In 1 tablet voriconazole 50 mg and 200 mg. Lactose monohydrate, starch, magnesium stearate, croscarmellose sodium, povidone, as excipients.
In 1 ml of suspension voriconazole 40 mg
In 1 bottle voriconazole lyophilisate 200 mg
50 mg and 200 mg coated tablets.
Powder for suspension with a measuring spoon and syringe.
Lyophilisate for the preparation of an infusion solution of 200 mg.
Pharmacodynamics and pharmacokinetics
Antifungal drug group triazoleshaving a wide spectrum of action. The mechanism of action is associated with inhibition of biosynthesis ergosterolneeded to build a fungal cell. The antifungal activity of the drug includes all strains Candida spp.strainsAspergillus spp., as well as Scedosporium sppwhich are practically not sensitive to other antifungal agents.
Effective in infections caused by Alternaria spp., Blastomyces dermatitidis, Cladosporium spp., Blastoschizomyces capitatus, Coccidioides immitis, Cryptococcus neoformans, Conidiobolus coronatus, Exserohilum rostratum, Fonsecaea pedrosoi, Exophiala spinifera, Madurella mycetomatis, Penicillium spp., Paecilomyces lilacinusstrainsAcremonium spp., Bipolaris spp., Alternaria spp., Histoplasma capsulatum, Cladophialophora spp. The growth of the strains was suppressed at concentrations of 0.05 - 2 μg / ml.
Fully absorbed by ingestion. Bioavailability is 96%. Cmax in the blood is determined after 1-2 hours. When taken with fatty foods, Cmax is reduced by 34%. Absorption does not depend on the acidity of the gastric contents. It is actively distributed in tissue and is determined in cerebrospinal fluid. Binding to proteins - 58%.
Metabolized by isoenzymes cytochrome P450. Enzyme CYP2C19 plays an important role in this, but has a genetic polymorphism (decreased metabolism in 20% of Asians). The main metabolite (72% among all metabolites) is N-oxide. It has a slight antifungal activity. With urine in an unchanged form, 2% of the dose is excreted, and most of it within 96 hours after application of the drug. The half-life is 6 hours.
Indications for use
- esophageal candidiasis;
- invasive aspergillosis;
- candidaemia Without neutropenia;
- invasivecandidiasis severe course;
- fungal infections that are caused Fusarium spp. and Scedosporium spp.;
- severe invasive infections with intolerance to other antifungal drugs;
- relapse prevention of fungal infections leukemiadecreased immune system function, neutropenia, after stem cell transplantation.
- simultaneous use with terfenadine, cisapride, astemizole, quinidine;
- simultaneous use with sirolimus, rifampicin, carbamazepine;
- sharing with ergot alkaloids;
With caution is prescribed for severe hepatic and renal failure, in children under 2 years of age, since the safety of use has not been established.
Common adverse reactions:
- visual disturbances ("veil" before the eyes, photophobia);
- rash (maculopapular, papular, macular), itchy skin, alopecia, dermatitis, erythema;
- sinusitisflu-like syndrome;
- cheilitis, gastroenteritis;
- vomiting diarrheanausea
- cholecystitisenlarged liver;
- abdominal pain;
- peripheral edema;
- chest pain;
- pulmonary edema;
- respiratory failure;
- decline HELL;
- hallucinations, depressionanxiety;
- thrombophlebitis, phlebitis;
- pancytopenia, leukopenia, thrombocytopenia, anemia;
- increase in concentration creatinine;
- hypokalemia, hypoglycemia;
- increased activity ACT, Ajit.
Less common adverse reactions:
- ventricular fibrillation, atrial arrhythmia, ventricular extrasystole;
- cerebral edema;
- hypertonicity, nystagmus;
- cramps, encephalopathy;
- hepatic encephalopathy;
- peripheral neuropathy;
- scleritis, diplopia, blepharitis;
- optic atrophy;
- vertigo, noise in ears;
- constipation, gingivitis, pancreatitis, pseudomembranous colitis;
- agranulocytosis, eosinophilia;
- hyperthyroidism, hypothyroidism.
Vfend, instructions for use (Method and dosage)
Treatment begins with intravenous administration, and after clinical improvement, they switch to oral forms of the drug. The effect of the drug with intravenous administration is two times higher than when taken orally in the same dose. Treatment is carried out under strict medical supervision.
Vfend tablets should be taken orally 1 hour before or 1 hour after a meal. Adults are prescribed on the first day in a saturating dose - 400 mg every 12 hours for patients weighing more than 40 kg and 200 mg every 12 hours for a patient weighing less than 40 kg. Maintenance doses for all diseases are 200 mg every 12 hours in patients weighing more than 40 kg. In this case, it is more advisable to prescribe Vfend 200 mg.
Patients weighing less than 40 kg take 100 mg of the drug every 12 hours. The maintenance dose can be increased to 300 mg and, accordingly, up to 150 mg, depending on the weight of the patient. If there is poor tolerability of the drug in this dose, it is reduced again to 200 mg (or 100 mg) and taken every 12 hours.
The Vfend suspension is prepared by adding 46 ml of water to the powder in two divided doses. Water is measured with a measuring cup. Then shake the bottle well to obtain a suspension. The finished suspension is valid for 14 days, so the final shelf life should be noted on the bottle. Shake well before use for 10 seconds. Using a measuring syringe, measure the required amount for admission: 5 ml of the suspension contains 200 mg voriconazole, respectively, in 2.5 ml - 100 mg. This is a maintenance dose for all diseases, which is taken every 12 hours, depending on the weight of the patient - 5 ml or 2.5 ml.
