Voriconazole is indicated for the following infections caused by susceptible species of fungi-

• Invasive aspergillosis.
• Candidaemia
• Candida infections (including C. krusei).
• Fungal infections caused by Scedosporium spp. and Fusarium spp.

Candidaemia

Aspergillosis

Candidiasis

• Voriconazole is available as tablets, suspension and IV infusion.
• Intravenous dose: The loading dosage regimen is 6mg/kg every 12 hours for the first 24 hours. The maintenance dose is 4mg/kg twice daly.
• Oral dose: The recommended loading dose for patients over 40kg is 400 mg every 12 hours with a maintenance dose of 200mg twice daily. For patients under 40kg, the dosage is to be reduced by half.

How to reconstitute voriconazole suspension:

Powder For Suspension

Commonly associated side effects of voriconazole include-

• Headache
• Visual impairment
• Edema
• Respiratory problems
• Diarrhea
• Vomiting
• Nausea
• Rash

Headache	Visual Disorder	Edema
Nausea	Rash	Diarrhea

• Voriconazole should be administered with caution to patients with potentially proarrhythmic conditions, such as:
• • Congenital or acquired QTc prolongation.
  • Cardiomyopathy, in particular when heart failure is present.
  • Sinus bradycardia.
  • Existing symptomatic arrhythmias
• There have been occurrences of significant hepatic problems with voriconazole administration in clinical studies (including clinical hepatitis, cholestasis and fulminant hepatic failure, including fatalities). Patients with substantial underlying medical issues were more likely to experience hepatic responses (predominantly haematological malignancy). Patients with no additional known risk factors have experienced transient hepatic responses such as hepatitis and jaundice. When therapy is stopped, liver impairment is usually reversible.
• Phototoxicity has been linked to voriconazole, with symptoms such as ephelides, lentigo, actinic keratosis, and pseudoporphyria being reported. During voriconazole treatment, it is recommended that all patients, including children, avoid direct sunlight and use protective clothes and sunscreen with a high sun protection factor (SPF).