Vfend (voriconazole)

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Visual disturbances.

Fever.

Skin reactions such as rash or itch.

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.

Headache.

Swelling of the legs and ankles due to fluid retention (peripheral oedema).

Flushing and nausea during infusion.

Weakness.

Chest or back pain.

Respiratory distress syndrome.

Hair loss.

Low blood pressure.

Dizziness.

Hallucinations.

Confusion.

Depression.

Anxiety.

Tremor.

Pins and needles sensations.

Liver or kidney disorders.

Disturbances in the components of the blood.

Abnormal heart beats.

Inflammation of the pancreas (pancreatitis) in children.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

This medicine must not be used in combination with any of the following medicines:

astemizole

carbamazepine

cisapride

dihydroergotamine

ergotamine

phenobarbital

pimozide

quinidine

rifampicin

high doses of ritonavir (400 mg and above twice daily)

sirolimus

terfenadine

the herbal remedy St John's wort (Hypericum perforatum).

This medicine should be avoided in people taking low dose ritonavir (100 mg twice daily), unless your doctor considers the benefits to outweigh the risks. This is because ritonavir decreases the blood level of voriconazole and could make it less effective at treating infection.

This medicine may increase the blood level of the immunosuppressants ciclosporin and tacrolimus. If you are taking ciclosporin or tacrolimus when you start this medicine your doctor should decrease your dose to prevent side effects from the immunosuppressant. The level of ciclosporin or tacrolimus in your blood should be monitored after starting and stopping treatment with this medicine.

This medicine may increase the anti-blood-clotting effect of anticoagulants such as warfarin. If you are taking an anticoagulant medicine your blood clotting time (INR) should be monitored while taking this medicine.

This medicine may increase the blood level of sulphonylurea medicines, such as tolbutamide, glipizide, glyburide, that are used to treat type 2 diabetes. This could cause blood sugar to fall (hypoglycaemia). People taking any of these medicines should therefore carefully monitor their blood sugar during treatment with this medicine.

This medicine may increase the blood level of methadone. If you are taking methadone when you start this medicine your doctor may need to reduce your methadone dose in order to avoid side effects.

This medicine may increase the blood level of hormones from oral contraceptives containing ethinylestradiol and norethisterone. It should not make these contraceptives any less effective, but may increase the chance of getting side effects like nausea or changes in your bleeding.

This medicine may also increase the blood levels of the following medicines. As this could increase the chance of their side effects, your doctor may need to reduce the dose of these medicines if you are taking any of them when you start treatment with voriconazole:

benzodiazepines such as triazolam and midazolam

statins such as simvastatin

vincristine

vinblastine

omeprazole.

Phenytoin and rifabutin decrease the blood level of voriconazole. Conversely, voriconazole may increase the blood levels of these medicines. These combinations should be avoided where possible, but if considered necessary your doctor will prescribe you a higher than normal dose of voriconazole and monitor you for side effects of the other medicine.

The anti-HIV medicine efavirenz also decreases the blood level of voriconazole, while its blood level is increased by the voriconazole. As a result, if you are taking efavirenz you will be prescribed a higher than normal dose of voriconazole. In addition, your dose of efavirenz will be decreased during the treatment and then increased again once your course of voriconazole is finished.

If you are taking other anti-HIV medicines, such as protease inhibitors, your doctor will want to monitor you carefully for any new side effects if you are also prescribed this medicine.

There may be an increased risk of abnormal heart rhythms (prolonged QT interval on the heart monitoring trace or ECG) if this medicine is taken with the following:

medicines to treat abnormal heart rhythms, eg amiodarone, procainamide, disopyramide, sotalol

certain antidepressants, eg maprotiline, amitriptyline, imipramine

certain antipsychotics, eg thioridazine, chlorpromazine, sertindole, haloperidol

antimalarials, eg halofantrine, chloroquine, quinine, Riamet

certain antimicrobials, eg erythromycin, moxifloxacin or pentamidine.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain voriconazole as the active ingredient.

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