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Voriconazole (Oral route)

Pronunciation:

vor-i-KON-a-zole

Brand Names:

  • Vfend

Dosage Forms:

  • Powder for Suspension
  • Tablet

Classifications:

Therapeutic—

Antifungal

Chemical—

Triazole

Uses of This Medicine:

Voriconazole is used to treat serious fungal or yeast infections, such as aspergillosis (fungal infection in the lungs), candidemia (fungal infection in the blood), esophageal candidiasis (candida esophagitis), or other fungal infections (infections in the skin, stomach, kidney, bladder, or wounds). It may also be used to treat patients with serious fungal or yeast infections who cannot tolerate other types of treatment or do not respond to other types of treatment.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of voriconazole in children younger than 12 years of age. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of voriconazole in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Astemizole
  • Carbamazepine
  • Cisapride
  • Conivaptan
  • Dihydroergotamine
  • Dronedarone
  • Efavirenz
  • Eliglustat
  • Ergoloid Mesylates
  • Ergonovine
  • Ergotamine
  • Fluconazole
  • Ivabradine
  • Lomitapide
  • Lovastatin
  • Lurasidone
  • Maraviroc
  • Mephobarbital
  • Mesoridazine
  • Methylergonovine
  • Methysergide
  • Nelfinavir
  • Nimodipine
  • Phenobarbital
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Primidone
  • Quinidine
  • Rifabutin
  • Rifampin
  • Ritonavir
  • Simvastatin
  • Sirolimus
  • Sparfloxacin
  • St John's Wort
  • Terfenadine
  • Thioridazine
  • Tolvaptan

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acenocoumarol
  • Ado-Trastuzumab Emtansine
  • Alprazolam
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether
  • Asenapine
  • Avanafil
  • Axitinib
  • Azithromycin
  • Bedaquiline
  • Boceprevir
  • Bosutinib
  • Bretylium
  • Buserelin
  • Cabazitaxel
  • Cabozantinib
  • Ceritinib
  • Chloramphenicol
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clopidogrel
  • Clozapine
  • Cobicistat
  • Crizotinib
  • Cyclobenzaprine
  • Cyclosporine
  • Dabrafenib
  • Daclatasvir
  • Darunavir
  • Dasatinib
  • Delamanid
  • Delavirdine
  • Desipramine
  • Deslorelin
  • Dicumarol
  • Disopyramide
  • Docetaxel
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Droperidol
  • Eletriptan
  • Elvitegravir
  • Entacapone
  • Enzalutamide
  • Erlotinib
  • Erythromycin
  • Escitalopram
  • Eslicarbazepine Acetate
  • Eszopiclone
  • Everolimus
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluoxetine
  • Fluticasone
  • Formoterol
  • Fosphenytoin
  • Gatifloxacin
  • Gemifloxacin
  • Glimepiride
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydrocodone
  • Ibrutinib
  • Ibutilide
  • Idelalisib
  • Ifosfamide
  • Iloperidone
  • Imipramine
  • Ivacaftor
  • Ixabepilone
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Levomilnacipran
  • Lopinavir
  • Lumefantrine
  • Macitentan
  • Mefloquine
  • Metronidazole
  • Mifepristone
  • Mitotane
  • Moxifloxacin
  • Nafarelin
  • Nevirapine
  • Nilotinib
  • Nitisinone
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Paliperidone
  • Pasireotide
  • Pazopanib
  • Perflutren Lipid Microsphere
  • Phenprocoumon
  • Phenytoin
  • Pomalidomide
  • Ponatinib
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinine
  • Ranolazine
  • Regorafenib
  • Retapamulin
  • Rivaroxaban
  • Romidepsin
  • Ruxolitinib
  • Salmeterol
  • Sevoflurane
  • Sildenafil
  • Siltuximab
  • Simeprevir
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Suvorexant
  • Tacrolimus
  • Tamsulosin
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Temsirolimus
  • Tetrabenazine
  • Ticagrelor
  • Tizanidine
  • Toremifene
  • Trabectedin
  • Trazodone
  • Triazolam
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Vilanterol
  • Vilazodone
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinflunine
  • Vinorelbine
  • Vorapaxar
  • Warfarin
  • Ziprasidone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil
  • Amprenavir
  • Atorvastatin
  • Cerivastatin
  • Desogestrel
  • Dienogest
  • Drospirenone
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Etravirine
  • Fosamprenavir
  • Glipizide
  • Glyburide
  • Ibuprofen
  • Levonorgestrel
  • Medroxyprogesterone Acetate
  • Meloxicam
  • Mestranol
  • Methadone
  • Midazolam
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Omeprazole
  • Oxycodone
  • Saquinavir
  • Tolbutamide
  • Tretinoin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Cancer treatment (eg, chemotherapy), recent or history of or
  • Heart disease, history of or
  • Mineral imbalance (eg, low potassium, magnesium, or calcium in the blood) or
  • Stem cell transplant—Use with caution. These conditions may increase your risk of having serious side effects.
  • Galactose intolerance (rare hereditary problem) or
  • Glucose-galactose malabsorption (rare hereditary problem) or
  • Lapp lactase deficiency (rare hereditary problem) or
  • Any condition that makes it hard for you to digest sugars or dairy products—Use with caution. The tablet form of this medicine contains lactose (milk sugar) and the oral liquid contains sucrose (table sugar), which can make these conditions worse.
  • Heart rhythm problems (eg, arrhythmia, QT prolongation) or
  • Kidney disease or
  • Liver disease (including cirrhosis) or
  • Pancreas problems—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with a patient information leaflet. Read and follow the instructions carefully. Talk with your doctor if you have any questions.

