• Broad-spectrum antifungal activity: Effective against severe fungal infections including invasive aspergillosis, non-neutropenic candidemia, esophageal candidiasis, and infections by Fusarium or Scedosporium species, especially in patients intolerant to other treatments Oral and systemic use: Suitable for systemic administration in adults and adolescents (≥ 12 years); allows for oral loading and maintenance therapy as an alternative to intravenous formulations 

• Initiation with loading dose: Typical adult regimen begins with 400 mg orally twice daily for the first 24 hours (loading), followed by maintenance of 200 mg twice daily taken at least one hour before or after meals Affordable local option: Priced around ৳ 20 per tablet (strip of 10 for ৳ 200), making it a cost-effective option in Bangladesh .

ℹ️ Precautions & Safety Notes

• Visual disturbances: Common side effects include blurred vision, photophobia, and rare transient visual hallucinations. Users should avoid driving or using machinery until they know how the drug affects them .

• Hepatic toxicity risk: Elevations in liver enzymes are possible; liver function testing is recommended before and during therapy, particularly for prolonged courses longer than six months .

• Photosensitivity & skin cancer risk: Long-term use (>180 days) may increase risk of squamous cell carcinoma and severe sun sensitivity. Recommend sun protection and skin monitoring .

• QT prolongation risk: May affect heart rhythm—especially in patients with hypokalemia/hypomagnesemia or on QT-prolonging agents; ECG monitoring may be advised 

• Drug interactions via CYP450 enzymes: Voriconazole is extensively metabolized by CYP2C19, CYP2C9, and CYP3A4. Co-administration with inhibitors or inducers of these enzymes may require dosage adjustments or alternative therapy .

• Contraindications: Avoid in patients with known hypersensitivity to voriconazole or those taking contraindicated medications such as terfenadine, cisapride, rifampin, carbamazepine, sirolimus, St. John’s wort, etc. .

• Pregnancy & breastfeeding caution: Not recommended during pregnancy or lactation unless the potential benefits justify risks. Effective contraception is advised during treatment. .