Is Voriconazole the New Primary Treatment for Orbital Aspergillosis?


VoriconazoleVoriconazole is also known as the brand name Vfend, which is marketed by Pfizer. As an antifungal medication, voriconazole is typically reserved for treating patients with serious fungal infections, like invasive aspergillosis. Voriconazole is a formidable opponent for fungal infections that begin in the lungs and spread through the bloodstream to other organs, like invasive aspergillosis, as well as esophageal candidiasis. Voriconazole slows the growth of dangerous fungi, and is an antifungal medication in the class deemed triazoles. Available in both a tablet and a suspension form, voriconazole is most effective when taken every 12 hours on an empty stomach. The majority of patients will be administered voriconazole for at least fourteen days, however, the patients with invasive aspergillosis may need this potent antifungal for several months or longer. Adverse effects include vision difficulties, such as light sensitivity or blurry vision, headache, diarrhea, vomiting, dizziness and abdominal pain. Thirty percent of clinical trial participants reported visual disturbances, which is a unique adverse effect for this particular class of drugs. Vfend dosages are dispensed in 50 and 200 milligram tablets. The oral suspension of Vfend, or voriconazole, is 40 milligrams/milliliters. Vials of 200 milligrams are also available for I.V. infusions.

The online publication, Case Reports in Opthalmology, dated February 4, 2012, touted voriconazole as being a new standard treatment for Orbital Aspergillosis. This case report and clinical study was conducted by the University of Florida’s Neuro-Opthalmology Department, under the guidance of Dr. Derek Ohlstein. When treating patients suffering from the often fatal Orbital Aspergillosis, voriconazole was compared with the current standard drug of choice, Amphotericin B. Clinical research revealed a better survival rate for patients given voriconazole in lieu of amphotericin B, and patients who received voriconazole also showed a better tolerability to it, and displayed less adverse systemic effects. While amphotericin B has remained a preferred treatment for Orbital Aspergillosis for many years, researchers are questioning it’s efficacy as the gold standard of treatment for this often misdiagnosed condition. Once the patient with the infection manifests it as an orbital apex syndrome the mortality rate is 70-80%, even with the treatment of amphotericin B. Patients who have been treated with amphotericin B reported numerous side effects as well, including irreversible nephrotoxicity. As a second generation triazole antifungal, voriconazole has shown a 22% survival benefit over amphotericin B in comparative studies. Evidence is mounting in favor of utilizing voriconazole as a primary treatment for Orbital Aspergillosis, however, additional research needs to be completed.

LGM Pharma works in close collaboration with manufacturers worldwide, and is a preferred supplier of Voriconazole CAS# 137234-62-9 as well as Amphotericin B CAS# 1397-89-3 for research and development purposes. Clients can be assured of quality API products and continuous support throughout the R&D process.

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