Vfend (Voriconazole)

Do’s

• Before starting Vfend, read the Patient Information Leaflet provided by your pharmacist. If you have any questions, ask your healthcare provider for clarification.
• Take Vfend by mouth without food, at least 1 hour before or 1 hour after meals, as directed by your healthcare provider. This is usually done every 12 hours.
• The dosage and length of treatment are determined by your medical condition, weight, response to treatment, and other medications you may be taking. Inform your healthcare provider about all the products you use, including prescription drugs, nonprescription drugs, and herbal products.
• For the best effect, take this antifungal at evenly spaced times. To help you remember, take it at the same times every day.
• Continue to take Vfend until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.
• If your condition does not improve or worsens, be sure to inform your healthcare provider.

Common Side Effects:

• Vomiting
• Rash
• Low blood potassium levels
• Nausea
• Stomach pain
• Upper respiratory tract infection

Less Common Side Effects:

• Anemia
• Leukopenia
• Pancytopenia
• Bradycardia
• Palpitations
• Supraventricular tachycardia
• Asthenia
• Catheter site pain
• Chills
• Hypothermia
• Lethargy

Rare Side Effects:

• Neuropathy (very rare)
• Visual disturbances, including changes in vision such as decreased electroretinogram (ERG) waveform amplitude, decreased visual field, and altered color perception
• Prolonged visual adverse reactions, including optic neuritis and papilledema

Inform your healthcare provider if you experience any side effects that bother you or do not go away. Additionally, if you have concerns about the side effects of Vfend, seek medical advice.

In clinical trials, there have been uncommon cases of serious hepatic reactions during treatment with Vfend, including clinical hepatitis, cholestasis, and fulminant hepatic failure, including fatalities. Instances of hepatic reactions were noted to occur primarily in patients with serious underlying medical conditions, predominantly hematological malignancy. It is recommended to measure serum transaminase levels and bilirubin at the initiation of Vfend therapy and monitor at least weekly for the first month of treatment. Monitoring frequency can be reduced to monthly during continued use if no clinically significant changes are noted. If liver function tests become markedly elevated compared to baseline, Vfend should be discontinued unless the medical judgment of the benefit/risk of the treatment for the patient justifies continued use.

Some azoles, including Vfend, have been associated with prolongation of the QT interval on the electrocardiogram (ECG).

Patients should be instructed that visual disturbances such as blurring and sensitivity to light may occur with the use of Vfend. Vfend can also cause serious photosensitivity, and patients should immediately contact their healthcare provider for new or worsening skin rash.

Severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) have been reported during treatment with Vfend. Erythema multiforme has also been reported during treatment with Vfend. Vfend has also been associated with additional photosensitivity-related skin reactions such as pseudoporphyria, cheilitis, and cutaneous lup.

Before taking Vfend, inform your healthcare provider if you have heart rhythm problems, an electrolyte imbalance, liver or kidney disease, or a history of allergy to other antifungal medications such as fluconazole (Diflucan), ketoconazole (Nizoral), or itraconazole (Sporanox). 

Take Vfend for the full prescribed length of time and not skip doses, as doing so may increase the risk of further infection that is resistant to antifungal medicine.

Consult a healthcare provider before taking any drug, changing any diet, or commencing or discontinuing any course of treatment.