Vfend I.V. (Intravenous)

Voriconazole injection is used to treat certain serious fungal or yeast infections, such as aspergillosis (a fungal infection in the lungs), candidemia (a fungal infection in the blood), esophageal candidiasis (candida esophagitis), or other fungal infections (including infections in the skin, stomach, kidney, bladder, and wounds). It may also be used to treat patients with serious fungal or yeast infections who cannot tolerate or do not respond to other types of medicine.

This medicine is to be given only by or under the direct supervision of your doctor.

It is very important that your doctor checks you or your child closely while receiving this medicine. This is to ensure that the medicine is working properly. Blood and urine tests will be needed to check for unwanted effects.

If you or your child's symptoms do not improve within a few days or if they get worse, contact your doctor.

Receiving this medicine while pregnant can harm your unborn baby. Use an effective form of birth control to prevent pregnancy. If you think you have become pregnant while using this medicine, tell your doctor immediately.

You or your child should not use astemizole (Hismanal®), barbiturates (e.g., phenobarbital, Luminal®), carbamazepine (Tegretol®), efavirenz (Sustiva®), ergot medicines (e.g., dihydroergotamine, ergotamine, Cafergot®, Ergomar®, Wigraine®), ivabradine (Corlanor®, Procoralan®), lemborexant (Dayvigo®), lurasidone (Latuda®), naloxegol (Movantik®), pimozide (Orap®), quinidine (Quinaglute®), rifabutin (Mycobutin®), rifampin (Rifadin®, Rimactane®), ritonavir (Norvir®), sirolimus (Rapamune®), St. John's wort, terfenadine (Seldane®), tolvaptan (Jynarque®, Samsca®), or venetoclax (Venclexta®). Using any of these with this medicine may increase the chance of unwanted effects.

This medicine may cause some people to have changes in vision, such as blurred vision and seeing bright spots or wavy lines. Do not drive (especially at night) or do anything else that could be dangerous until you know how this medicine affects you.

Contact your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be signs of a serious liver problem.

Reach out to your doctor immediately if you or your child notice any changes in heart rhythm. You might feel dizzy or faint, or you may experience a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm issue, including QT prolongation.

This medicine may cause a serious allergic reaction known as an infusion reaction. This can be life-threatening and requires immediate medical help. Tell your doctor or nurse right away if you or your child have a fever, chills, flushing, itching or skin rash, sweating, trouble breathing, lightheadedness, fainting, or chest tightness within a few hours after receiving it.

This medicine may cause serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS). Contact your doctor immediately if you or your child have black, tarry stools, blistering, peeling, loosening of the skin, chest pain, chills, cough, diarrhea, fever, itching, joint or muscle pain, red irritated eyes, red skin lesions (often with a purple center), sore throat, sores, ulcers, or white spots in the mouth or on the lips, painful or difficult urination, swollen glands, trouble breathing, unusual bleeding, bruising, tiredness, or weakness.

Voriconazole may increase your or your child's risk of kidney problems, including acute kidney failure. Contact your doctor immediately if you have blood in the urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, decreased awareness or responsiveness, severe sleepiness, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

Pancreatitis (swelling of the pancreas) may occur while you or your child are receiving this medicine. Contact your doctor immediately if you or your child have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

This medicine may make your skin more sensitive to sunlight when used with methotrexate (Reditrex®). Use sunscreen when outdoors. Avoid sunlamps and tanning beds.

This medicine may cause problems with the adrenal glands. Contact your doctor immediately if you or your child have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

This medicine may cause bone pain if used for a long time. Contact your doctor immediately if you or your child experience bone pain while receiving this medicine.

Do not take other medicines unless discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a drug, the chances of using the medicine must be weighed against the beneficial it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medication or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of voriconazole injection in children younger than 2 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific issues that would limit the usefulness of voriconazole injection in the elderly.

