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Formulas

Voriconazole 20 mg/ml Oral Liquid

Voriconazole 20 mg/ml Oral Liquid is a specially compounded medication designed for oral use, offering a precise and accessible means of administering the antifungal agent voriconazole. This liquid formulation is particularly beneficial for patients who have difficulty swallowing pills, such as children and the elderly. Voriconazole is used to treat a variety of fungal infections, including invasive aspergillosis, candidemia, esophageal candidiasis, and serious fungal infections caused by Scedosporium and Fusarium species. The liquid dosage form ensures accurate dosing and provides a convenient alternative to tablet or intravenous forms of the medication.

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Oral Liquid
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Formula Information

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Voriconazole 20 mg/ml Oral Liquid is a custom-prepared medication designed for oral use, specifically tailored to meet the needs of patients who require voriconazole in a liquid form. This antifungal agent is effective in treating a variety of fungal infections, including invasive aspergillosis, candidemia, esophageal candidiasis, and serious fungal infections caused by Scedosporium and Fusarium species. The liquid formulation is particularly beneficial for patients who have difficulty swallowing pills, such as children and the elderly, or those with conditions that impair their ability to ingest solid dosage forms.

The concentration of 20 mg/ml allows for precise dosing as per the individual's weight, severity of infection, and specific pathogen involved. Voriconazole works by inhibiting the fungal cytochrome P450 enzymes, which are essential for the synthesis of ergosterol, a key component of the fungal cell membrane. By disrupting this process, voriconazole compromises the integrity of the fungal cell membrane, leading to cell death and resolution of the infection.

It is important for prescribers to consider the potential for drug interactions, as voriconazole is metabolized by the liver and can affect or be affected by other medications metabolized through the same pathway. Monitoring of liver function tests is recommended due to the risk of hepatotoxicity. Additionally, voriconazole has been associated with visual disturbances and photosensitivity, so patients should be counseled on these potential side effects. Dose adjustments may be necessary for patients with hepatic impairment, and therapeutic drug monitoring is often recommended to ensure optimal plasma concentrations are achieved for efficacy while minimizing toxicity.

For patients and prescribers considering Voriconazole 20 mg/ml Oral Liquid, Bayview Pharmacy provides expert compounding services to ensure the highest quality and precision in medication formulation. Our team of knowledgeable compounding pharmacists is available to answer any questions and provide guidance on the use of this specialized medication. If you have any questions or require further information, please do not hesitate to reach out to us at Bayview Pharmacy.

Drug Interactions

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Voriconazole is a triazole antifungal medication used to treat a variety of fungal infections, including invasive aspergillosis, candidemia, esophageal candidiasis, and serious fungal infections caused by Scedosporium spp. and Fusarium spp. As a potent inhibitor of the cytochrome P450 (CYP) enzymes, particularly CYP2C19, CYP2C9, and CYP3A4, voriconazole has the potential to interact with a wide range of medications. It is important for both patients and prescribers to be aware of these interactions to avoid adverse effects or reduced efficacy of treatment.

Concomitant use of drugs that are CYP2C19, CYP2C9, and CYP3A4 substrates can result in increased plasma concentrations of these drugs when taken with voriconazole, potentially leading to toxicity. Examples include, but are not limited to, warfarin, phenytoin, and certain statins such as simvastatin and atorvastatin. Close monitoring and possible dose adjustments of these medications are recommended when co-administered with voriconazole.

Similarly, voriconazole plasma concentrations can be affected by other drugs that are strong inducers or inhibitors of CYP enzymes. For instance, rifampin, carbamazepine, and phenobarbital may significantly decrease voriconazole levels, potentially leading to therapeutic failure. On the other hand, inhibitors like ritonavir, ketoconazole, and certain fluoroquinolones may increase voriconazole levels, increasing the risk of adverse effects such as visual disturbances, hepatic toxicity, and QT prolongation.

Additionally, voriconazole can enhance the QT-prolonging effect of other drugs that have this potential, such as certain antiarrhythmics, antipsychotics, and macrolide antibiotics. Caution is advised when voriconazole is prescribed with these medications, and monitoring of the QT interval may be necessary.