It is best to take this medicine at least 1 hour before or 1 hour after a meal.

Shake the oral liquid well before each use. Use the oral dispenser that comes with the package to measure the dose. Rinse the oral dispenser with water after each use.

Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (suspension or tablets):
    • For fungal infections:
      • Adults and children older than 12 years of age—At first, a loading dose of voriconazole injection is given by your doctor on the first 24 hours of treatment. Then, your doctor may switch you to an oral maintenance dose of 200 milligrams (mg) taken every 12 hours.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not refrigerate or freeze the mixed suspension. The mixed suspension should be kept at room temperature and used within 14 days.

Precautions While Using This Medicine:

It is very important that your doctor check the progress of you or your child at regular visits to make sure that this medicine is working properly. Blood tests will be needed to check for unwanted effects.

If your or your child's symptoms do not improve, or if they become worse, check with your doctor. You may need to take this medicine for several months before your infection gets better.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

You or your child should not use astemizole (Hismanal®), barbiturates (such as phenobarbital or Luminal®), carbamazepine (Tegretol®), cisapride (Propulsid®), efavirenz (Sustiva®), ergot medicines (such as dihydroergotamine, ergotamine, Cafergot®, Ergomar®, or Wigraine®), pimozide (Orap®), quinidine (Quinaglute®), rifabutin (Mycobutin®), rifampin (Rifadin®, Rimactane®), ritonavir (Norvir®), sirolimus (Rapamune®), St. John's wort, or terfenadine (Seldane®). Using any of them together with this medicine may increase the chance of unwanted effects.

This medicine may cause vision problems. Avoid driving (especially at night), using machines, or doing anything else that could be dangerous if you cannot see well. Call your doctor if you or your child have any vision changes or if bright lights bother your eyes.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Contact your doctor right away if you or your child have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation.

This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Serious skin reactions can occur during treatment with this medicine. Check with your doctor right away if you or your child have blistering, peeling, loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine.

This medicine may cause bone pain when used for a long period of time. Check with your doctor right away if you or your child have bone pain while using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Difficulty seeing at night
increased sensitivity of the eyes to sunlight
rash
vision changes
Less common
Abdominal or stomach pain
bloating or swelling of the face, arms, hands, lower legs, or feet
blurred vision
chills
clay-colored stools
confusion
convulsions
dark urine
decreased urine
dizziness
dry mouth
faintness or lightheadedness when getting up suddenly from a lying or sitting position
fever
flushing
increased thirst
irregular or pounding heartbeat
itching
loss of appetite
muscle pain or cramps
muscle spasms or twitching
nausea
nervousness
numbness or tingling in the hands, feet, or lips
pounding in the ears
rapid weight gain
rash with flat lesions or small raised lesions on the skin
shortness of breath
slow or fast heartbeat
sweating
trembling
unpleasant breath odor
unusual tiredness or weakness
vomiting of blood
yellow eyes or skin
Rare
Agitation
blistering, peeling, or loosening of the skin
hostility or anger
increased sensitivity of the skin to sunlight
irritability
redness or other discoloration of the skin
seeing things that are not there
severe sunburn
Incidence not known
Bone pain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
Diarrhea
headache
vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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