Vori
Generic Name
Voriconazole
Manufacturer
Beacon Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vori 50 mg tablet | ৳ 35.00 | ৳ 350.00 |
Description
Overview of the medicine
Voriconazole is a broad-spectrum triazole antifungal agent used to treat serious fungal infections.
Uses & Indications
Dosage
Adults
Oral maintenance dose: Typically 200 mg every 12 hours. May be increased to 300 mg every 12 hours if response is inadequate.
Elderly
Similar dosage to adults, but monitor for adverse effects and consider age-related physiological changes.
Renal_impairment
No dosage adjustment required for oral administration in patients with renal impairment. Avoid IV formulation if CrCl < 50 mL/min due to cyclodextrin accumulation.
How to Take
Administer at least one hour before or one hour after a meal. Swallow tablets whole with water.
Mechanism of Action
It inhibits fungal cytochrome P450-dependent 14α-sterol demethylation, which is essential for fungal cell membrane integrity.
Pharmacokinetics
Onset
Steady-state plasma concentrations are generally achieved within 5-7 days of dosing.
Excretion
Mainly through hepatic metabolism, with less than 2% of the dose excreted unchanged in urine.
Half life
Dose-dependent; ranges from 6 to >24 hours with increasing doses.
Absorption
Rapid and almost complete oral absorption; bioavailability of approximately 90%. Absorption is reduced with food.
Metabolism
Primarily hepatic, mediated by CYP2C19, CYP2C9, and CYP3A4 enzymes. CYP2C19 is highly polymorphic.
Side Effects
Contraindications
- Hypersensitivity to voriconazole or any component of the formulation.
- Co-administration with rifampin, carbamazepine, phenobarbital, ritonavir (high dose), efavirenz (high dose), or ergot alkaloids.
- Co-administration with CYP3A4 substrates that prolong the QT interval (e.g., quinidine, cisapride, pimozide).
Drug Interactions
Rifampin
Significantly decreases voriconazole plasma concentrations, leading to loss of efficacy. Concomitant use is contraindicated.
Warfarin
Increases warfarin levels and risk of bleeding. Monitor INR frequently.
Phenytoin
Decreases voriconazole levels and increases phenytoin levels. Monitor phenytoin levels.
Cyclosporine
Increases cyclosporine levels. Reduce cyclosporine dose and monitor levels.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive treatment is recommended. Voriconazole is hemodialyzable but cyclodextrin is not. No specific antidote is available.
Pregnancy & Lactation
Pregnancy Category D (potential for fetal harm). Not recommended during pregnancy unless the benefits outweigh the risks. Avoid during lactation as it is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to voriconazole or any component of the formulation.
- Co-administration with rifampin, carbamazepine, phenobarbital, ritonavir (high dose), efavirenz (high dose), or ergot alkaloids.
- Co-administration with CYP3A4 substrates that prolong the QT interval (e.g., quinidine, cisapride, pimozide).
Drug Interactions
Rifampin
Significantly decreases voriconazole plasma concentrations, leading to loss of efficacy. Concomitant use is contraindicated.
Warfarin
Increases warfarin levels and risk of bleeding. Monitor INR frequently.
Phenytoin
Decreases voriconazole levels and increases phenytoin levels. Monitor phenytoin levels.
Cyclosporine
Increases cyclosporine levels. Reduce cyclosporine dose and monitor levels.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive treatment is recommended. Voriconazole is hemodialyzable but cyclodextrin is not. No specific antidote is available.
Pregnancy & Lactation
Pregnancy Category D (potential for fetal harm). Not recommended during pregnancy unless the benefits outweigh the risks. Avoid during lactation as it is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 to 3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
FDA Approved
Patent Status
Patent expired, generic versions available
WHO Essential Medicine
YesClinical Trials
Voriconazole has undergone extensive clinical trials demonstrating its efficacy and safety in various fungal infections, leading to its global approval.
Lab Monitoring
- Liver function tests (LFTs) should be monitored at baseline and at least weekly during the first month of therapy, then less frequently if stable.
- Renal function should be monitored.
- Therapeutic drug monitoring (TDM) of voriconazole plasma levels may be useful, especially in patients with hepatic impairment, drug interactions, or inadequate response/adverse effects.
Doctor Notes
- Monitor liver function tests and consider therapeutic drug monitoring for optimal patient management, especially in those with risk factors for toxicity or subtherapeutic levels.
- Counsel patients on phototoxicity prevention (sunscreen, protective clothing) and to report any visual disturbances or skin lesions promptly.
- Be aware of significant drug interactions, particularly with CYP450 enzyme inhibitors/inducers and QT-prolonging agents.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Avoid direct sunlight and use protective measures (e.g., sunscreen, protective clothing) due to increased photosensitivity.
- Report any visual changes, skin reactions, or symptoms of liver problems (e.g., unexplained nausea, vomiting, yellowing of skin/eyes) to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Driving Precautions
Vori may cause temporary and reversible visual disturbances, including blurred vision and altered light perception. Patients should avoid driving or operating machinery if they experience these effects.
Lifestyle Advice
- Maintain good personal hygiene to help prevent infections.
- Avoid exposure to environments known to have high fungal spore counts (e.g., construction sites, decaying vegetation).
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