Vorifix 200 - Tablet Voriconazole - 200mg 10 Tablet(s) / Box NIPRO JMI Pharma Limited Introduction: Vorifix 200 belongs to a group of medicines called antifungals. It works by stopping the growth of fungus and is used to treat a wide range of fungal infection. It kills fungi by destroying the fungal cell membrane. Vorifix 200 should be taken in the dose and duration as prescribed by your doctor. It should be swallowed whole. It should be taken one hour before or one hour after a meal. The dosage and length of treatment will depend on the condition you are being treated for. Sometimes this will be in cycles of use and non-use. To get the... Uses of Vorifix 200: Severe fungal infections Side effects of Vorifix 200: Abnormal liver function testsHallucinationSlow heart rateAltered visionHeadacheNauseaRashVomiting How to use Vorifix 200: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Vorifix 200 is to be taken empty stomach. How Vorifix 200 works: Vorifix 200 is an antifungal medication. It kills and stops the growth of the fungi by destroying its cell membrane, thereby treating your skin infection. Indication: Candidemia, Deep tissue Candida infections, Invasive aspergillosis, Scedosporiosis and Fusariosis Administration: Should be taken on an empty stomach. Take at least 1 hr before or after meals. Infuse IV over 1-2 hr, not to exceed 3 mg/kg/hr Adult Dose: Adult Invasive Aspergillosis, Candidemia, Serious Fungal Infections 6 mg/kg IV q12hr for first 24 hours, then 4 mg/kg IV q12hr or 200 mg PO q12hr Esophageal Candidiasis Candida albicans, Candida glabrata, Candida krusei 200 mg PO q12hr Hepatic impairment: Mild to moderate (Child-Pugh category A and B): Standard loading dose but maintenance doses should be reduced by 50%. Child Dose: 12 years Invasive Aspergillosis, Candidemia, Serious Fungal Infections 6 mg/kg IV q12hr for first 24 hours, then 4 mg/kg IV q12hr or 200 mg PO q12hr Esophageal Candidiasis Candida albicans, Candida glabrata, Candida krusei 200 mg PO q12hr Contraindication: Hypersensitivity. Co-admin w/ CYP3A4 substrates, terfenadine, astemizole, cisapride, pimozide, quinidine, rifampicin, carbamazepine, long-acting barbiturates (e.g. phenobarbital, mephobarbital), ergot alkaloids (e.g. ergotamine and dihydroergotamine), efavirenz (≥400 mg once daily), ritonavir (≥400 mg bid), sirolimus, rifabutin, St John's wort. Mode of Action: Voriconazole is a triazole antifungal agent which inhibits cytochrome P450-dependent enzymes thereby inhibiting ergosterol synthesis in fungal cell membranes. It has a broad spectrum of activity against all Candida spp. including strains resistant to fluconazole), Aspergillus spp., Scedosporium spp., and Fusarium spp. Precaution: Patient w/ potentially proarrhythmic conditions, risk for acute pancreatitis. Correct electrolyte disturbances e.g. hypokalaemia, hypomagnesaemia and hypocalcaemia prior to treatment. Hepatic and renal impairment. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Avoid intense or prolonged exposure to direct sunlight. Monitoring Parameters Monitor hepatic (prior and during treatment) and renal (during treatment) function, serum electrolytes, visual and pancreatic function. Lactation: Not known if excreted in breast milk, a decision should be made whether to discontinue nursing or drug; weigh risk/benefit Side Effect: >10% Visual changes (photophobia, color changes, increased or decreased visual acuity, or blurred vision occur in 21%) 1-10% Tachycardia,Hypertension,Hypotension,Vasodilation,Peripheral edema,Fever,Chills,Headache,Hallucinations,Dizziness,Rash,Pruritus,Photosensitizing skin reactions,Hypokalemia,Hypomagnesemia,Nausea,Vomiting,Abdominal pain,Diarrhea,Xerostomia,Thrombocytopenia,Alkaline phosphatase increased,Serum transaminases increased, ALT/AST increased,Cholestatic jaundice,ARF Interaction: Increased prothrombin time w/ oral anticoagulants. May increase plasma concentrations of ciclosporin and tacrolimus, long-acting opiates (e.g. oxycodone, methadone), NSAIDs (e.g. ibuprofen, diclofenac), omeprazole, short-acting opiates (e.g. alfentanil, fentanyl). Decreased voriconazole plasma concentration and increased phenytoin plasma concentrations when used concomitantly. May increase plasma concentration w/ oral contraceptives. Potentially Fatal: May increase risk of QT prolongation or torsades de pointes w/ astemizole, cisapride, pimozide, quinidine and terfenadine. May increase risk of ergotism w/ ergot alkaloids (e.g. ergotamine and dihydroergotamine). May significantly increase plasma concentrations of sirolimus. Decreased plasma concentrations w/ rifampicin, carbamazepine, long-acting barbiturates (e.g. phenobarbital, mephobarbital), efavirenz (?400 mg...