VORY 200mg TAB 10s

Description

Vory 200 mg Tablet (Voriconazole) – Long Description

Brand Name: Vory
Generic Name: Voriconazole
Strength: 200 mg
Dosage Form: Oral Tablet
Drug Class: Triazole Antifungal
Route of Administration: Oral

Overview:

Vory 200 mg contains voriconazole, a broad-spectrum triazole antifungal medication used for the treatment of serious and potentially life-threatening fungal infections, particularly in immunocompromised patients. It is effective against a wide range of fungal pathogens, including Aspergillus, Candida, Fusarium, and Scedosporium species.

Voriconazole works by inhibiting fungal cytochrome P450-dependent enzyme lanosterol 14-α-demethylase, an essential enzyme for ergosterol synthesis, which is a critical component of fungal cell membranes. Disruption of ergosterol production leads to impaired cell membrane integrity and fungal cell death.

Indications:

Vory 200 mg is indicated for the treatment of:

• Invasive aspergillosis
• Candidemia in non-neutropenic patients
• Serious invasive Candida infections, including esophageal candidiasis
• Scedosporium and Fusarium infections, especially in patients who are intolerant of or refractory to other antifungals
• Prophylaxis of invasive fungal infections in high-risk immunocompromised patients (e.g., stem cell transplant recipients)

Mechanism of Action:

Voriconazole inhibits the fungal enzyme lanosterol 14α-demethylase, a key component in ergosterol biosynthesis. Ergosterol is a crucial component of fungal cell membranes, and its depletion results in membrane instability, increased permeability, and cell lysis.

Dosage and Administration:

• Standard adult oral dose:
  • Loading dose: 400 mg every 12 hours for the first 24 hours
  • Maintenance dose: 200 mg every 12 hours thereafter
• Dosage adjustments may be needed in patients with liver impairment or based on therapeutic drug monitoring (TDM) to ensure optimal blood levels and minimize toxicity.

Voriconazole should be taken at least 1 hour before or 1 hour after meals to improve absorption.

Pharmacokinetics:

• Absorption: Rapid and extensive oral bioavailability (~96%)
• Peak concentration: ~1–2 hours after dosing
• Metabolism: Hepatic (mainly via CYP2C19, CYP2C9, and CYP3A4)
• Half-life: Variable; ~6 hours in extensive metabolizers
• Excretion: Primarily via urine (as inactive metabolites)

Adverse Effects:

Common side effects:

• Visual disturbances (blurred vision, altered color perception)
• Headache
• Nausea and vomiting
• Elevated liver enzymes
• Skin rash

Serious or rare side effects:

• Hepatotoxicity
• QT prolongation and cardiac arrhythmias
• Hallucinations or other neurotoxic effects
• Severe photosensitivity and skin reactions (including risk of skin cancer with prolonged use)
• Stevens-Johnson syndrome or toxic epidermal necrolysis (rare)

Contraindications and Precautions:

• Contraindicated in patients with known hypersensitivity to voriconazole or any component of the formulation
• Avoid use with certain drugs that prolong the QT interval or are metabolized by CYP3A4 (e.g., rifampin, carbamazepine, sirolimus)
• Use with caution in hepatic or renal impairment
• Monitor liver function tests regularly during treatment
• Caution in pediatric and elderly populations—dosing and metabolism vary significantly

Drug Interactions:

Voriconazole is a substrate and inhibitor of CYP2C19, CYP2C9, and CYP3A4, leading to multiple potential drug interactions, including with:

• Immunosuppressants (e.g., cyclosporine, tacrolimus)
• Warfarin and other anticoagulants
• Benzodiazepines
• Statins
• Anticonvulsants (e.g., phenytoin, carbamazepine)

Therapeutic drug monitoring is recommended in long-term or complex therapy scenarios.

Special Considerations:

• Photosensitivity warning: Patients should avoid sunlight and use sun protection during treatment due to risk of phototoxicity
• May cause vision-related adverse effects (e.g., blurred vision, photophobia) that are usually reversible
• Prolonged treatment should include dermatologic monitoring due to the risk of squamous cell carcinoma

Storage:

• Store at a temperature below 30°C (86°F)
• Protect from moisture and direct sunlight
• Keep out of reach of children

Conclusion:

Vory 200 mg Tablet (Voriconazole) is a powerful antifungal agent designed for the treatment of severe systemic fungal infections, especially in immunocompromised patients. With its broad spectrum of activity and high oral bioavailability, it is a critical tool in the management of invasive mycoses. However, due to its complex metabolism, potential toxicity, and extensive drug interactions, it should be used under careful medical supervision, often with therapeutic drug monitoring.