Vfend (Voriconazole)

Introduction

Vfend (voriconazole) is an oral antifungal medication indicated for the treatment of serious invasive fungal infections. It is supplied as 200 mg tablets and belongs to the triazole class of antifungals. The drug is manufactured by Pfizer and is also available in intravenous form for hospital use. In addition to its FDA-approved indications, voriconazole is sometimes used off-label for other fungal diseases where clinical data suggest benefit.

What is Vfend?

Vfend is the brand name for the synthetic triazole antifungal voriconazole. It was developed in the late s to improve the spectrum of activity and safety profile of earlier azoles such as fluconazole. Pfizer markets Vfenc under brand names such as Vfend and Vfend IV worldwide. The medication is supplied as film-coated tablets containing 200 mg of voriconazole.

Vfend is the generic version of well-known medications, containing the active compound Voriconazole. Our online pharmacy provides this generic alternative as a cost-effective treatment option.

How Vfend Works

Voriconazole inhibits the fungal cytochrome P450 enzyme 14α-demethylase, a key step in ergosterol synthesis. Ergosterol is an essential component of the fungal cell membrane; its depletion leads to membrane instability, impaired cell growth, and ultimately fungal cell death. The drug achieves rapid plasma concentrations after oral administration, with a half-life of approximately 6 hours in healthy adults, allowing steady-state levels within 2-3 days of twice-daily dosing. Clearance occurs primarily via hepatic metabolism (CYP2C19, CYP2C9, and CYP3A4 pathways), which explains many drug-drug interactions.

Conditions Treated with Vfend

• Invasive Aspergillosis: First-line therapy for proven or probable infection in immunocompromised patients. Voriconazole’s broad activity against Aspergillus species and favorable penetration into lung tissue make it highly effective.
• Invasive Candidiasis (non-albicans species): Approved for infections caused by Candida species resistant to fluconazole, such as C. glabrata and C. krusei.
• Serious Infections Caused by Scedosporium spp. and Fusarium spp.: Limited clinical data support use when other agents are ineffective, and these indications are reflected in regulatory labeling.

The drug is preferred when rapid fungal clearance is needed, and when the infecting organism demonstrates susceptibility to voriconazole in vitro.

Off-Label and Investigational Uses of Vfend

• Chronic Pulmonary Aspergillosis (CPA): Small prospective studies have shown that long-term voriconazole reduces radiologic progression and improves symptom scores. CPA is not an FDA-approved indication, and therapy should be guided by specialist input.
• Cryptococcal Meningitis (in patients intolerant to standard therapy): Case series suggest voriconazole achieves therapeutic CSF concentrations, but it is not a first-line regimen.
• Ophic Fungal Keratitis: Topical formulations are experimental; systemic voriconazole may be used adjunctively when infection penetrates intra-ocular structures.

These off-label applications are based on peer-reviewed case reports or limited trials. They have not received formal approval from regulatory agencies. Patients should discuss potential benefits and risks with a qualified healthcare provider before pursuing such uses.

Is Vfend the Right Medication for You?

Vfend is adults with confirmed or highly suspected invasive infections caused by susceptible fungi, particularly when rapid fungicidal activity is required. Ideal candidates include:

• Individuals with hematologic malignancies undergoing chemotherapy or stem-cell transplantation.
• Patients receiving prolonged corticosteroid therapy or other immunosuppressants.
• Those with documented infection by Aspergillus spp., non-albicans Candida spp., or rare molds resistant to alternative agents.

Contraindications include known hypersensitivity to voriconazole or any azole, severe hepatic impairment (Child-Pugh C), and co-administration with drugs that are potent CYP3A4 inducers (e.g., rifampin). Caution is advised in patients with a history of QT prolongation, those with genetic polymorphisms affecting CYP2C19 metabolism, and pregnant or breastfeeding women.

Risks, Side Effects, and Interactions

Common

• Visual disturbances (e.g., altered color perception, flashes of light) - usually transient.
• Elevated liver enzymes (ALT, AST) - monitor baseline and periodic hepatic labs.
• Gastrointestinal upset (nausea, diarrhea).
• Skin rash or mild pruritus.

Rare

• Severe hepatotoxicity leading to hepatitis or liver failure.
• Photosensitivity reactions, especially with prolonged sun exposure.
• Peripheral neuropathy with long-term therapy.

Serious

• QT interval prolongation - can precipitate torsades de pointes, especially when combined with other QT-prolonging agents.
• Acute severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis).
• Anaphylaxis - rare but requires immediate emergency care.

Drug-Drug Interactions

• CYP450 inhibitors (e.g., fluconazole, erythromycin, ketoconazole) increase voriconazole levels → dose reduction may be needed.
• CYP450 inducers (e.g., rifampin, carbamazepine, St. John’s wort) decrease concentrations → therapeutic failure risk.
• Statins (simvastatin, lovastatin) - increased risk of myopathy; consider alternative lipid-lowering agents.
• Immunosuppressants (cyclosporine, tacrolimus) - voriconazole raises their plasma levels; close monitoring of trough concentrations is essential.

Drug-Food Interactions

• Alcohol - may exacerbate hepatic toxicity; moderate consumption is advised.
• Grapefruit juice - inhibits CYP3A4, potentially increasing voriconazole exposure.

Patients should provide a complete medication list, including over-the-counter products and supplements, before initiating therapy.

