Vcand 200 | 1 Strip

✔️ Pharmacology

Voriconazole, a triazole antifungal, acts by inhibiting the fungal cytochrome P450–dependent enzyme 14-α-sterol demethylase, a key enzyme in the ergosterol biosynthesis pathway. Inhibition of this enzyme disrupts ergosterol production, compromising fungal cell membrane integrity and leading to cell death.

✔️ Dosage & Administration:

Oral Administration

Take at least 1 hour before or after meals.

Patients ≥40 kg:

Loading dose: 400 mg (10 ml) every 12 hours for the first 24 hours

Maintenance dose: 200 mg (5 ml) twice daily

Patients <40 kg:

Loading dose: 200 mg (5 ml) every 12 hours for the first 24 hours

Maintenance dose: 100 mg (2.5 ml) twice daily

✔️ Dosage & Administration

Intravenous Administration

Invasive Aspergillosis:

Loading: 6 mg/kg every 12 hours for first 24 hours

Maintenance: 4 mg/kg every 12 hours

Candidemia and Deep Tissue Candida Infections:

Loading: 6 mg/kg every 12 hours for first 24 hours

Maintenance: 3–4 mg/kg every 12 hours

Scedosporiosis & Fusariosis:

Loading: 6 mg/kg every 12 hours for first 24 hours

Maintenance: 4 mg/kg every 12 hours

✔️ Side Effects:

• Common adverse reactions include:
• Abdominal discomfort
• Nausea, diarrhea
• Headache, blurred vision
• Anemia, chest pain

✔️ Drug Interactions

Voriconazole interacts with CYP3A4, CYP2C9, and CYP2C19 inhibitors/inducers; dosage adjustments and monitoring are necessary.

May increase plasma concentrations of drugs metabolized by these enzymes — dose reductions and close monitoring recommended.

Phenytoin or efavirenz co-administration requires increased maintenance dosing of Voriconazole.

✔️ Contraindications

• Known hypersensitivity to voriconazole or its excipients
• Concurrent use with terfenadine, astemizole, cisapride, pimozide, quinidine, or sirolimus due to risk of serious adverse effects
• Concomitant use with rifampin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir, rifabutin, ergot alkaloids, or St. John’s Wort due to loss of efficacy

✔️ Pregnancy & Lactation

There are no adequate or well-controlled studies in pregnant women. Use only if the potential benefit outweighs the potential fetal risk. Exercise caution during lactation.

✔️ Precautions & Warnings

Long-term use (>180 days) requires careful benefit–risk evaluation.

Squamous cell carcinoma (SCC) of the skin has been associated with prolonged therapy.

Not recommended in children below 12 years, as efficacy and safety have not been established.

✔️ Storage Conditions

• Store below 25°C, in a dry place, away from light.
• Keep out of reach of children.
• Store the powder for suspension between 2°–8°C.