Vfend Dosage

Generic name: voriconazole (oral/injection)
Drug class: Azole antifungals

Medically reviewed by  A Ras MD.

 Recommended Adult Dosing

Dosage forms:  TAB: 50 mg, 200 mg; SUSP: 40 mg per mL; INJ: various

Infections, severe fungal

[<40 kg]

Dose: 4 mg/kg/dose IV q12h; Start: 6 mg/kg/dose IV q12h x2 doses; Info: may decr. maint. dose to 3 mg/kg/dose IV q12h if 4 mg/kg/dose IV q12h not tolerable; may switch to 100-150 mg PO q12h after 7 days of IV tx; for infections due to S. apiospermum or Fusarium spp; give PO 1h before or after meal

[>40 kg]

Dose: 4 mg/kg/dose IV q12h; Start: 6 mg/kg/dose IV q12h x2 doses; Info: may decr. maint. dose to 3 mg/kg/dose IV q12h if 4 mg/kg/dose IV q12h not tolerable; may switch to 200-300 mg PO q12h after 7 days of IV tx; for infections due to S. apiospermum or Fusarium spp; give PO 1h before or after meal

Aspergillosis, invasive

[<40 kg]

Dose: 4 mg/kg/dose IV q12h; Start: 6 mg/kg/dose IV q12h x2 doses; Info: may decr. maint. dose to 3 mg/kg/dose IV q12h if 4 mg/kg/dose IV q12h not tolerable; may switch to 100-150 mg PO q12h after 7 days of IV tx; give PO 1h before or after meal

[>40 kg]

Dose: 4 mg/kg/dose IV q12h; Start: 6 mg/kg/dose IV q12h x2 doses; Info: may decr. maint. dose to 3 mg/kg/dose IV q12h if 4 mg/kg/dose IV q12h not tolerable; may switch to 200-300 mg PO q12h after 7 days of IV tx; give PO 1h before or after meal

Candidemia, non-neutropenic pts

[<40 kg]

Dose: 3-4 mg/kg/dose IV q12h; Start: 6 mg/kg/dose IV q12h x2 doses; Info: treat x14 days after sx resolution or last positive culture; may switch to 100-150 mg PO q12h anytime after day 1; give PO 1h before or after meal

[>40 kg]

Dose: 3-4 mg/kg/dose IV q12h; Start: 6 mg/kg/dose IV q12h x2 doses; Info: treat x14 days after sx resolution or last positive culture; may switch to 200-300 mg PO q12h anytime after day 1; give PO 1h before or after meal

Candidiasis, deep tissue

[<40 kg]

Dose: 3-4 mg/kg/dose IV q12h; Start: 6 mg/kg/dose IV q12h x2 doses; Info: treat x14 days after sx resolution or last positive culture; may switch to 100-150 mg PO q12h anytime after day 1; give PO 1h before or after meal

[>40 kg]

Dose: 3-4 mg/kg/dose IV q12h; Start: 6 mg/kg/dose IV q12h x2 doses; Info: treat x14 days after sx resolution or last positive culture; may switch to 200-300 mg PO q12h anytime after day 1; give PO 1h before or after meal

Candidiasis, esophageal

[<40 kg]

Dose: 100 mg PO q12h; Alt: 3 mg/kg/dose IV q12h; Info: treat x14 days minimum and x7 days after sx resolution; give PO 1h before or after meal

[>40 kg]

Dose: 200 mg PO q12h; Alt: 3 mg/kg/dose IV q12h; Info: treat x14 days minimum and x7 days after sx resolution; give PO 1h before or after meal

Candidiasis, oropharyngeal

[200 mg PO q12h]

Info: for fluconazole-refractory dz; give 1h before or after meal

Endophthalmitis, fungal

[50-100 mcg in 0.1 mL sterile water intravitreally x1]

Info: part of multi-drug regimen; refer to institution protocol; may repeat q48h

Renal dosing

[PO route]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

[IV route]

CrCl <50: avoid use; Info: PO route preferred due to accumulation of toxic IV vehicle

HD/PD: avoid use; Info: PO route preferred due to accumulation of toxic IV vehicle

Hepatic dosing

[adjust dose amount]

Child-Pugh Class A or B: decr. maint. dose 50%; Child-Pugh Class C: not defined; chronic HBV or HCV: not defined

SRC: NLM .