Voriconazole (Vfend) is an azole antifungal. It's used in adults and children ages 2 years and older to treat serious fungal infections, including invasive aspergillosis (IA) and esophageal candidiasis (EC). If you have a serious infection that needs voriconazole (Vfend), your healthcare team will typically give you this medication as an intravenous infusion in a hospital setting first. Once your condition improves, they might switch you to voriconazole (Vfend) tablet or oral suspension that's taken by mouth every 12 hours. Some common side effects of voriconazole (Vfend) include vision changes, nausea, and rash.
Candidemia (candidiasis infection of the bloodstream)
Candidiasis infections that have spread to deep tissue areas, including stomach and wounds
Scedosporiosis and fusariosis fungal infections in people who can't take, or didn't respond well, to other treatment
Voriconazole (Vfend) is an azole antifungal medication that works by stopping the fungus from being able to make a protective covering. This causes the fungus to not grow or survive.
Source: DailyMed
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
Black, tarry stools
blistering, peeling, loosening of the skin
chills
difficulty seeing at night
increased sensitivity of the eyes to sunlight
itching, rash
joint or muscle pain
painful or difficult urination
red irritated eyes
red skin lesions, often with a purple center
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
trouble breathing
unusual bleeding or bruising
unusual tiredness or weakness
vision changes
Less common
Bloating or swelling of the face, arms, hands, lower legs, or feet
blurred vision
chills
clay-colored stools
confusion
dark urine
decreased urine
dizziness
faintness or lightheadedness when getting up suddenly from a lying or sitting position
feeling of warmth
increased thirst
irregular or pounding heartbeat
loss of appetite
muscle pain or cramps
muscle spasms or twitching
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
redness of the face, neck, arms, and occasionally, the upper chest
seizures
stomach pain
slow or fast heartbeat
sweating
trembling
unpleasant breath odor
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
Backache
blindness
blue-yellow color blindness
bone pain
darkening of the skin
decreased vision
facial hair growth in females
fainting
fractures
full or round face, neck, or trunk
increased urination
irritability
loss of sexual desire or ability
menstrual irregularities
mental depression
muscle wasting
vomiting
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
Headache
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.
Liquid suspension available for people who can't swallow tablets
Liquid suspension can be stored at room temperature
Possible option in children as young as 2 years old
Interacts with many medications, including omeprazole (Prilosec)
Can cause serious skin reactions, vision problems, and sensitivity to light
Tablets contain lactose, not a good choice for people who need to avoid lactose
Food affects how well voriconazole (Vfend) is absorbed into your body. Be sure to take voriconazole (Vfend) at least 1 hour before or 1 hour after a meal.
Take voriconazole (Vfend) exactly as prescribed. Make sure to finish your treatment course, even if you're feeling better. Stopping the medication earlier than prescribed can make your infection come back and become more difficult to treat.
Voriconazole (Vfend) can cause skin sensitivity to the sun. To protect your skin, make sure to wear a high-SPF sunscreen when going outside, wear long-sleeve clothing, and avoid being exposed to light or sun for a long time as much as possible. Contact a dermatologist if you notice any changes in your skin.
Voriconazole (Vfend) can cause vision changes, including blurry vision, changes to color vision, and sensitivity to light. This medication can also cause dizziness. Don't drive or operating machinery until you know how this medication affects you.
Let your prescriber know if you're lactose intolerant or have a dairy allergy because voriconazole (Vfend) contains lactose.
If you're able to become pregnant, you're recommended to use effective birth control during voriconazole (Vfend) treatment due to the risk of harm to babies. Talk to your healthcare professional about your options.
Voriconazole (Vfend) can interact with several medications, including warfarin (Coumadin), omeprazole (Prilosec), and statins. This isn't a complete list of everything that interacts with voriconazole (Vfend). Make sure to tell your pharmacist about all of the medications you take before and during treatment with voriconazole (Vfend).
Contact your prescriber if you develop other symptoms of an illness or if your symptoms become worse. This could be a sign that you're infected with a virus or bacteria instead of a fungus. If so, you'll need to a different medication than voriconazole (Vfend) because it's only used to treat certain fungal infections.