Breast Feeding

There are no adequate studies in women for determining infant chance when using this medication during breastfeeding. Weigh the potential benefits against the potential chances before using this medicine while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different drugs may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this drug, it is especially critical that your healthcare professional know if you are using any of the medications listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not advised. Your doctor may decide not to treat you with this medicine or change some of the other medicines you take.

• Alprazolam
• Astemizole
• Atazanavir
• Bepridil
• Carbamazepine
• Cisapride
• Colchicine
• Conivaptan
• Dihydroergotamine
• Dronedarone
• Efavirenz
• Eletriptan
• Eliglustat
• Eplerenone
• Ergoloid Mesylates
• Ergonovine
• Ergotamine
• Finerenone
• Flibanserin
• Fluconazole
• Gepirone
• Isavuconazonium Sulfate
• Ivabradine
• Levoketoconazole
• Lomitapide
• Lovastatin
• Lurasidone
• Maraviroc
• Mavacamten
• Mephobarbital
• Mesoridazine
• Methylergonovine
• Methysergide
• Naloxegol
• Nelfinavir
• Nimodipine
• Nirmatrelvir
• Pacritinib
• Phenobarbital
• Pimozide
• Piperaquine
• Posaconazole
• Primidone
• Quinidine
• Rifabutin
• Rifampin
• Ritonavir
• Saquinavir
• Simvastatin
• Sirolimus
• Sparfloxacin
• St John's Wort
• Terfenadine
• Thioridazine
• Tolvaptan
• Ubrogepant
• Venetoclax
• Voclosporin
• Ziprasidone

Using this medication with any of the following medications is usually not advised, but may be required in some cases. If both medications are prescribed together, your clinician may change the dose or how frequently you use one or both of the drugs.