It is also important to note that voriconazole should not be administered with terfenadine, astemizole, pimozide, quinidine, or cisapride due to the risk of significant QT prolongation and rare occurrences of torsades de pointes. Co-administration with ergot alkaloids is contraindicated due to the risk of ergotism.

Given the complexity of potential drug interactions with voriconazole, it is crucial for prescribers to thoroughly review a patient's medication history before initiating treatment with voriconazole. Patients should be advised to inform their healthcare provider of all medications they are taking, including over-the-counter drugs and herbal supplements. For any questions or concerns regarding drug interactions with voriconazole 20 mg/ml oral liquid, please reach out to us at Bayview Pharmacy for professional advice and guidance.

How Does it Work

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Voriconazole is an antifungal medication that works by inhibiting the growth of various fungi by disrupting the synthesis of the fungal cell membrane. The active ingredient, voriconazole, targets an enzyme called cytochrome P450-dependent 14α-sterol demethylase. This enzyme is crucial for converting lanosterol to ergosterol, an essential component of the fungal cell membrane. By inhibiting this enzyme, voriconazole depletes ergosterol, leading to an increase in cellular permeability and ultimately causing cell death of the fungus. This mechanism of action makes voriconazole effective in treating a wide range of fungal infections, including invasive aspergillosis, candidemia, esophageal candidiasis, and serious fungal infections caused by Scedosporium and Fusarium species.

The formulation of voriconazole as a 20 mg/ml oral liquid provides several advantages, particularly for patients who have difficulty swallowing pills or tablets, such as young children, the elderly, or those with esophageal disorders. The liquid form allows for flexible dosing, which is especially important for voriconazole due to its variable pharmacokinetics and the need for individualized dosing to achieve optimal therapeutic levels while minimizing the risk of toxicity. The oral liquid formulation is also beneficial for patients with malabsorption or those who are unable to receive intravenous medications.

When administered, the voriconazole oral liquid is absorbed into the bloodstream through the gastrointestinal tract. It is then distributed throughout the body, where it can reach the site of fungal infection. Voriconazole has excellent bioavailability, and its absorption is not significantly affected by food, allowing for consistent plasma levels and effective treatment of fungal infections.

It is important for patients and prescribers to understand that the success of treatment with voriconazole oral liquid depends on adherence to the prescribed dosing regimen and monitoring of drug levels to avoid potential side effects. These may include visual disturbances, liver enzyme abnormalities, skin reactions, and others. Regular follow-up and communication with the healthcare provider are essential to ensure the safe and effective use of this medication.

For any questions regarding the voriconazole 20 mg/ml oral liquid formulation, or for more information on its use and potential side effects, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is dedicated to providing support and guidance to ensure the best possible outcomes for our patients and prescribers.

Other Uses

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Aside from its primary indication for the treatment of invasive fungal infections such as aspergillosis, candidiasis, and certain less common fungal infections, Voriconazole 20 mg/ml Oral Liquid may have other valuable uses in clinical practice. Due to its broad spectrum of action against various types of fungi, voriconazole might be considered for compassionate or off-label use in treating fungal infections for which there are limited treatment options or where resistance to other antifungal drugs has developed. It’s important to note that these off-label uses should only be considered when strongly supported by clinical evidence and when undertaken by a healthcare professional knowledgeable in treating such infections.

As an oral liquid formulation, voriconazole provides certain advantages in special patient populations. For instance, it can be utilized in patients who have difficulty swallowing pills, such as those with esophageal dysmotility, neurodegenerative disorders, or severe mucositis due to cancer treatments. In the pediatric setting, where precise dosing and palatability are crucial, this liquid formulation can help ensure accurate dosing for young patients and improve adherence to the treatment regimen. In geriatric patients, it can also facilitate administration when polypharmacy is involved, and the risk of pill burden is a concern.