More tips for voriconazole (Vfend) 40 mg/mL oral suspension
Shake the voriconazole (Vfend) suspension bottle well for 10 seconds before measuring out and taking your dose. Only use the measuring device provided at the pharmacy. Don't use household spoons to measure your dose since this could cause you to take the wrong amount.
Never mix the voriconazole (Vfend) suspension with any other beverages, syrups, flavorings, or other medications. Take it exactly as it's supplied to you from the pharmacy. If the taste is bothersome, try drinking a citrus drink right after you take your dose to get rid of the bad taste.
Store voriconazole (Vfend) suspension at room temperature. The mixture is good for 2 weeks from the time the pharmacist mixes it for you. If you need to take voriconazole (Vfend) suspension for longer than 2 weeks, your pharmacist will dispense a new bottle of medication every 2 weeks. Make sure to discard the old bottle, even if there's still some medication left.
Voriconazole (Vfend) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Liver problems | Alcohol use | Current liver problems | Certain blood cancers | Children | Taking other medications that cause liver problems
Although rare, people who took voriconazole (Vfend) have developed liver problems. Because of this risk, your prescriber might order blood tests before you start and during treatment to check your liver function tests to make sure your liver is healthy. Also, it's recommended to limit or avoid alcohol because it can also cause liver damage. Get medical attention right away if you notice yellowing of your skin or the whites of your eyes; stool changes; dark or brown urine; swelling of your stomach; stomach pain; or confusion. Your prescriber might ask you to stop taking voriconazole (Vfend) in order to prevent further liver damage.
Risk factors: Low blood potassium or magnesium levels | Older age | Kidney problems | History of heart problems, slow heart rate, or other abnormal heart rhythms (arrhythmias) | Personal or family history of long QT syndrome | Taking other medications that cause QT prolongation
Voriconazole (Vfend) can affect your heart rhythm, which can be serious and life-threatening. One example includes lengthening the time period from when the heart pumps and then relaxes. This is known as QT prolongation. Your risk is higher if you have certain factors, including abnormal electrolyte levels, heart rhythm problems, or are taking other medications that cause heart rhythm problems, such as amiodarone (Pacerone) and ciprofloxacin (Cipro), among others. To lower your risk, your prescriber might periodically monitor your heart and perform electrocardiograms (ECGs) to make sure your heart rhythm is normal. If you feel your chest pounding, have trouble breathing, have chest pain, or feel faint or lightheaded while taking voriconazole (Vfend), call 911 right away.
Risk factors: Taking voriconazole (Vfend) longer than 28 days
Voriconazole (Vfend) can cause blurred vision, changes in eyesight, and sensitivity to light. Your risk is higher if you take voriconazole (Vfend) for longer than 28 days. Schedule an eye exam with your optometrist if you are going to be taking voriconazole (Vfend) for more than 28 days or if you notice any major changes to your vision while using this medication. Avoid driving at night and wear sunglasses if bright lights bother you while taking this medication. If this side effect is bothersome that you can't continue your usual daily activities, contact your prescriber.
Severe allergic reactions to voriconazole (Vfend) are possible, including life-threatening reactions like facial swelling, hives, and anaphylaxis (e.g., closing of the throat). If you notice difficulty breathing; a choking sensation; dizziness; fast heartbeat; nausea; or swelling around your eyes, lips, or tongue after taking voriconazole (Vfend), get medical attention right away.
Very rarely, voriconazole (Vfend) can cause Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or drug reaction with eosinophilia and systemic symptoms (DRESS). If you notice changes in your skin, such as rash, blisters, or skin reddening or peeling, and have a fever and swollen lymph nodes, seek medical help right away.
Voriconazole (Vfend) makes your skin more sensitive to the sun and ultraviolet (UV) light. This means you can get sunburns more easily than usual. This can happen even during the winter and on overcast days. To lower your risk, make sure to wear a high-SPF sunscreen when going outside and wear long-sleeved clothing to protect your skin. Also avoid being exposed to light or sun for a long time.
Voriconazole (Vfend) should be avoided during pregnancy due to the potential for severe development problems in babies. If you're able to get pregnant, it's recommended to use birth control while taking voriconazole (Vfend). Let your prescriber know right away if you're pregnant or thinking of becoming pregnant.
