Treatment of invasive aspargillosis 

LIST OF DRUGS DURING 2004

Most common- Abdominal pain, diarrhea, fever, headache, nausea, peripheral edema, rash, respiratory disorder sepsis, visual disturbances and vomiting

Most often adverse reactions that led to discontinuation are- elevated LFTs, rash and visual disturbances

Hypersensity to the drug Use caution while prescribing voriconazole to patients hypersentive to other azoles Coadm with CYP3A4 substrates eg, terfenadine, astemizole, cisapride, pimozide, quinidine, rifampicin, ergot alkaloids, ritonavir

Special precautions-

Visual disturbances- If treatment continues beyond 28 days, monitor visual function, including visual acuity, visual field and color preception

Hepatic toxicity- Hepatic reactions including hepatitis and jaundice have occured. Liver function is usually reversible on discontinuation of drug.

Galactose intolerance- Do not give tablets to patients with rare hereditary problems of galactose intolerance, glucose- galactose malabsorption

Renal toxicity- Acute renal failure has been observed in severly ill patients undergoing treatment with voriconazole

Arrhythmias and QT prolongation- Administer voriconazole with caution to patients with potentially proarrhythmic coditions

Pregnancy- Cause fetal harm when administered to pregnant women

Lactation- Breast feeding mothers should not use vorniconazole unless benefits clearly outweighs risk Children- Safety and efficacy in children less than 12 years have not been established

Treatment of invasive aspargillosis

Dosage-

Tabs should be taken 1 hour before or 1 hour after food Loading dose for firsyt 24 hours- 400mg every 12 hours ( over 40kg body weight ) or 200mg every 12 hours Maintenance - 200mg twice daily

1. Advice patients to take voriconazole tablets or suspn. at least 1 hour before or 1 hour after a meal

2. Advice patients not to drive at night while taking voroconazole . Voriconazole may cause changes to vison, including blurring and or/ photophobia

3. Advice patients to avoid potentially hazardous tasks such as driving, or operating machinery if they perceive any change in vision

4. Advice patients to avoid strong sun light during voriconazole therapy

5.Advice of child bearing potential to use effective contraception during treatment

6. Voriconazole for oral suspn. contains sucrose and is not recommended for patients with rare heriditary problems of fructose intolerance, sucrase isomaltase defeciency or glucose -galactose malabsorption

Tabs should be taken 1 hour before or 1 hour after food

Prenancy- Cause fetal harm when administered to pregnant women

Lactation- Breast feeding mothes should not use vorniconazole unless benefits clearly outweighs risk

Children- Safety and efficacy in children less than 12 years have not been established