The Brand Name REXTRO Has Generic Salt :: VORICONAZOLE
REXTRO Is From Company DR. REDDY’S Priced :: Rs. 4272
REXTRO have VORICONAZOLE is comes under Sub class Anti Fungals of Main Class Anti Infectives
Main Medicine Class:: Anti Infectives Sub Medicine Class :: Anti Fungals
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Indications for Drugs ::
Candidemia, Deep tissue Candida infections, Invasive aspergillosis, Scedosporiosis and Fusariosis
Drug Dose ::
Adult: PO Candidemia; Deep tissue Candida infections; Invasive aspergillosis; Scedosporiosis and Fusariosis >40 kg: 400 mg 12 hrly for the 1st 24 hr. Maintenance: 200 mg 12 hrly, up to 300 mg 12 hrly if needed. <40 kg: 200 mg 12 hrly for the 1st 24 hr. Maintenance: 100 mg 12 hrly, up to 150 mg 12 hrly if needed. For oesophageal candidiases: Loading dose is not recommended and treatment is for at least 14 days and continued for 7 days after symptoms resolved. IV Candidemia; Deep tissue Candida infections; Invasive aspergillosis; Scedosporiosis and Fusariosis Loading dose: 6 mg/kg 12 hrly for the 1st 24 hr. Maintenance: 4 mg/kg 12 hrly (3-4 mg/kg 12 hrly for candidemia in non-neutropenic patients or patients intolerant of high doses). Max duration: 6 mth.Max infusion rate: 3 mg/kg/hr over 1-2 hr. Child: 2-14 yr <50 kg: 9 mg/kg 12 hrly for the 1st 24 hr, then 8 mg/kg 12 hrly. Max infusion rate: 3 mg/kg/hr. May switch to oral therapy once patient is able to tolerate oral admin. Renal impairment: CrCl (ml/min) <50 Use oral voriconazole when possible. Hepatic impairment: Mild to moderate (Child-Pugh category A and B): Standard loading dose but maintenance doses should be reduced by 50%. Contraindication ::
Drug Precautions ::
Monitor renal and hepatic function before and during treatment. Monitor visual function if used >28 days. Monitor pancreatic function in patients at risk of acute pancreatitis. Haematological malignancy; patients with proarrhythmic conditions; hepatic and renal impairment. Use in pregnancy not recommended, ensure effective contraception during treatment. Avoid exposure to sunlight. Correct electrolyte abnormalities before treatment initiation. May affect ability to drive or operate machinery and do not drive at nght.
Drug Side Effects ::
Transient and reversible visual disturbances; fever; headache; abdominal pain; chills; asthenia; back pains; chest pain; face oedema; flu-like syndrome; hypotension; thrombophloebitis; phloebitis; GI disturbances (eg, nausea, vomiting, diarrhoea); jaundice; cheilitis; cholestatic jaundice; gastroenteritis; blood dyscrasias; purpura; peripheral oedema; facial oedema; hypokalaemia; hypoglycaemia; dizziness; hallucinations; confusion; depression; anxiety; tremor; agitation; paraesthesia; respiratory distress syndrome; sinusitis; rash; pruritus; photosensitivity; alopecia; exfoliative dermatitis; acute kidney failure; haematuria; infusion-related reactions. Increased LFT and serum creatinine; prolongation of QT interval. Potentially Fatal: Stevens-Johnson Syndrome, toxic epidermal necrolysis.
Pregnancy category ::
Drug Mode of Action ::
Voriconazole is a triazole antifungal agent which inhibits cytochrome P450-dependent enzymes thereby inhibiting ergosterol synthesis in fungal cell membranes. It has a broad spectrum of activity against all Candida spp. including strains resistant to fluconazole), Aspergillus spp., Scedosporium spp., and Fusarium spp.
Drug Interactions ::
Increased prothrombin time w/ oral anticoagulants. May increase plasma concentrations of ciclosporin and tacrolimus, long-acting opiates (e.g. oxycodone, methadone), NSAIDs (e.g. ibuprofen, diclofenac), omeprazole, short-acting opiates (e.g. alfentanil, fentanyl). Decreased voriconazole plasma concentration and increased phenytoin plasma concentrations when used concomitantly. May increase plasma concentration w/ oral contraceptives. Potentially Fatal: May increase risk of QT prolongation or torsades de pointes w/ astemizole, cisapride, pimozide, quinidine and terfenadine. May increase risk of ergotism w/ ergot alkaloids (e.g. ergotamine and dihydroergotamine). May significantly increase plasma concentrations of sirolimus. Decreased plasma concentrations w/ rifampicin, carbamazepine, long-acting barbiturates (e.g. phenobarbital, mephobarbital), efavirenz (?400 mg once daily), ritonavir (?400 mg bid). Concomitant use may significantly increase rifabutin and decrease voriconazole plasma concentration.