Voriconazole: An Antifungal for Severe Fungal Infections
Voriconazole is a triazole antifungal used in serious fungal infections caused by Aspergillus, Candida, and other resistant fungi. It is often used in immunocompromised patients, such as those undergoing organ transplants or those with HIV/AIDS.
Mechanism of Action
Voriconazole works by inhibiting the synthesis of ergosterol, a key component of the fungal cell membrane. This weakens the fungal membrane and inhibits growth.
Indications
● Aspergillosis: To treat infections caused by Aspergillus species.
● Candida Infections: For treating invasive candidiasis, especially in immunocompromised patients.
● Fungal Infections in Immunocompromised Individuals: For patients undergoing organ transplants or with HIV/AIDS.
Dosage and Administration
● Adults: The typical starting dose is 6 mg/kg intravenously every 12 hours for the first 24 hours, followed by 4 mg/kg every 12 hours. Oral dosing is 200 mg every 12 hours.
● Pediatric Dosage: Adjusted based on age and weight, but typically the loading dose is 9 mg/kg/dose for the first 2 doses on day 1, followed by 4-8 mg/kg/dose every 12 hours. Maximum dose is 350 mg/dose.
Side Effects
● Common: Visual disturbances (blurred vision, changes in color perception), nausea, headache, and fever.
● Serious: Liver toxicity, hallucinations, and arrhythmias.
Pregnancy Category(Category D): Should be avoided during pregnancy as it can harm the fetus significantly.
Common Brands
● Vorier, Voritrol, Voritek.