Voriderm
Generic Name
Voriconazole
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| voriderm 200 mg tablet | ৳ 110.00 | ৳ 1,100.00 |
Description
Overview of the medicine
Voriderm 200 mg Tablet contains Voriconazole, an antifungal medication used to treat serious fungal infections, including invasive aspergillosis, candidemia in non-neutropenic patients, and other severe Candida infections. It is also used for prophylaxis in high-risk patients undergoing bone marrow transplantation.
Uses & Indications
Dosage
Adults
Loading dose: 400 mg every 12 hours for 2 doses. Maintenance dose: 200 mg every 12 hours.
Elderly
No dose adjustment is required for elderly patients.
Renal_impairment
No dose adjustment for oral administration. For IV formulation, accumulation of excipient (SBECD) may occur; oral formulation preferred.
How to Take
Take one tablet every 12 hours. Tablets should be swallowed whole with water, at least one hour before or one hour after a meal.
Mechanism of Action
Voriconazole is a triazole antifungal agent. It inhibits fungal cytochrome P450-dependent 14-alpha-demethylation of lanosterol, an essential step in fungal ergosterol biosynthesis. Inhibition of ergosterol synthesis leads to increased fungal cell membrane permeability, leakage of cellular contents, and inhibition of fungal growth.
Pharmacokinetics
Onset
Within 1-2 hours for therapeutic effect, steady state reached in approximately 5-7 days.
Excretion
Primarily hepatic metabolism followed by renal excretion of metabolites. Less than 2% of the dose is excreted unchanged in urine.
Half life
Dose-dependent, typically 6-10 hours at therapeutic doses, but can be longer with higher doses due to non-linear kinetics.
Absorption
Rapid and almost complete absorption after oral administration, bioavailability approximately 90%.
Metabolism
Extensively metabolized by hepatic cytochrome P450 enzymes (CYP2C19, CYP2C9, and CYP3A4). CYP2C19 is the primary enzyme involved.
Side Effects
Contraindications
- Hypersensitivity to voriconazole or any component of the formulation.
- Co-administration with terfenadine, astemizole, cisapride, pimozide, quinidine, sirolimus, rifampicin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir (at high doses), rifabutin, St. John's Wort.
- Severe hepatic impairment.
Drug Interactions
Warfarin
Increased anticoagulant effect, monitor INR.
Efavirenz
Contraindicated due to significant drug interaction (voriconazole levels decrease, efavirenz levels increase).
Rifampicin, Carbamazepine, Phenytoin
Significant decrease in voriconazole levels; avoid co-administration.
Immunosuppressants (e.g., Cyclosporine, Tacrolimus)
Voriconazole increases levels of immunosuppressants; reduce immunosuppressant dose and monitor.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include visual disturbances and hepatotoxicity. There is no specific antidote. Treatment is symptomatic and supportive. Voriconazole is dialyzable.
Pregnancy & Lactation
Pregnancy Category D. Should not be used during pregnancy unless the benefit outweighs the potential risk to the fetus. It is excreted in breast milk; breastfeeding should be discontinued during treatment.
Side Effects
Contraindications
- Hypersensitivity to voriconazole or any component of the formulation.
- Co-administration with terfenadine, astemizole, cisapride, pimozide, quinidine, sirolimus, rifampicin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir (at high doses), rifabutin, St. John's Wort.
- Severe hepatic impairment.
Drug Interactions
Warfarin
Increased anticoagulant effect, monitor INR.
Efavirenz
Contraindicated due to significant drug interaction (voriconazole levels decrease, efavirenz levels increase).
Rifampicin, Carbamazepine, Phenytoin
Significant decrease in voriconazole levels; avoid co-administration.
Immunosuppressants (e.g., Cyclosporine, Tacrolimus)
Voriconazole increases levels of immunosuppressants; reduce immunosuppressant dose and monitor.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include visual disturbances and hepatotoxicity. There is no specific antidote. Treatment is symptomatic and supportive. Voriconazole is dialyzable.
Pregnancy & Lactation
Pregnancy Category D. Should not be used during pregnancy unless the benefit outweighs the potential risk to the fetus. It is excreted in breast milk; breastfeeding should be discontinued during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Generic available (original patent expired)
WHO Essential Medicine
YesClinical Trials
Voriconazole has undergone extensive clinical trials demonstrating its efficacy and safety in various severe fungal infections, leading to its approval by major regulatory bodies. Ongoing post-marketing surveillance and studies continue.
Lab Monitoring
- Liver function tests (ALT, AST, alkaline phosphatase, bilirubin)
- Renal function tests (creatinine, BUN)
- Electrolytes (especially potassium)
- Serum voriconazole levels (therapeutic drug monitoring) in certain patients.
- INR if co-administered with warfarin.
Doctor Notes
- Monitor liver function closely during treatment.
- Be aware of significant drug interactions.
- Advise patients about potential visual disturbances and photosensitivity.
Patient Guidelines
- Take as directed by your doctor.
- Do not stop taking the medicine suddenly.
- Report any visual disturbances or severe side effects immediately.
- Avoid direct sunlight and use sunscreen due to increased photosensitivity.
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 resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause visual disturbances (e.g., blurred vision, altered light perception) and dizziness. Do not drive or operate machinery if you experience these effects.
Lifestyle Advice
- Maintain good hygiene to prevent further infections.
- Stay hydrated.
- Avoid alcohol, as it can worsen liver side effects.
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