• Acalabrutinib
• Acenocoumarol
• Adagrasib
• Ado-Trastuzumab Emtansine
• Afatinib
• Alectinib
• Alfentanil
• Amiodarone
• Amisulpride
• Amitriptyline
• Amoxapine
• Anagrelide
• Apalutamide
• Apixaban
• Apomorphine
• Aprepitant
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Artemether
• Asenapine
• Atogepant
• Atorvastatin
• Avacopan
• Avanafil
• Avapritinib
• Axitinib
• Azithromycin
• Baricitinib
• Bedaquiline
• Belzutifan
• Benzhydrocodone
• Boceprevir
• Bosutinib
• Brentuximab Vedotin
• Bretylium
• Brexpiprazole
• Brigatinib
• Bromocriptine
• Budesonide
• Buprenorphine
• Buserelin
• Cabazitaxel
• Cabozantinib
• Calcifediol
• Capmatinib
• Cariprazine
• Carvedilol
• Ceritinib
• Chloramphenicol
• Chloroquine
• Chlorpromazine
• Cilostazol
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clofazimine
• Clomipramine
• Clothiapine
• Clozapine
• Cobicistat
• Cobimetinib
• Codeine
• Copanlisib
• Crizotinib
• Cyclobenzaprine
• Cyclosporine
• Dabrafenib
• Daclatasvir
• Daridorexant
• Darunavir
• Dasabuvir
• Dasatinib
• Deflazacort
• Degarelix
• Delamanid
• Delavirdine
• Desipramine
• Deslorelin
• Deutetrabenazine
• Dexamethasone
• Dexmedetomidine
• Dicumarol
• Dihydrocodeine
• Disopyramide
• Docetaxel
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Droperidol
• Duvelisib
• Elacestrant
• Elagolix
• Elexacaftor
• Elvitegravir
• Encorafenib
• Entacapone
• Entrectinib
• Enzalutamide
• Erlotinib
• Erythromycin
• Escitalopram
• Eslicarbazepine Acetate
• Eszopiclone
• Etrasimod
• Everolimus
• Fedratinib
• Fentanyl
• Fesoterodine
• Fexinidazole
• Fingolimod
• Flecainide
• Fluoxetine
• Fluticasone
• Formoterol
• Fosaprepitant
• Foscarnet
• Fosphenytoin
• Fostamatinib
• Fostemsavir
• Gatifloxacin
• Gefitinib
• Gemifloxacin
• Gilteritinib
• Glasdegib
• Glimepiride
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Haloperidol
• Histrelin
• Hydrocodone
• Hydroxychloroquine
• Hydroxyzine
• Ibrexafungerp
• Ibrutinib
• Ibutilide
• Idelalisib
• Ifosfamide
• Iloperidone
• Imipramine
• Infigratinib
• Inotuzumab Ozogamicin
• Irinotecan
• Irinotecan Liposome
• Istradefylline
• Ivacaftor
• Ivosidenib
• Ixabepilone
• Ketoconazole
• Lansoprazole
• Lapatinib
• Larotrectinib
• Lefamulin
• Lemborexant
• Leniolisib
• Lenvatinib
• Letermovir
• Leuprolide
• Levofloxacin
• Levomilnacipran
• Lofexidine
• Lopinavir
• Lorlatinib
• Lumacaftor
• Lumateperone
• Lumefantrine
• Lurbinectedin
• Macimorelin
• Macitentan
• Manidipine
• Mefloquine
• Meperidine
• Methadone
• Methotrexate
• Methylprednisolone
• Metronidazole
• Midostaurin
• Mifepristone
• Mirtazapine
• Mirvetuximab Soravtansine-gynx
• Mitapivat
• Mobocertinib
• Moxifloxacin
• Nafarelin
• Neratinib
• Nevirapine
• Nifedipine
• Nilotinib
• Nintedanib
• Norfloxacin
• Nortriptyline
• Octreotide
• Ofloxacin
• Olanzapine
• Olaparib
• Omaveloxolone
• Ombitasvir
• Omeprazole
• Ondansetron
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Oxycodone
• Ozanimod
• Palbociclib
• Paliperidone
• Palovarotene
• Panobinostat
• Paritaprevir
• Paroxetine
• Pasireotide
• Pazopanib
• Pemigatinib
• Pentazocine
• Pexidartinib
• Phenprocoumon
• Phenytoin
• Pimavanserin
• Pirtobrutinib
• Pitolisant
• Ponatinib
• Ponesimod
• Pralsetinib
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Protriptyline
• Quetiapine
• Quinine
• Quizartinib
• Ranolazine
• Reboxetine
• Regorafenib
• Relugolix
• Retapamulin
• Ribociclib
• Rimegepant
• Rivaroxaban
• Romidepsin
• Ruxolitinib
• Salmeterol
• Selpercatinib
• Selumetinib
• Sertraline
• Sevoflurane
• Sildenafil
• Simeprevir
• Siponimod
• Sirolimus Protein-Bound
• Sodium Phosphate
• Sodium Phosphate, Dibasic
• Sodium Phosphate, Monobasic
• Solifenacin
• Sonidegib
• Sorafenib
• Sotalol
• Sparsentan
• Sufentanil
• Sulpiride
• Sunitinib
• Suvorexant
• Tacrolimus
• Tadalafil
• Tamsulosin
• Tazemetostat
• Telaprevir
• Telavancin
• Telithromycin
• Temsirolimus
• Tetrabenazine
• Tezacaftor
• Thiotepa
• Ticagrelor
• Toremifene
• Trabectedin
• Tramadol
• Trazodone
• Triazolam
• Triclabendazole
• Trifluoperazine
• Trimipramine
• Triptorelin
• Tucatinib
• Upadacitinib
• Valbenazine
• Vamorolone
• Vandetanib
• Vardenafil
• Vemurafenib
• Venlafaxine
• Vilanterol
• Vilazodone
• Vinblastine
• Vincristine
• Vincristine Sulfate Liposome
• Vinflunine
• Vinorelbine
• Vorapaxar
• Warfarin
• Zanubrutinib
• Zolpidem
• Zuclopenthixol
• Zuranolone

Using this medicine with any of the following medicines may cause an increased chance of certain adverse effects, but using both drugs may be the best therapy for you. If both medications are prescribed together, your physician may change the dose or how frequently you use one or both of the medicines.

