Progil (Voriconazole). Therapeutic Class: Other antifungal preparations
Generic: Voriconazole (azole antifungal), Children under 12 years: Safety and efficacy not established
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Voriconazole, a triazole antifungal, works by blocking ergosterol biosynthesis. It selectively inhibits CYP450-dependent 14-alpha sterol demethylase, an essential enzyme in fungal cell membrane formation. The inhibition leads to ergosterol depletion, compromising membrane integrity and ultimately inhibiting fungal growth.
≥40 kg body weight
Loading dose: 400 mg (or 10 ml) every 12 hours for the first 24 hours
Maintenance dose: 200 mg (or 5 ml) twice daily
<40 kg body weight
Loading dose: 200 mg (or 5 ml) every 12 hours for the first 24 hours
Maintenance dose: 100 mg (or 2.5 ml) twice daily
Tablets and suspension should be taken at least 1 hour before or after meals.
CYP3A4, CYP2C9, CYP2C19 inhibitors/inducers may alter Progil levels → dosage adjustment and monitoring required
Progil increases plasma concentrations of drugs metabolized by these enzymes → monitor for adverse effects and reduce co-administered drug doses if necessary
Phenytoin and Efavirenz co-administration may require increased maintenance doses of Progil
Known hypersensitivity to Voriconazole or formulation components
Concomitant use with:
Terfenadine, astemizole, cisapride, pimozide, quinidine, sirolimus (risk of severe cardiac adverse events)
Rifampin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir, rifabutin, ergot alkaloids, St. John’s Wort (loss of efficacy or serious reactions)
No adequate well-controlled studies in pregnant women
Use only if potential benefit outweighs risks
Caution advised during breastfeeding
Long-term therapy (>180 days) should be carefully weighed against potential risks
Reports of cutaneous squamous cell carcinoma (SCC) with prolonged use → monitor patients under extended therapy
Store below 25°C, in a dry place, away from light
Keep out of reach of children
Powder for suspension: store at 2–8°C
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