Moreover, in the context of enteral feeding, where medications may need to be administered through a feeding tube, the oral liquid formulation of voriconazole can be beneficial. The liquid formulation ensures that the medication can be given without the need for crushing tablets or opening capsules, which can affect the stability and efficacy of the medication, and also presents a risk of exposure to healthcare providers. In such scenarios, the oral liquid formulation is a safer and more effective alternative.

It's essential for patients and prescribers to be aware that although the oral liquid formulation of voriconazole offers these additional benefits and potential uses, it should be used judiciously under appropriate medical supervision. Due to the risk of adverse effects and drug interactions, monitoring of drug levels, liver function, and renal function may be necessary. If considering voriconazole for a use that falls outside of the established indications, it should be done with a clear understanding of the benefits and risks, as well as with patient consent where applicable.

If you have any questions or require further information regarding the voriconazole 20 mg/ml Oral Liquid formulation, its uses, or its administration, please do not hesitate to reach out to us at Bayview Pharmacy. Our team is equipped to provide the information you need to make informed decisions regarding your treatment options and ensure that medication use is safe, effective, and appropriate for your particular health needs.

Frequently Asked Questions

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What is Voriconazole 20 mg/ml Oral Liquid used for?

Voriconazole 20 mg/ml Oral Liquid is an antifungal medication used to treat a variety of serious fungal infections, including invasive aspergillosis and severe candida infections. It works by stopping the growth of the fungi causing the infection.

How should Voriconazole Oral Liquid be taken?

This medication should be taken exactly as prescribed by your healthcare provider. The liquid can be measured using the supplied dosing syringe or a medicine cup to ensure you are taking the correct dose. It should be taken on an empty stomach, at least one hour before or after a meal.

Is Voriconazole Oral Liquid suitable for children?

Yes, Voriconazole Oral Liquid can be suitable for children, especially in cases where they have difficulty swallowing pills. However, the dose will differ depending on the child's weight and the condition being treated. Always consult a pediatrician before administering this medication to a child.

Can geriatric patients use Voriconazole Oral Liquid?

Geriatric patients may use Voriconazole Oral Liquid, particularly those who have difficulty swallowing solid dosage forms. The dose may need to be adjusted based on the patient's liver function, kidney function, and overall health status. Regular monitoring is often required.

What if I miss a dose of Voriconazole Oral Liquid?

If you miss a dose, take it as soon as you remember. However, if it's almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.

Are there any side effects of taking Voriconazole Oral Liquid?

Like all medications, Voriconazole Oral Liquid can cause side effects, although not everybody experiences them. Common side effects include but are not limited to visual disturbances, skin rash, headache, gastrointestinal discomfort, and changes in liver function tests. If you experience any severe side effects or signs of an allergic reaction, seek medical attention immediately.

How should I store Voriconazole Oral Liquid?

Voriconazole Oral Liquid should be stored at room temperature away from light, heat, and moisture. Keep the bottle tightly closed when not in use. Make sure to keep this medication out of reach of children and pets.

Can Voriconazole Oral Liquid be taken with other medications?

Some medications may interact with Voriconazole Oral Liquid, which can alter how your medications work or increase your risk for serious side effects. It's important to discuss all your current medicines, including over-the-counter drugs and herbal supplements, with your healthcare provider.

What should I do if I take too much Voriconazole Oral Liquid?

In the event of an overdose, you should contact poison control or seek emergency medical attention immediately. Overdosing on Voriconazole can be serious and immediate medical intervention may be required.

Will my ability to drive or operate machinery be affected by taking Voriconazole Oral Liquid?

Voriconazole Oral Liquid can cause visual disturbances and dizziness. It is advised that you avoid driving or operating heavy machinery until you know how Voriconazole affects you. If you experience any such side effects, you should avoid engaging in these activities.

Can I drink alcohol while taking Voriconazole Oral Liquid?

Alcohol consumption is typically discouraged while taking Voriconazole, as it can increase the risk of liver toxicity and can also intensify the side effect profile of the medication. Always consult with your healthcare provider for specific recommendations related to alcohol consumption.

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Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.