Vfend (voriconazole)

How does it work?

Vfend infusion, tablets and oral suspension contain the active ingredient voriconazole, which is a type of medicine called a triazole antifungal. It is used to treat infections caused by fungi.

Voriconazole works by preventing fungi from producing a substance called ergosterol, which is a component of fungal cell membranes.

The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. Without ergosterol as part of the cell membrane, the membrane is weakened and damaged, and essential constituents of the fungal cells can leak out. This kills the fungi and hence clears up the infection.

Voriconazole is used to treat serious fungal infections, including those caused by Candida, Aspergillus, Scedosporium and Fusarium species of fungi. To make sure the fungi causing an infection are susceptible to voriconazole your doctor may take a tissue sample, for example a swab from the throat or skin, or a urine or blood sample.

Voriconazole is usually reserved as treatment for progressive infections in people whose immune systems are underactive, for example due to cancer treatment, AIDS, or following an organ transplant. Serious fungal infections can sometimes be life-threatening in these groups of patients.

What is it used for?

Serious fungal infections, primarily in people with progressive and possibly life-threatening infections.

Warning!

Vfend tablets should be taken at least an hour before, or an hour after a meal. Vfend suspension should be taken at least an hour before, or two hours after a meal.

Before starting treatment with this medicine you should have a blood test to measure the levels of electrolytes (salts, such as potassium, calcium and magnesium) in your blood. If there are any problems your doctor will give you treatment to correct them before you start this medicine.

This medicine may cause visual disturbances such as blurred vision and so may affect your ability to drive or operate machinary safely. Do not drive or operate machinary until you know how this medicine affects you.

This medicine can make your skin more sensitive to sunlight. For this reason you should avoid exposing your skin to direct sunlight or sun lamps during treatment. Tell your doctor if you get a rash while taking this medicine.

This medicine can sometimes cause liver problems and for this reason your liver function will be monitored during treatment. Tell your doctor if you experience any of the following symptoms while taking this medicine, as they may suggest a problem with your liver: unexplained itching, loss of appetite, nausea and vomiting, abdominal pain, yellowing of the skin or whites of the eyes (jaundice), unusually dark urine or pale stools.

Your kidney function should also be monitored during treatment with this medicine.

Unless your doctor tells you otherwise, it is important that you finish the prescribed course of this antifungal medicine, even if you feel better or it seems the infection has cleared up. Stopping the course early increases the chance that the infection will come back and that the fungi will grow resistant to the medicine.

Use with caution in

Allergy to other azole antifungal medicines, eg fluconazole, itraconazole.

Decreased liver function.

Liver cirrhosis.

Low level of potassium in the blood (hypokalaemia).

People, particularly children, at risk of inflammation of the pancreas (acute pancreatitis).

People who have recently received cancer chemotherapy, particularly that which could have side effects on the heart.

Any long term disorder affecting the muscle of the heart (cardiomyopathy).

Heart failure.

Irregular heart beats (arrhythmias).

Abnormal rhythm of the heart beat (prolonged QT interval on a heart monitor or ECG).

People taking medicines that can cause prolonged QT interval on an ECG (see end of factsheet for examples).

Slow heart rate caused by the pacemaker of the heart (sinus bradycardia).

Not to be used in

Breastfeeding.

People taking certain other medicines - see end of factsheet for more details.

Vfend tablets contain lactose and are not suitable for people with rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption.

Vfend suspension contains sucrose and is not suitable for people with rare hereditary problems of fructose intolerance, sucrase-isomaltase deficiency or glucose-galactose malabsorption.

This medicine is not recommended for children under two years of age, as its safety and effectiveness have not been studied in this age group.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine in pregnancy has not been established. It should therefore not be used during pregnancy, unless the benefits to the mother outweigh any possible risks to the developing baby. Women who could get pregnant should use effective contraception to avoid getting pregnant while they are taking this medicine. Seek medical advice from your doctor.

It is not known if this medicine passes into breast milk. Mothers who need to take this medicine should not breastfeed their infants during treatment. Seek medical advice from your doctor.

Label warnings

Avoid exposure of skin to direct sunlight or sun lamps.

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