Initiating voriconazole (Vfend®) therapy
For maximum exposure, initiate therapy with voriconazole intravenous regimen1,2
• To maintain optimal plasma concentrations, therapy should be initiated with voriconazole intravenous (IV) regimen1,2
• Patients can be subsequently switched to an oral regimen when appropriate to maintain plasma voriconazole concentrations comparable to those achieved following IV administration2
• In a phase I dose-escalation study with healthy volunteers, voriconazole showed higher mean values for maximum plasma concentrations (Cmax) following initial IV dosing than those obtained with initial oral administration2
• Maximum plasma exposure observed following oral dosing ranged from 62.7% to 89.6% of the IV value2
The convenience of oral and IV formulations with voriconazole
|Vfend® Tablets||50mg and 200mg film-coated tablets|
|Vfend® IV||200mg single-use vial of powder for solution for infusion|
|Vfend® Suspension||An orange-flavoured powder for oral suspension preparation is available|
|Vfend® Powder and Solvent for Solution||
200mg powder for solution for infusion
Vfend® powder for oral suspension
Vfend® powder for oral suspension (POS) is intended for use in children (aged 2 to <12 years) and young adolescents with low body weight (12‒14 years and <50 kg)1
• Initiation in all children should be with IV Vfend®1
• Oral dosing should be considered once significant clinical improvement is observed1
• The oral suspension is recommended in children 2 to <12 years.
• Young adolescents with low body weight (12‒14 years and <50 kg) may metabolize voriconazole more similarly to children than to adults.
• In children with very low body weight for age or malabsorption, IV dosing is recommended.
• Use of Vfend® POS in patients aged 2–12 years with renal or hepatic impairment has not been studied.1
|THE RECOMMENDED DOSING REGIMEN IS AS FOLLOWS:1|
Loading Dose (Day 1)
|IV||9 mg/kg twice daily|
|Oral (tablets or suspension)||Not Recommended|
|IV||8 mg/kg twice daily|
|Oral (tablets or suspension)||9 mg/kg twice daily (maximum dose 350 mg twice daily)|
Note: Based on a population pharmacokinetic analysis in 112 immunocompromised paediatric patients aged 2 to <12 years and 26 immunocompromised adolescents aged 12 to <17 years.1
These oral dose recommendations for children are based on studies in which voriconazole was administered as the powder for oral suspension. Bioequivalence between the powder for oral suspension and tablets has not been investigated in a paediatric population. Considering the assumed limited gastro-enteric transit time in paediatric patients, the absorption of tablets may be different in paediatric compared to adult patients. It is therefore recommended to use the oral suspension formulation in children aged 2- to <12.
1. Vfend® Summary of Product Characteristics.
2. Purkins L, et al. Antimicrob Agents Chemother. 2002; 46(8): 2546–53.