• Amlodipine
• Amprenavir
• Cerivastatin
• Desogestrel
• Dienogest
• Drospirenone
• Esomeprazole
• Estetrol
• Estradiol
• Ethinyl Estradiol
• Ethynodiol
• Etravirine
• Fosamprenavir
• Gestodene
• Glipizide
• Glyburide
• Levonorgestrel
• Meloxicam
• Mestranol
• Midazolam
• Nomegestrol
• Norethindrone
• Norgestimate
• Norgestrel
• Tolbutamide
• Tretinoin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may additionally cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you inform your physician if you have any other medical problems, especially:

• Cancer therapy (eg, chemotherapy), recent or history of or
• Electrolyte imbalance (eg, low potassium, magnesium, calcium) or
• Heart disease, history of or
• Stem cell transplant—Use with caution. These conditions may raise your chance of having serious adverse effects.

• Heart rhythm issues (eg, arrhythmia, QT prolongation) or
• Liver disease (such as cirrhosis) or
• Kidney disease or
• Pancreas problems—Use with caution. May make these conditions worse.

• Hypocalcemia (low calcium in the blood), uncorrected or
• Hypokalemia (low potassium in the blood), uncorrected or
• Hypomagnesemia (low magnesium in the blood)—Use with caution. These should be corrected first prior to starting therapy and during therapy with voriconazole.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

• Black, tarry stools
• blistering, peeling, loosening of the skin
• chest pain
• chills
• cough
• diarrhea
• difficulty seeing at night
• fever
• increased sensitivity of the eyes to sunlight
• itching, rash
• joint or muscle pain
• painful or difficult urination
• red irritated eyes
• red skin lesions, often with a purple center
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• swollen glands
• trouble breathing
• unusual bleeding or bruising
• unusual tiredness or weakness
• vision changes

Less common

• Bloating or swelling of the face, arms, hands, lower legs, or feet
• blurred vision
• chills
• clay-colored stools
• confusion
• dark urine
• decreased urine
• dizziness
• dry mouth
• faintness or lightheadedness when getting up suddenly from a lying or sitting position
• feeling of warmth
• increased thirst
• irregular or pounding heartbeat
• loss of appetite
• muscle pain or cramps
• muscle spasms or twitching
• nausea
• nervousness
• numbness or tingling in the hands, feet, or lips
• pounding in the ears
• rapid weight gain
• rash with flat lesions or small raised lesions on the skin
• redness of the face, neck, arms, and occasionally, the upper chest
• seizures
• slow or fast heartbeat
• stomach pain
• sweating
• trembling
• unpleasant breath odor
• vomiting of blood
• yellow eyes or skin

Rare

• Black, bloody, or tarry stools
• bleeding gums
• blood in the eye
• blood in the urine or stools
• eye pain
• pale skin
• pinpoint red spots on the skin
• redness in the white part of the eyes
• seeing things that are not there

Incidence not known

• Backache
• blindness
• blue-yellow color blindness
• bone pain
• chapped, red, or swollen lips
• darkening of the skin
• decreased vision
• diarrhea
• facial hair growth in females
• fainting
• fractures
• full or round face, neck, or trunk
• increased urination
• irritability
• loss of sexual desire or ability
• menstrual irregularities
• mental depression
• muscle wasting
• scaling, redness, burning, pain, or other signs of inflammation of the lips
• vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Headache
• pain or swelling at the injection site

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Vfend I.V.

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Antifungal

Chemical Class: Triazole

A nurse or other trained health professional will give you or your child this medicine. It is given through a needle placed into one of your veins. It must be given slowly, so your IV tube should stay in place for up to 2 hours.

Your doctor will give you or your child a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

This medicine comes with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.