Use: Dosing, Missed Dose, Overdose

• Standard adult dosing: 200 mg orally every 12 hours after a loading dose of 400 mg (200 mg × 2) administered 12 hours apart on day 1. Adjustments are required for hepatic impairment, renal failure, or CYP2C19 poor metabolizers.
• Missed dose: Take the missed tablet as soon as remembered unless the next scheduled dose is within 2 hours. In that case, skip the missed dose and resume the regular schedule; do not double the dose.
• Overdose: Symptoms may include severe visual changes, nausea, vomiting, and hepatic dysfunction. Seek emergency medical attention immediately; supportive care and activated charcoal (if within 1 hour) are standard measures.

Administration tips: Voriconazole tablets should be taken with food to improve absorption and reduce gastrointestinal upset. Avoid driving or operating heavy machinery until visual side effects have resolved.

FAQ

• What storage conditions are recommended for Vfend tablets? The tablets should be kept in a dry place at controlled room temperature, between 20 °C and 25 °C (68 °F-77 °F). Protect them from moisture and direct sunlight to maintain potency.

• Can I travel internationally with Vfend? Yes, but you should carry the medication in its original packaging with a copy of the prescription and a letter from your prescriber. Check the destination country’s import regulations, as some nations require prior approval for antifungal agents.

• Does voriconazole affect hormonal contraceptives? Voriconazole does not appear to reduce the effectiveness of combined estrogen-progestin contraceptives. However, use of hormonal methods should be discussed with a healthcare provider, especially if other interacting drugs are taken simultaneously.

• What are the inactive ingredients in the 200 mg tablet? The film-coated tablet contains lactose monohydrate, maize starch, microcrystalline cellulose, magnesium stearate, and povidone. Patients with severe lactose intolerance should consult a pharmacist.

• Is there a difference in efficacy between oral and intravenous voriconazole? Pharmacokinetic studies demonstrate comparable bioavailability (approximately 96 % after oral dosing). Switching between routes is acceptable when clinical status changes, but dose adjustments may be required for renal replacement therapies.

• Do genetic differences in CYP2C19 affect dosing? Yes. Poor metabolizers may achieve higher plasma concentrations, increasing toxicity risk, while rapid metabolizers may have subtherapeutic levels. Genotype-guided dosing or therapeutic drug monitoring is recommended for patients with known CYP2C19 variants.

• Can I take Vfend with antacids? Antacids containing aluminum or magnesium do not significantly affect voriconazole absorption, but it is prudent to separate dosing by at least two hours to avoid any potential interaction.

• What is the typical duration of treatment for invasive aspergillosis? Treatment usually extends for at least 6-12 weeks, depending on clinical response, radiologic improvement, and immune status. Shorter courses increase the risk of relapse.

• Are there any special considerations for elderly patients? Elderly individuals often have reduced hepatic clearance and are more susceptible to visual and cardiac side effects. Starting at the lower end of the dosing range and close monitoring of liver function and ECG are advisable.

• How does voriconazole compare to itraconazole for fungal infections? Voriconazole has a broader spectrum, higher potency against Aspergillus, and more predictable oral absorption. Itraconazole may be preferred for certain dermatophyte infections, but it is less effective for invasive mold disease.

Glossary

Triazole antifungal

A class of drugs that block fungal ergosterol synthesis by inhibiting the enzyme 14α-demethylase, destabilizing the cell membrane.

Therapeutic drug monitoring (TDM)

The measurement of drug concentrations in blood to maintain a target range that maximizes efficacy while minimizing toxicity.

CYP450 enzyme system

A family of liver enzymes (e.g., CYP2C19, CYP3A4) that metabolize many medications; variations can influence drug levels and interaction risk.

Invasive aspergillosis

A severe infection where Aspergillus spores invade lung tissue and can disseminate to other organs, commonly affecting immunocompromised patients.

Buying Vfend from Our Online Pharmacy

Patients who face limited access to voriconazole through local pharmacies or who encounter high out-of-pocket costs can obtain the medication from our online pharmacy. We source the drug from licensed, vetted suppliers that meet international pharmaceutical standards, ensuring each batch adheres to potency and purity specifications.

• Cost-effectiveness: By operating as a pharmacy broker, we negotiate near-manufacturer pricing, passing the savings directly to you without compromising quality.
• Verified quality: All products are stored and shipped under controlled conditions, and every shipment includes a certificate of analysis confirming compliance with regulatory specifications.
• Discreet delivery: Orders are packaged in unmarked, secure parcels and dispatched via trusted carriers. Express shipping typically arrives within 7 days, while standard airmail takes approximately 3 weeks, depending on destination.
• Privacy-focused service: Your personal information is encrypted and handled according to strict data-protection policies, ensuring confidentiality throughout the transaction.

Our platform offers a reliable, affordable pathway to obtain Vfend when conventional channels are unavailable, while upholding the highest standards of safety and patient privacy.

Disclaimer

The information presented about Vfend is intended for general educational purposes and does not substitute professional medical advice. Treatment decisions, including any off-label applications, must be made under the guidance of a qualified healthcare provider. Readers are presumed to be competent adults capable of making informed health choices. Our online pharmacy provides access to Vfend for individuals who may experience limited availability through conventional pharmacies or insurance programs, or who are looking for cost-effective generic options. Always discuss initiation, modification, or discontinuation of any medication with your clinician.