Voriconazole (Systemic)

Brand name(s): VFEND

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For voriconazole, the following should be considered:

Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to voriconazole or other azole antifungal (e.g., fluconazole [Diflucan], itraconazole [Sporanox], ketoconazole [Nizoral]). Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy-Voriconazole has been shown to cause fetal harm. Women should use effective contraception during treatment with voriconazole. However, this medicine may be needed in serious diseases or other situations that threaten the mother's life. Before taking this medicine, be sure your doctor knows if you are pregnant or plan to become pregnant.

Breast-feeding-It is not known whether voriconazole passes into breast milk. Voriconazole should not be used by nursing mothers unless the benefit outweighs the risk.

Children-Studies on this medicine have been done only in patients 12 and older, and there is no specific information comparing the use of voriconazole in children with use in other age groups.

Older adults-Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. Voriconazole is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking voriconazole, it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Alprazolam (e.g., Xanax) or
• Midazolam (e.g., Versed) or
• Triazolam (e.g., Halcion)- Voriconazole may increase the amount of these medicines in your body. Taking these medicines at the same time as voriconazole is not recommended.

• Amprenavir (e.g., Agenerase) or
• Nelfinavir (e.g., Viracept) or
• Saquinavir (e.g., Invirase)-Taking these medicines together with voriconazole can increase blood levels of either these medicines or of voriconazole.

• Astemizole (e.g., Hismanal) or
• Cisapride or
• Pimozide (e.g., Orap) or
• Quinidine or
• Terfenadine-Voriconazole may cause these drugs to remain in your body longer, which can lead to heart problems. Taking these medicines at the same time as voriconazole is not recommended.

• Barbiturates, long acting or
• Carbamazepine (e.g., Tegretol)-These medicines may decrease the amount of voriconazole in your body. Taking these medicines at the same time as voriconazole is not recommended.

• Calcium channel blockers (medicine for high blood pressure) such as:
• Felodipine (e.g., Plendil)-Using these medicines together with voriconazole can increase blood levels of these medicines. Your doctor may want to change the dose of your medicine.

• Cyclosporine or
• Tacrolimus (e.g., Prograf)-Using these medicines together with voriconazole can increase blood levels of these medicines.

• Efavirenz (e.g., Sustiva)-Taking this medicine with voriconazole is not recommended.

• Ergot alkaloids (e.g., Belladonna, Phenobarbital, Ergotamine tartrate)-Voriconazole may increase the blood levels of these medicines. Taking these medicines at the same time as voriconazole is not recommended.

• HMG CoA reductase inhibitors ("statins"), such as:
• Lovastatin (e.g., Mevacor)-Using these medicines with voriconazole may increase blood levels of the "statin" and increase your chance of side effects. Your doctor may change the amount of "statin" that you take.

• Methadone (e.g., Dolophine, Methadose)-Using this medicine with voriconazole may increase blood levels of methadone and increase your chance of serious side effects. Your doctor may change the amount of methadone you take.

• Rifabutin-Using this medicine with voriconazole may increase blood levels of rifabutin and decrease blood levels of voriconazole. Taking this medicine at the same time as voriconazole is not recommended.

• Rifampin-Using this medicine with voriconazole may decrease blood levels of voriconazole. Taking this medicine at the same time as voriconazole is not recommended.

• Ritonavir (e.g., Norvir)-Using this medicine with voriconazole may decrease blood levels of voriconazole. Taking this medicine at the same time as voriconazole is not recommended.

• Sirolimus (e.g., Rapamune)-Using this medicine with voriconazole may increase blood levels of sirolimus. Taking this medicine at the same time as voriconazole is not recommended.

• Warfarin (e.g., Coumadin)-Taking this medicine with voriconazole may increase your bleeding time. The dose of warfarin may need to be adjusted.

Other medical problems-The presence of other medical problems may affect the use of voriconazole. Make sure you tell your doctor if you have any other medical problems, especially:

• Hypersensitivity to voriconazole, other azole antifungal agents, or any of the ingredients in voriconazole.

Last Revised: 04/12/2005