Voriced
(Voriconazole 200mg Vial & 200mg Tablets)
INDICATIONS, ADMINISTRATION AND DOSAGE
| Indications | Loading Dose Regimen (first 24 hours) | Maintenance Dose (after first 24 hours) | ||||
|---|---|---|---|---|---|---|
| IV | Oral | IV | Oral | |||
| Patients ≥ 40 kg | Patients < 40 kg | Patients ≥ 40 kg | Patients < 40 kg | |||
| Invasive Aspergillosis | 6 mg/kg BID | 400 mg BID | 200 mg BID | 4 mg/kg BID | 200 mg BID | 100 mg BID |
| Candidemia* and Invasive Candidiasis** | 6 mg/kg BID | 400 mg BID | 200 mg BID | 3-4 mg/kg BID | 200 mg BID | 100 mg BID |
Duration of Therapy: Depends upon the patient's clinical and mycological response. Patients with candidemia should be treated for at least 14 days following resolution of symptoms or following last positive culture, whichever is longer.
American Thoracic Society Guideline: Treatment of Fungal Infections in Adult Pulmonary and Critical Care Patients
Initial Recommended Therapy for Pulmonary Aspergillus Infection
| Disease Manifestation | Treatment Recommendation |
|---|---|
| Invasive Aspergillosis | Primary therapy: IV Voriconazole (6 mg/kg every 12 h for 1 d, followed by 4 mg/kg every 12 h) until improvement, followed by oral Voriconazole (200 mg every 12 h) or oral Itraconazole (400- 600 mg/d) until resolution or stabilization of all clinical and radiographic manifestations |
| Chronic necrotizing ("semi-invasive") Pulmonary Aspergillosis | For mild to moderate disease: Voriconazole (200 mg every 12 h) or Itraconazole (400-600 mg/d) until resolution or stabilization of all clinical and radiographic manifestations. If clinically severe consider beginning with either IV Voriconazole or liposomal Amphotericin B as described above for invasive disease. Consider surgical resection |
Initial Recommended Therapy for Candidemia
| Disease Manifestation | Treatment |
|---|---|
| Candidemia, clinically unstable & unknown species | Voriconazole (6 mg/kg/12 h x 2, then 3 mg/kg/12 h) |
Treatment Recommendations for other Rare Fungi
| Fungus | Primary Therapy |
|---|---|
| Paecilomyces/Trichosporon | Voriconazole |
| Fusarium | Voriconazole |
| Scedosporium apiospermum | Voriconazole (200 mg IV or orally twice daily) |
| Phaeohyphomycosis | Voriconazole (200 mg orally twice daily) |