항생제
Voriconazole

Voriconazole

제한된

Low
Excellent

Spectrum Of Activity

General Information

Candida infections both mucocutaneous and invasive (i.e. Candidemia).

Antifungal prophylaxis in immunocompromised patients.

Monitor renal function, especially serum creatinine.

Obtain fungal cultures and other relevant laboratory studies such as histopathology prior to therapy.

Assess visual function if used beyond 28 days.

Monitor serum transaminase levels, bilirubin, serum trough concentrations, and hepatic function.

Common

  • Diarrhea
  • Nausea
  • Vomiting
  • Hypokalemia
  • Headache
  • Fever

Serious

  • Prolonged QT interval
  • Torsades de pointes
  • Cholestasis (rare)
  • Liver failure (rare)

Contraindications:

  • Alkaloids (including ergotamine and dihydroergotamine)
  • HMG-CoA reductase inhibitors
  • CY3A4 substrates
  • Sirolimus
  • QT interval prolonging drugs
  • CYP450 interactions ++

Review of patient medications due to high frequency of significant interactions.

Antimicrobial class: Antifungal, 2nd Generation Triazole

Pregnancy category: D

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor

Precautions:

  • Avoid IV formulation in patients with moderate or severe renal impairment (ie, CrCl <50 mL/min) unless benefits justify use.
  • Use cautiously in patients with hypersensitivity to other azole antifungal agents.
  • Pediatric patients at increased risk for phototoxic reactions; monitoring recommended.
  • Monitoring recommended for liver enzyme elevations and hepatic reactions.
  • Do not administer tablets to patients with galactose intolerance.
  • If phototoxic reactions occur, refer patient to dermatologist and consider discontinuation of therapy.