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Votab is a triazole class antifungal medicine used for the treatment of serious fungal infections in patients aged 12 years and above. It is prescribed for conditions such as invasive aspergillosis, candidemia and disseminated candidiasis involving organs like the skin, kidneys, bladder wall, abdomen, and wounds. It is also effective in esophageal candidiasis and in severe infections caused by Scedosporium apiospermum and Fusarium species, including Fusarium solani. Votab may be used in patients who are intolerant to or not responding to other antifungal therapies.
Voriconazole works by inhibiting fungal growth through interference with ergosterol synthesis. It blocks the CYP450-dependent 14-alpha sterol demethylase enzyme, which is essential for producing ergosterol—a key component of the fungal cell membrane. This disruption weakens the cell membrane and ultimately leads to antifungal activity.
Dosage & Administration
Oral use:
Take voriconazole tablets or suspension at least 1 hour before or after meals.
- ≥40 kg body weight:
Loading dose: 400 mg (or 10 ml) every 12 hours for the first day
Maintenance dose: 200 mg (or 5 ml) twice daily thereafter - <40 kg body weight:
Loading dose: 200 mg (or 5 ml) every 12 hours for the first day
Maintenance dose: 100 mg (or 2.5 ml) twice daily thereafter
(or as directed by physician)
Injection:
- Invasive aspergillosis:
Loading: 6 mg/kg every 12 hours for 24 hours
Maintenance: 4 mg/kg every 12 hours - Candidemia and deep Candida infections:
Loading: 6 mg/kg every 12 hours
Maintenance: 3–4 mg/kg every 12 hours - Scedosporium/Fusarium infections:
Loading: 6 mg/kg every 12 hours
Maintenance: 4 mg/kg every 12 hours
রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন
Drug Interaction
Votab interacts with drugs that affect CYP3A4, CYP2C9, and CYP2C19 enzymes. Dose adjustment and monitoring may be required when used with enzyme inhibitors or inducers. It may also increase levels of other medicines metabolized by these enzymes, requiring dose reduction. Co-administration with phenytoin or efavirenz may require increasing Votab dose.
Contraindications
- Hypersensitivity to voriconazole or any component
- Avoid with terfenadine, astemizole, cisapride, pimozide, quinidine, or sirolimus due to serious interaction risks
- Avoid combination with rifampin, carbamazepine, barbiturates, efavirenz, ritonavir, rifabutin, ergot derivatives, and St. John’s Wort due to reduced efficacy
Side Effects
Common adverse effects include abdominal pain, anemia, headache, blurred vision, nausea, chest pain, and diarrhea.
Pregnancy & Lactation
Safety data in pregnancy is limited. It should be used only when clearly needed and when benefits outweigh risks.
Precautions
Long-term therapy beyond 180 days requires careful risk-benefit evaluation. Rare cases of skin squamous cell carcinoma have been reported with prolonged use.
Special Populations
Safety and efficacy in children under 12 years have not been established.
Overdose
No specific overdose data is available.
Storage
Store below 25°C in a dry place away from light and keep out of reach of children. Powder for suspension should be stored at 2–8°C.