Voriconazole: Difference between revisions
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+ | == Therapeutic Drug Monitoring == |
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− | == Dosing == |
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+ | * Measure trough within 7 days of starting, and at regular intervals or following dose adjustment |
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+ | * Target trough > 1 mg/L for prophylaxis and treatment |
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− | ! Trough (mcg/mL) |
+ | ! Trough (mcg/mL) !! Recommendation |
− | ! Recommendation |
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− | | 0.0 to 0.6 |
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− | | 0.7 to 0.9 |
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− | | 1.0 to 4.0 |
+ | | 1.0 to 4.0 || At target, no dose adjustment needed |
− | | At target, no dose adjustment needed |
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− | | 4.1 to 5.5 |
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− | | 5.6 to 7.9 |
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− | | ≥8.0 |
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== Adverse Effects == |
== Adverse Effects == |
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* Visual |
* Visual |
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** Floaters etc that may improve with time |
** Floaters etc that may improve with time |
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== Further Reading == |
== Further Reading == |
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* [https://doi.org/10.1093/ofid/ofv133.527 Voriconazole Dose Modification Guideline to Optimize Therapeutic Levels in Patients With Hematologic Malignancies]. ''Open Forum Infect Dis''. 2015(2)S1:810. |
* [https://doi.org/10.1093/ofid/ofv133.527 Voriconazole Dose Modification Guideline to Optimize Therapeutic Levels in Patients With Hematologic Malignancies]. ''Open Forum Infect Dis''. 2015(2)S1:810. |
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Revision as of 21:41, 20 November 2019
Therapeutic Drug Monitoring
- Measure trough within 7 days of starting, and at regular intervals or following dose adjustment
- Target trough > 1 mg/L for prophylaxis and treatment
Trough (mcg/mL) | Recommendation |
---|---|
0.0 to 0.6 | Increase dose by 100 mg and recheck trough on day 5 of new regimen |
0.7 to 0.9 | Increase dose by 50 mg and recheck trough on day 5 of new regimen |
1.0 to 4.0 | At target, no dose adjustment needed |
4.1 to 5.5 | Decrease dose by 50 mg and recheck trough on day 5 of new regimen |
5.6 to 7.9 | Hold dose. Follow daily trough levels, then restart when trough is ≤2.5 at a dose decreased by 100 mg. Recheck trough on day 5 of new regimen. |
≥8.0 | Hold dose. Follow daily trough levels, then restart when trough is ≤2.5 at a dose decreased by 50%. Recheck trough level on day 5 of new regimen. |
Adverse Effects
- Visual
- Floaters etc that may improve with time
- Visual hallucinations
- Hepatotoxicity
- QTc prolongation
Further Reading
- Voriconazole Dose Modification Guideline to Optimize Therapeutic Levels in Patients With Hematologic Malignancies. Open Forum Infect Dis. 2015(2)S1:810.
References
- ^ Romeo-Gabriel Mihăilă. Voriconazole and the liver. World Journal of Hepatology. 2015;7(13):1828. doi:10.4254/wjh.v7.i14.1828.