Some people taking azole antifungals like voriconazole (Vfend) have reported low adrenal hormone levels. Symptoms include tiredness, dizziness, and nausea. Tell your prescriber if you have these symptoms.
Risk factors: Recent chemotherapy | Recent stem cell transplant
Pancreatitis (inflammation of the pancreas) has been reported by people who took voriconazole (Vfend). If you experience stomach pain, nausea, vomiting, tingling in your arms, legs, hands, or feet, or yellowing of the whites of your eyes or skin, tell your prescriber so you can be checked for these problems.
Risk factors: Long-term use of voriconazole (Vfend)
Long-term use of voriconazole (Vfend) can sometimes cause bone problems or discolored teeth. While both of these reactions can be mild and temporary, if left untreated, they can become very painful or damaging. Let your prescriber know right away if you experience any bone pain or discoloration in your teeth. You'll likely need to stop taking voriconazole (Vfend).
People who take voriconazole (Vfend) have reported kidney problems. But it's unclear whether this was caused by voriconazole (Vfend) or by other medications. Your healthcare team might order lab work to check on your kidney health from time to time.
Voriconazole (Vfend) is available as a tablet and oral suspension that are taken by mouth (oral) and an injection that's given as an infusion through the veins (IV).
For serious infections, your care team will give you voriconazole (Vfend) IV infusion in a hospital setting for at least a week before switching you to the oral forms of voriconazole (Vfend).
Adults and children ages 15 years or older:
Aspergillosis, scedosporiosis, and fusariosis: The typical starting dose is 6 mg/kg IV every 12 hours for two doses, then 4 mg/kg IV every 12 hours. Once your condition improves and you're able to take medications by mouth, your care team might switch you to oral voriconazole (Vfend) 200 mg by mouth every 12 hours.
Candidiasis in the bloodstream or deep tissue: The typical starting dose is 6 mg/kg IV every 12 hours for two doses, then 3–4 mg/kg IV every 12 hours. Once your condition improves and you're able to take medications by mouth, your care team might switch you to oral voriconazole (Vfend) 200 mg by mouth every 12 hours.
Candidiasis in the esophagus: The typical dose is 200 mg by mouth every 12 hours.
Children (ages 2 to under 12 years, and ages 12 to under 15 years who weigh less than 50 kg):
Aspergillosis, candidiasis in the bloodstream or deep tissue, scedosporiosis, and fusariosis: The typical starting dose is 9 mg/kg IV every 12 hours for two doses, then 8 mg/kg IV every 12 hours. Once your child's condition improves and they're able to take medications by mouth, their pediatrician might switch them to oral voriconazole (Vfend) 9 mg/kg (up to 350 mg) by mouth every 12 hours.
Candidiasis in the esophagus: The typical dose is 9 mg/kg (up to 350 mg) by mouth every 12 hours.
Your prescriber will adjust your dose based on different factors, such as your liver health and how well voriconazole (Vfend) is treating your infection.
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.
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.
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.
Taking pimozide, quinidine, ivabradine (Corlanor), sirolimus (Rapamune), rifampin (Rifadin), carbamazepine (Tegretol), long-acting barbiturates, St. John's Wort, rifabutin (Mycobutin), ergot alkaloids, naloxegol (Movantik), tolvaptan (Samsca, Jynarque), or lurasidone (Latuda)
Taking efavirenz 400 mg or higher every 24 hours
Taking ritonavir (Norvir) 400 mg every 12 hours
Taking venetoclax (Venclexta) with voriconazole (Vfend) at starting and ramp-up phases in people with CLL or SLL due to the risk of tumor lysis syndrome
Candidemia (candidiasis infection of the bloodstream)
Candidiasis infections that have spread to deep tissue areas, including stomach and wounds
Scedosporiosis and fusariosis fungal infections in people who can't take, or didn't respond well, to other treatment
Prevention of serious fungal infections caused by Candida and Aspergillus
Treatment of serious Aspergillus infection - tablets only
Treatment of oral thrush of the mouth and throat - liquid suspension only
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