Vorifast
Generic Name
Voriconazole
Manufacturer
Beacon Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vorifast 100 mg tablet | ৳ 70.00 | ৳ 700.00 |
Description
Overview of the medicine
Vorifast 100 mg Tablet contains Voriconazole, a broad-spectrum triazole antifungal agent used to treat serious fungal infections in patients aged 12 years and above.
Uses & Indications
Dosage
Adults
Loading dose: 400 mg every 12 hours for 2 doses (oral or IV). Maintenance dose: 200 mg every 12 hours (oral), adjusted based on response and tolerability.
Elderly
No dose adjustment is required for elderly patients.
Renal_impairment
No oral dose adjustment is required. For IV formulation, oral route preferred due to accumulation of SBECD vehicle.
How to Take
Vorifast tablets should be taken at least one hour before or one hour after a meal. Swallow the tablet whole with water.
Mechanism of Action
Voriconazole inhibits fungal cytochrome P450-dependent 14-alpha-lanosterol demethylation, an essential step in ergosterol biosynthesis. This leads to the disruption of fungal cell membrane integrity and function, resulting in the inhibition of fungal growth.
Pharmacokinetics
Onset
Therapeutic plasma concentrations are generally achieved within 1-2 hours after oral dosing.
Excretion
Less than 2% of the dose is excreted unchanged in urine. Primarily eliminated via hepatic metabolism followed by renal and fecal excretion of metabolites.
Half life
Dose-dependent, ranging from approximately 6 to 12 hours. Exhibits non-linear kinetics.
Absorption
Rapid and almost complete oral absorption (approx 90%). Bioavailability ~96%. Absorption is reduced with high-fat meals.
Metabolism
Extensively metabolized in the liver, primarily by CYP2C19, CYP2C9, and CYP3A4 enzymes. CYP2C19 is subject to genetic polymorphism.
Side Effects
Contraindications
- Hypersensitivity to voriconazole or any component of the formulation.
- Co-administration with substrates of CYP3A4 that prolong the QT interval (e.g., terfenadine, astemizole, cisapride, pimozide, quinidine).
- Co-administration with rifampin, carbamazepine, phenobarbital, ritonavir (at certain doses), efavirenz (doses >400mg/day), ergot alkaloids, sirolimus, or St. John's wort.
Drug Interactions
Warfarin
Increased prothrombin time; monitor INR and adjust warfarin dose.
Omeprazole
Increased omeprazole levels and potential for voriconazole level increase.
Benzodiazepines (e.g., Midazolam)
Increased benzodiazepine levels, monitor for sedation.
Cyclosporine, Tacrolimus, Sirolimus
Increased immunosuppressant levels; monitor drug levels and adjust dose.
Phenytoin, Rifampin, Carbamazepine, Phenobarbital
Significant decrease in voriconazole levels; avoid co-administration.
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 measures should be initiated. Voriconazole is not effectively removed by hemodialysis. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category D. Voriconazole should not be used during pregnancy unless the benefit to the mother clearly outweighs the potential risk to the fetus. It is excreted in breast milk; therefore, breastfeeding should be discontinued during treatment.
Side Effects
Contraindications
- Hypersensitivity to voriconazole or any component of the formulation.
- Co-administration with substrates of CYP3A4 that prolong the QT interval (e.g., terfenadine, astemizole, cisapride, pimozide, quinidine).
- Co-administration with rifampin, carbamazepine, phenobarbital, ritonavir (at certain doses), efavirenz (doses >400mg/day), ergot alkaloids, sirolimus, or St. John's wort.
Drug Interactions
Warfarin
Increased prothrombin time; monitor INR and adjust warfarin dose.
Omeprazole
Increased omeprazole levels and potential for voriconazole level increase.
Benzodiazepines (e.g., Midazolam)
Increased benzodiazepine levels, monitor for sedation.
Cyclosporine, Tacrolimus, Sirolimus
Increased immunosuppressant levels; monitor drug levels and adjust dose.
Phenytoin, Rifampin, Carbamazepine, Phenobarbital
Significant decrease in voriconazole levels; avoid co-administration.
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 measures should be initiated. Voriconazole is not effectively removed by hemodialysis. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category D. Voriconazole should not be used during pregnancy unless the benefit to the mother clearly outweighs the potential risk to the fetus. It is excreted in breast milk; therefore, breastfeeding should be discontinued during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date, check packaging for exact expiry.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory bodies
Patent Status
Patent expired, generics available
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of voriconazole for the treatment of various invasive fungal infections. Ongoing research continues to explore its use in new populations and for emerging fungal pathogens.
Lab Monitoring
- Liver function tests (ALT, AST, alkaline phosphatase, bilirubin) at baseline and during treatment.
- Renal function tests (creatinine, BUN).
- Electrolytes (potassium, magnesium) due to risk of QT prolongation.
- Therapeutic drug monitoring (TDM) may be considered in certain patients (e.g., those with poor response, drug interactions, or hepatic impairment).
Doctor Notes
- Careful monitoring of liver function tests and renal function is crucial during treatment.
- Consider therapeutic drug monitoring (TDM) to optimize voriconazole levels, especially in patients with varying CYP2C19 metabolizer status, hepatic impairment, or drug interactions.
- Counsel patients on potential visual disturbances, photosensitivity, and the importance of taking the medication on an empty stomach.
Patient Guidelines
- Take Vorifast exactly as prescribed by your doctor.
- Do not stop taking the medicine early, even if you feel better.
- Report any new or worsening side effects, especially visual disturbances, skin reactions, or signs of liver problems.
- Avoid direct sunlight and use protective measures like sunscreen and clothing.
- Do not drive or operate machinery if you experience visual disturbances.
Missed Dose Advice
If you miss a dose, 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 dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Voriconazole may cause transient and reversible visual disturbances (e.g., blurred vision, altered color perception, photophobia). Patients should be cautioned against driving, operating machinery, or performing tasks requiring good vision, especially at night, while taking Vorifast.
Lifestyle Advice
- Avoid excessive sun exposure and use sunscreen due to increased photosensitivity.
- Avoid alcohol consumption as it can increase the risk of liver problems.
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