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In adults, an oral Voriconazole dosage of 200 mg every 12 hours results in an area under the plasmaconcentration time curve (AUC) similar to that achieved with an intravenous dosage of 3 mg/kg every 12 hours; an oral Voriconazole dosage of 300 mg every 12 hours results in an AUC similar to that reported with an intravenous dosage of 4 mg/kg every 12 hours.
Adoption of Voriconazole as first-line treatment for invasive aspergillosis has been associated with improved survival versus other treatments. (See table.)
Click on icon to see table/diagram/imageDosage adjustment: For patients 40 kg and above: If patient response is inadequate, the maintenance dosage may be increased from 200 mg every 12 hours to 300 mg every 12 hours, depending on condition.
If patients are unable to tolerate 300 mg every 12 hours, reduce the maintenance dosage by 50 mg steps to a minimum of 200 mg every 12 hours, depending on condition.
For patients less than 40 kg: If the patient response is inadequate, the maintenance dosage may be increased from 100 mg every 12 hours to 150 mg every 12 hours, depending on condition.
If patients are unable to tolerate 150 mg every 12 hours, reduce the maintenance dosage by 50 mg steps to a minimum of 100 mg every 12 hours, depending on condition.
Children 2 to less than 12 years: A loading dose of 9 mg/kg twice daily for the first 24 hours followed by 8 mg/kg twice daily is recommended for intravenous regimen. For oral maintenance dosage, 9 mg/kg every 12 hours of oral suspension with a maximum dose of 350 mg every 12 hours is recommended.
Patients with hepatic impairment: In adults with mild to moderate hepatic cirrhosis (Child-Pugh class A or B), usual oral loading dosage of Voriconazole should be used, but oral maintenance dosages should be decreased by 50%.
Patients with renal impairment: Adjustment of oral Voriconazole dosage is not necessary in patients with mild to severe renal impairment.
Geriatric patients: Dosage adjustment based on age is not necessary on geriatric adults.
