Indications

Candicon (Voriconazole) is an azole antifungal medicine indicated for use in patients 12 years and older for the treatment of the following serious fungal infections:

• Invasive aspergillosis.
• Candidemia (nonneutropenic) and disseminated candidiasis in the skin, abdomen, kidney, bladder wall, and wounds.
• Esophageal candidiasis.
• Serious infections caused by Scedosporium apiospermum and Fusarium species (including Fusarium solani).
• For patients intolerant of, or refractory to, other antifungal therapy.

Pharmacology

Voriconazole is a triazole antifungal that works by binding to and inhibiting CYP450-dependent 14-alpha sterol demethylase. This action depletes ergosterol, a vital component in the fungal cell membrane, thereby preventing the fungus from growing.

Dosage & Administration

Voriconazole tablet and powder for suspension must be taken at least one hour before or one hour after a meal.

Injection (IV): | Indication | Loading Dose (First 24 hours) | Maintenance Dose | | :--- | :--- | :--- | | Invasive Aspergillosis / Scedosporiosis / Fusariosis | 6 mg/kg 12 hourly | 4 mg/kg 12 hourly | | Candidemia / Deep tissue Candida infections | 6 mg/kg 12 hourly | 3-4 mg/kg 12 hourly |

Interaction

• Other Drugs: Candicon may increase the concentration and activity of drugs that are substrates of CYP3A4, CYP2C9, and CYP2C19 enzymes. Doses of these co-administered drugs may need to be reduced.
• Enzyme Inducers/Inhibitors: Adjust Candicon dosage when co-administered with CYP450 inhibitors or inducers. Increase the maintenance dose of Candicon if taken with Phenytoin or Efavirenz.

Contraindications

• Hypersensitivity to Voriconazole or any component of the drug.
• Co-administration with terfenadine, astemizole, cisapride, pimozide, quinidine, or sirolimus due to the risk of serious adverse reactions.
• Co-administration with rifampin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir, rifabutin, ergot alkaloids, and St. John's Wort due to the risk of loss of Candicon efficacy.

Side Effects

The most common side effects are abdominal pain, anemia, blurred vision, headache, chest pain, nausea, and diarrhea.

Pregnancy & Lactation

There are no adequate studies in pregnant women. Candicon should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Precautions & Warnings

• Long-term exposure (over 180 days) requires careful assessment of the benefit-risk balance.
• Squamous cell carcinoma of the skin (SCC) has been reported in relation to long-term Candicon treatment.
• The efficacy in children under 12 years of age is not established.

Therapeutic Class

Other Antifungal preparations.

Storage Conditions

Keep out of reach of children. Store in a dry place, below 25∘C and protected from light. Store the powder for suspension between 2∘ to 8∘C.