伏立康唑

用途

• Orbital aspergillosis
• Aspergillosis
• General / Pharmacokinetic study
• Avian aspergillosis
• Coccidioidomycosis

給藥方式

可能的副作用

• Dogs: Liver enlargement, significant increase in cytochrome P450 hepatic enzymes
• Cats: Azotemia, inappetence, lethargy, weight loss, cutaneous drug reactions, ataxia, hind limb paresis/paraplegia, visual signs (mydriasis, decreased PLR), arrhythmias, hypokalemia
• Humans: Visual disturbances (blurring, spots, wavy lines), rashes, GI effects (nausea, vomiting, diarrhea), hepatotoxicity, hypertension/hypotension, tachycardia, peripheral edema, hypokalemia, hypomagnesemia
• Rare (Humans): Eye hemorrhage, anemia, leukopenia, thrombocytopenia, pancytopenia, QT prolongation, nephrotoxicity

注意事項與禁忌

• Hypersensitivity to voriconazole or other azole antifungals
• Concurrent use with barbiturates, carbamazepine, cisapride, pimozide, quinidine, rifampin, or rifabutin
• Caution in patients with hepatic dysfunction
• Caution in patients with proarrhythmic conditions
• Caution with the IV formulation in patients with decreased renal function (due to accumulation of the SBECD vehicle)
• > **Feline Warning**: Cats are highly susceptible to severe neurologic and systemic adverse effects. Use only as a last resort. * **Hepatic Effects**: Can cause liver enlargement and enzyme induction (in dogs). Use with caution in patients with pre-existing hepatic dysfunction. * **Renal Impairment**: The IV formulation contains sulfobutyl ether beta-cyclodextrin sodium (SBECD), which can accumulate in patients with reduced renal function. * **Pregnancy**: Teratogenic in rats and embryotoxic in rabbits (FDA Category D). Weigh risks vs. benefits in pregnant animals. * **Cardiac**: Use with caution in patients with proarrhythmic conditions.

藥物相互作用

• Antidiabetic agents (sulfonylureas): May increase serum concentrations of these drugs and increase risk for hypoglycemia
• Barbiturates (phenobarbital): Decreased voriconazole concentrations; concurrent use is contraindicated
• Benzodiazepines: May increase benzodiazepine concentrations
• Calcium-channel blockers (amlodipine, diltiazem, verapamil): May increase serum concentrations; dosage adjustment may be required
• Carbamazepine: Decreased voriconazole concentrations; concurrent use is contraindicated
• Cisapride: Potential for serious cardiac arrhythmias; concurrent use is contraindicated
• Corticosteroids (prednisolone): Potentially increased AUC for prednisolone
• Immunosuppressive agents (cyclosporine, tacrolimus): Increased concentrations; decrease cyclosporine dosage by 50% and tacrolimus dosage by 33% when starting voriconazole
• Methadone: May increase plasma concentrations of R-methadone; monitor for toxicity
• Phenytoin: Can decrease voriconazole concentrations and voriconazole can increase phenytoin concentrations

常見問題