Vfend - DANGEROUS SIDE EFFECTS
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Vfend Warnings and Dangers
Vfend works by preventing fungi from producing a substance called ergosterol, which is a component of fungal cell membranes. The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. Without ergosterol as part of the cell membrane, the membrane is weakened and damaged, and essential constituents of the fungal cells can leak out. This kills the fungi and hence clears up the infection.
Vfend is used to treat serious fungal infections, including those caused by Candida, Aspergillus, Scedosporium and Fusarium species of fungi. To make sure the fungi causing an infection are susceptible to Vfend your doctor may take a tissue sample, for example a swab from the throat or skin, or a urine or blood sample.
Vfend is usually reserved as treatment for progressive infections in people whose immune systems are under active, for example due to cancer treatment, AIDS, or following an organ transplant. Serious fungal infections can sometimes be life-threatening in these groups of patients.
Vfend is a brand name for the generic drug Voriconazole.
Before starting treatment with this medicine you should have a blood test to measure the levels of electrolytes (salts, such as potassium, calcium and magnesium) in your blood. If there are any problems your doctor will give you treatment to correct them before you start this medicine.
This medicine may cause visual disturbances such as blurred vision and so may affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you.
This medicine can make your skin more sensitive to sunlight. For this reason you should avoid exposing your skin to direct sunlight or sun lamps during treatment. Tell your doctor if you get a rash while taking this medicine.
This medicine can sometimes cause liver problems and for this reason your liver function will be monitored during treatment. Tell your doctor if you experience any of the following symptoms while taking this medicine, as they may suggest a problem with your liver:
- Unexplained itching
- Loss of appetite
- Nausea and vomiting
- Abdominal pain
- Yellowing of the skin or whites of the eyes (jaundice)
- Unusually dark urine or pale stools
- Your kidney function should also be monitored during treatment with this medicine.
- Unless your doctor tells you otherwise, it is important that you finish the prescribed course of this antifungal medicine, even if you feel better or it seems the infection has cleared up. Stopping the course early increases the chance that the infection will come back and that the fungi will grow resistant to the medicine.
- The following are some of the side effects that are known to be associated with this medicine:
- Visual disturbances.
- Skin reactions such as rash or itch
- Disturbances of the gut such as diarrhea, constipation, nausea, vomiting or
- Abdominal pain.
- Swelling of the legs and ankles due to fluid retention (peripheral edema)
- Flushing and nausea during infusion.
- Chest or back pain
- Respiratory distress syndrome
- Hair loss
- Low blood pressure
- Pins and needles sensations
- Liver or kidney disorders
- Disturbances in the components of the blood
- Abnormal heart beats
- Inflammation of the pancreas (pancreatitis) in children
Vfend must not be used in combination with any of the following medicines:
- High doses of ritonavir (400 mg and above twice daily)
- The herbal remedy St John's wort (Hypericum perforatum).
Vfend should be avoided in people taking low dose ritonavir (100 mg twice daily), unless your doctor considers the benefits to outweigh the risks. This is because ritonavir decreases the blood level of Vfend and could make it less effective at treating infection.
Vfend may increase the blood level of the immunosuppressants cyclosporine and tacrolimus. If you are taking cyclosporine or tacrolimus when you start this medicine your doctor should decrease your dose to prevent side effects from the immunosuppressant. The level of cyclosporine or tacrolimus in your blood should be monitored after starting and stopping treatment with this medicine.
Vfend may increase the anti-blood-clotting effect of anticoagulants such as warfarin. If you are taking an anticoagulant medicine your blood clotting time (INR) should be monitored while taking this medicine.
Vfend may increase the blood level of sulphonylurea medicines, such as tolbutamide, glipizide, glyburide, that are used to treat type 2 diabetes. This could cause blood sugar to fall (hypoglycemia). People taking any of these medicines should therefore carefully monitor their blood sugar during treatment with this medicine.
Vfend may increase the blood level of methadone. If you are taking methadone when you start this medicine your doctor may need to reduce your methadone dose in order to avoid side effects.
Vfend may increase the blood level of hormones from oral contraceptives containing ethinylestradiol and norethisterone. It should not make these contraceptives any less effective, but may increase the chance of getting side effects like nausea or changes in your bleeding.
Vfend may also increase the blood levels of the following medicines. As this could increase the chance of their side effects, your doctor may need to reduce the dose of these medicines if you are taking any of them when you start treatment with Vfend:
- Benzodiazepines such as Triazolam and midazolam
- Statins such as simvastatin
Phenytoin and Rifabutin decrease the blood level of Vfend. Conversely, Vfend may increase the blood levels of these medicines. These combinations should be avoided where possible, but if considered necessary your doctor will prescribe you a higher than normal dose of Vfend and monitor you for side effects of the other medicine.
The anti-HIV medicine efavirenz also decreases the blood level of Vfend, while its blood level is increased by the Vfend. As a result, if you are taking efavirenz you will be prescribed a higher than normal dose of Vfend. In addition, your dose of efavirenz will be decreased during the treatment and then increased again once your course of Vfend is finished.
If you are taking other anti-HIV medicines, such as protease inhibitors, your doctor will want to monitor you carefully for any new side effects if you are also prescribed this medicine.
There may be an increased risk of abnormal heart rhythms (prolonged QT interval on the heart monitoring trace or ECG) if this medicine is taken with the following:
- Medicines to treat abnormal heart rhythms, eg amiodarone, procainamide, disopyramide, sotalol
- Certain antidepressants, such as maprotiline, amitriptyline, imipramine
- Certain antipsychotics, such as thioridazine, chlorpromazine, sertindole, haloperidol
- Antimalarials, such as halofantrine, chloroquine, quinine, vRiamet
- Certain antimicrobials, eg erythromycin, moxifloxacin or pentamidine.
Vfend may cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Vfend while you are pregnant. It is not known if Vfend is found in breast milk. If you are or will be breast-feeding while you use Vfend, check with your doctor. Discuss any possible risks to your baby.
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