Voriconazole

Serious infections voriconazole treats

Voriconazole is an antifungal for infections that need treating through the body rather than with a cream. It is used in adults and children from the age of two for invasive aspergillosis — a lung infection that can spread through the blood to other organs — for candidemia (a fungal infection in the blood), and for oesophageal candidiasis, a yeast infection that can leave white patches in the mouth and throat. It is also used for certain other fungal infections when other antifungals have not worked.

Aspergillus, the mould behind aspergillosis, is common indoors and outdoors, and most people who breathe in its spores come to no harm. The infection mainly takes hold in people whose immune defences are weakened or whose lungs are already damaged.

How it works

Voriconazole is a triazole, the same family as fluconazole and itraconazole. It blocks a step the fungus needs to build ergosterol, the substance that holds its cell membrane together. Without it the fungus cannot keep its outer wall intact and stops growing, which gives the body's own defences room to clear the infection.

Tablets are swallowed whole, usually twice a day, and a dose wants an hour's clear space before or after a meal. Keeping to roughly the same two times daily helps the levels stay steady. Courses often start with a vein injection in hospital and finish at home on tablets, taken in full even once fever and cough have gone.

What to expect while taking it

Vision changes are the effect people notice most: blurred sight, colours looking off, or bright light feeling harsh. They tend to appear early in a course and settle as it goes on. Headache, fever, nausea, vomiting and rash are also common, blood tests often pick up shifts in liver enzymes, and the skin becomes much more sensitive to sunshine, so sleeves and a hat outdoors are worth the trouble.

Some effects are more serious. Yellowing of the skin or eyes points to liver trouble, and a racing or irregular heartbeat needs urgent treatment. A spreading rash with blistering or peeling skin is a further serious effect.

Many medicines interact with voriconazole. Rifampicin, carbamazepine, phenytoin and St John's wort speed up the body's handling of it, so levels fall and treatment can fail; other drugs climb to unsafe levels when the two are combined. With a list this long, checking everything you take before the first dose saves trouble later. The tablets keep best in their original packaging in a dry cupboard.

Vfend 200mg tablets

Voriconazole is sold here as generic Vfend tablets, 200mg, and the same tablets are sold under the plain name Voriconazole too. Vfend is the brand name for the ingredient, and 200mg is the only strength in the range — the liquid suspension used in some hospitals is not stocked. Other fungal infection medicines are grouped under antifungals.