemia, non-neutropenic patients
- Loading dose: 6 mg/kg IV q12 hrs for 2 doses
- Maintenance dose: 200 mg PO q12 hrs if > 40 kgs or 100 mg PO q12 hrs if < 40 kgs
- Max: 600 mg/day if > 40 kgs or 300 mg/day if < 40 kgs
- Note: Treat for atleast 14 days following resolution of symptoms or following last positive culture. Give 1 hr before or after meal
Esophageal candidiasis
- 200 mg PO q12 hrs
- Give for atleast 14 days and for 7 days following symptom resolution. Give 1 hr before or after meal
Deep tissue candidiasis
- Loading dose: 6 mg/kg IV q12 hrs for 2 doses
- Maintenance dose: 200 mg PO q12 hrs if > 40 kgs or 100 mg PO q12 hrs if < 40 kgs
- Max: 600 mg/day if > 40 kgs or 300 mg/day if < 40 kgs
- Note: Treat for atleast 14 days following resolution of symptoms or following last positive culture. Give 1 hr before or after meal
Pediatric Dosing
Child (12-18 yrs)
- 100-300 mg PO q12 hrs or 4 mg/kg PO q12 hrs
[Outline]
Renal Dose Adjustment (Based on CrCl)
- <50 mL/min: Accumulation of the intravenous vehicle (cyclodextrin) occurs. After initial I.V. loading dose, oral voriconazole should be administered to these patients, unless an assessment of the benefit:risk to the patient justifies the use of I.V. voriconazole
- Hemodialysis: No supplement
Hepatic Dose Adjustment
- Mild/moderate hepatic dysfunstion (Child-Pugh Class A/B): Following standard loading dose, reduce maintenance dosage by 50%
- Severe hepatic impairment (Child-Pugh Class C): Should only be used if benefit outweighs risk; monitor closely for toxicity
- May cause prolongation of the QT interval. Rare cases of arrhythmias, cardiac arrests and sudden deaths have occurred in patients taking voriconazole. Patients w/ hx of cardiotoxic chemotherapy, cardiomyopathy, hypokalemia and concomitant medications that increase QT interval are at an increased risk
- Correct potassium, magnesium and calcium before starting voriconazole
- Rare cases of hepatotoxicity including clinical hepatitis, cholestasis and fulminant hepatic failure, have been reported. Monitor LFTs at baseline and periodically thereafter
- Prolonged visual adverse events, including optic neuritis and papilledema may occur if therapy > 28 days. Monitor visual function including visual acuity, visual field and color perception
Cautions: Use cautiously in
- Mild to moderate hepatic impairment
- Renal impairment (avoid use if CrCl < 50 mL/min)
- Cardiotoxic chemotherapy
- Cardiomyopathy
- Hypokalemia
- Electrolyte abnormality
- QT prolongation risk factors
- Congenital QT syndrome
- Concurrent use of QT prolonging agents
- Hematologic malignancy
- Long term use
Pregnancy Category:D
Breastfeeding: Safety unknown; it should not be used unless benefit outweighs risk
Pricing data from www.DrugStore.com in U.S.A.
- Vfend 40 MG/ML SUSR [Bottle] (PFIZER U.S.)
75 ml = $846.03
225 ml = $2409.9 - Vfend 50 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $389
90 mg = $1107.02 - Vfend 200 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $1445.99
90 mg = $4239.82
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
Drug Name: Vfend 200 MG Oral Tablet
Pill Image:
[
See full size image]
Ingredient(s): Voriconazole
Imprint: Pfizer;VOR200
Color(s): White
Shape: Oval
Size (mm): 15.00
Score: 1
Inactive Ingredient(s): lactose monohydrate / croscarmellose sodium / povidone / magnesium stearate / hypromellose / titanium dioxide / triacetin
Drug Label Author:
Roerig
DEA Schedule:
Non-Scheduled
Drug Name: Vfend 50 MG Oral Tablet
Ingredient(s): Voriconazole
Imprint: Pfizer;VOR50
Color(s): White
Shape: Round
Size (mm): 7.00
Score: 1
Inactive Ingredient(s): lactose monohydrate / croscarmellose sodium / povidone / magnesium stearate / hypromellose / titanium dioxide / triacetin
Drug Label Author:
Roerig
DEA Schedule:
Non-Scheduled
