보리코나졸

동물 종별 용량

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

• Hypersensitivity to voriconazole or other azole antifungals
• Concurrent use with barbiturates, carbamazepine, cisapride, pimozide, quinidine, rifampin, or rifabutin
• Caution in patients with hepatic dysfunction
• Caution in patients with proarrhythmic conditions
• Caution with the IV formulation in patients with decreased renal function (due to accumulation of the SBECD vehicle)

이상반응

• Dogs: Liver enlargement, significant increase in cytochrome P450 hepatic enzymes
• Cats: Azotemia, inappetence, lethargy, weight loss, cutaneous drug reactions, ataxia, hind limb paresis/paraplegia, visual signs (mydriasis, decreased PLR), arrhythmias, hypokalemia
• Humans: Visual disturbances (blurring, spots, wavy lines), rashes, GI effects (nausea, vomiting, diarrhea), hepatotoxicity, hypertension/hypotension, tachycardia, peripheral edema, hypokalemia, hypomagnesemia
• Rare (Humans): Eye hemorrhage, anemia, leukopenia, thrombocytopenia, pancytopenia, QT prolongation, nephrotoxicity

약물 상호작용

• Antidiabetic agents (sulfonylureas) · May increase serum concentrations of these drugs and increase risk for hypoglycemia
• Barbiturates (phenobarbital) · Decreased voriconazole concentrations; concurrent use is contraindicated
• Benzodiazepines · May increase benzodiazepine concentrations
• Calcium-channel blockers (amlodipine, diltiazem, verapamil) · May increase serum concentrations; dosage adjustment may be required
• Carbamazepine · Decreased voriconazole concentrations; concurrent use is contraindicated
• Cisapride · Potential for serious cardiac arrhythmias; concurrent use is contraindicated
• Corticosteroids (prednisolone) · Potentially increased AUC for prednisolone
• Immunosuppressive agents (cyclosporine, tacrolimus) · Increased concentrations; decrease cyclosporine dosage by 50% and tacrolimus dosage by 33% when starting voriconazole
• Methadone · May increase plasma concentrations of R-methadone; monitor for toxicity
• Phenytoin · Can decrease voriconazole concentrations and voriconazole can increase phenytoin concentrations
• Pimozide · Potential for serious cardiac arrhythmias; concurrent use is contraindicated
• Proton-pump inhibitors (omeprazole) · May increase omeprazole (and potentially other PPIs) concentrations

모니터링

• Clinical efficacy (resolution of fungal infection)
• Liver function tests (baseline and periodic)
• Serum electrolytes (potassium, magnesium)
• Neurologic and visual signs (especially in cats)

과용량

The minimum lethal dose in rats and mice is 300 mg/kg (4-7X maintenance dose). * **Clinical Signs**: Increased salivation, mydriasis, ataxia, depression, dyspnea, and seizures. In human pediatric patients, accidental 5X overdoses caused brief photophobia. * **Treatment**: No specific antidote is known. For very large oral overdoses, consider gut emptying (emesis/gastric lavage) followed by close observation and supportive treatment.