If the doctor believes the dose is ineffective, it increases to 7.5 ml of suspension (300 mg) for patients weighing more than 40 kg or 3.75 ml (150 mg) for patients weighing less than 40 kg. The duration of oral treatment depends on the results of mycological studies, but in general should not exceed 6 months.
Prophylactic administration of the drug after transplantation begins on the day of its conduct and lasts up to 3 months. In rare cases, prophylaxis is extended to 6 months if performed. immunosuppressive therapy or a graft versus host reaction develops. The dosage regimen for prevention is the same as for treatment.
Overdose cases were observed in children who were administered a dose that was five times the recommended dose. Antidote not known. In case of an overdose of the drug taken orally, gastric lavage is performed, symptomatic therapy is indicated. The active substance is removed when hemodialysis.
The level of active substance in the blood is significantly reduced when used with rifampicin and carbamazepinethat are contraindicated to prescribe.
A slight interaction is noted, and dose adjustment is not required when applied withcimetidine and ranitidine. No significant impact erythromycin and azithromycin.
Voriconazole can significantly increase the concentration of metabolized substances CYP450 isoenzymes: terfenadine, cisapride, astemizole, pimozideergot alkaloids,sirolimus and quinidine, therefore, use these drugs simultaneously with voriconazole contraindicated.
When using the following drugs with voriconazole dose adjustment is necessary in terms of reduction, since it increases the concentration of these drugs in plasma: cyclosporin, tacrolimus, warfarin, fenprokumon, acenocoumarolderivatives sulfonylureas, lovastatin, benzodiazepines, vincristine and vinblastine.
No significant interaction with the following drugs was detected: prednisone, digoxin, mycophenolic acid.
Phenytoin reduces Max Vfend, and the latter raises Max phenytointherefore, at their simultaneous use level determination is recommended phenytoin.
Rifabutin reduces Max active substance. If there is a need for joint use, then a maintenance dose of Vfend is necessary from 200 mg to 350 mg. Dose omeprazole It is recommended to halve. Indinavir no significant effect.
Terms of sale
Temperature up to 25 ° С.
Tablets 3 years.
Vfend analogsMatches for ATX Level 4 code:MedofluconItraconMycosystIruninMycomaxOrungalMycoflucanFluconazoleSporagedOrungamineFlucostatDifluzoleRumycosisFutsisVero-FluconazoleCandizoleCandidralItraconazoleDiflason
Voriconazole Canon, Voriconazole Teva, Wikand, Biflurin.
Reviews about Vfend
Vfend® is a first-line drug for treatment invasive aspergillosisthat develops in individuals receiving immunosuppressive therapy at granulomatous and myelomain patients with acute leukemia. Invasive mycoses are a fairly common complication after allogeneic organ transplantationtherefore, adequate prophylaxis is necessary, which is a condition for successful allotransplantation.
Studies have shown that the use of the drug for primary prevention in these patients is effective and safe. Voriconazole has great effectiveness against fungi of the genusAspergillus compared with itraconazole, has less toxicity, greater oral bioavailability. Also often used HIV infected at esophageal candidiasis and patients with refractory fungal infections. This is reflected in the reviews - everyone notes that the treatment is effective and takes a long time.
- "... The child has acute lymphoblastic leukemia. Chemotherapy courses were conducted, after which it was weakened, a fungal infection in the lungs developed. The treatment is very long and very expensive. Vfend took over four months".
- "... My daughter has acute myeloid leukemia. The disease was severe and a complication - a fungal infection of the lungs. We take it for half a year already and they said the same. The treatment is very expensive".
- "... I have Hodgkin's lymphoma. Transferred 12 courses of chemistry, after an autologous transplant. In connection with the development of pulmonary aspergillosis, he took this drug. After 5 months of taking a negative aspergillosis test".
- "... After undergoing chemotherapy courses, aspergillosis developed. I took the drug 3 months before receiving negative tests".
- "... The child has non-Hodgkin's lymphoma, he underwent 3 courses of treatment. Vfend has been taking all this time".
Vfend price, where to buy
At the moment, you can buy Vfend in the pharmacy network of Moscow, St. Petersburg, Kemerovo, Chelyabinsk, Novokuznetsk, Tomsk, where all forms of the drug are presented: 200 mg tablets No. 14 worth 21800-25221 rubles., The cost of 1 bottle of powder for suspension is 34413 rub., And 1 bottle of lyophilisate for infusion - 5690-6108 rub.
- Online Pharmacies in Russia
- Online pharmacies in UkraineUkraine
- Vfend tab. p.p.o. 200mg n14Pfizer Italy S.R.L. / R-Pharm Germany GmbH, 29128 rub.order
- Vfend 200 mg N1 powder Fareva Amboise, France 3928 UAH.order
- Vfend 200 mg N14 tablets R-Pharm Germani GmbH, Nimechchina 14 712 UAH.
- Vfend tablets Vfend tablets 200mg No. 14 Germany, R-Pharm Germany GmbH 14690 UAH order
- Vfend infusion Vfend powder for solution for infusion 200mg bottle No. 1 France, Fareva Amboise 3680 UAH order