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VORICONAZOLE MYX®

Voriconazole (vori-con-a-zole), IV injection


Consumer Medicine Information

What is in this leaflet

This leaflet answers some common questions about Voriconazole MYX.

It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking Voriconazole MYX against the benefits they expect it will have for you.

Ask the doctor if you have any concerns about you or your child taking this medicine.

Keep this leaflet even after your treatment You may need to read it again.

What Voriconazole MYX is used for

Voriconazole MYX is used to treat fungal and yeast infections such as:

  • invasive aspergillosis (as-pur-jilosis), a fungal infection caused by a fungus called Aspergillus (as-pur-jilus), which usually begins in the respiratory tract (in the nose, sinuses or lungs). Aspergillus is harmless in most healthy people; however, in people with poor immune systems (such as people who have had organ transplants and people with cancer or HIV/AIDS) invasive aspergillosis can be serious and spread to other tissues and organs.
  • serious Candida (can-did-da) infections, including Candida infections that have spread into the blood stream or to other parts of the body.
  • serious fungal infections caused by Scedosporium (ski-doe-sporerium) species and Fusarium (fewsaa-rium) species.
  • other serious fungal infections in patients who do not respond to, or cannot tolerate, other antifungal medicines.

Voriconazole MYX is also used to prevent invasive fungal infections in patients who are at risk of developing such infections.

This medicine belongs to a group of medicines called triazole antifungals.

This medicine works by preventing the growth of fungal and yeast organisms causing your infection.

Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.

This medicine is not addictive.

This medicine is available only with a doctor's prescription.

Before being treated with Voriconazole MYX

When you must not be given it

Voriconazole MYX must not be given if you or your child have ever had an allergy to:

  • any medicine containing voriconazole.
  • any of the ingredients listed at the end of this leaflet.
  • any other similar medicines.

Symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; skin rash, itching or hives.

Voriconazole MYX must not be given if you are taking any of the following medicines:

  • pimozide (e.g. Orap), a medicine used to treat mental illness.
  • quinidine (e.g. Kinidin Durules), a medicine used to treat irregular heartbeat.
  • rifampicin (e.g. Rifadin, Rimycin), a medicine used to treat tuberculosis and other infections.
  • carbamazepine (e.g. Tegretol, Teril), a medicine used to treat seizures.
  • long-acting barbiturates such as phenobarbitone, medicines used to treat severe insomnia and seizures.
  • rifabutin (e.g. Mycobutin) an antibiotic.
  • ergotamine (e.g. Cafergot) or dihydroergotamine (e.g. Dihydergot), medicines used to treat migraine.
  • sirolimus (e.g. Rapamune), a medicine used in transplant patients.
  • efavirenz (e.g. Stocrin) (a medicine used to treat HIV infection) in doses of 400 mg or more once a day.
  • ritonavir (e.g. Norvir, Kaletra) (a medicine used to treat HIV infection) in doses of 400 mg or more twice a day.
  • St John's Wort (a herbal medicine).

Voriconazole MYX should not be given to a child under the age of 2 years. Safety and effectiveness in children younger than 2 years has not been established.

Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.

If you are not sure whether you should start taking this medicine, talk to your doctor first.

Before you start to treatment with Voriconazole MYX

Tell your doctor if you have allergies to any foods, preservatives or dyes or any other medicines, especially antifungal medicines such as itraconazole (Sporanox), fluconazole (Diflucan), posaconazole (Noxafil) or ketoconazole (Nizoral) (not all brands given).

Tell your doctor if you have or have had any of the following medical conditions:

  • heart problems.
  • any problems affecting your kidneys.
  • any problems affecting your liver. If you have liver disease your doctor may prescribe a lower dose.
  • recent chemotherapy or stem cell transplant.

Tell your doctor if you are pregnant or plan to become pregnant. Voriconazole MYX should not be taken during pregnancy, unless indicated by your doctor. Effective contraception should be used in women of childbearing potential. Your doctor can discuss with you the risks and benefits involved.

Tell your doctor if you are breastfeeding. Voriconazole MYX should not be taken whilst breastfeeding, unless indicated by your doctor. It is not known if the active ingredient voriconazole passes into breast milk. Your doctor can discuss with you the risks and benefits involved.

If you have not told your doctor about any of the above, tell your doctor before you start taking Voriconazole MYX.

Taking other medicines

Tell your doctor if you are taking any other medicines, including any that you get without a prescription from a pharmacy, supermarket or health food shop.

Some medicines should not be taken with Voriconazole MYX. These include (not all brands given):

  • pimozide (e.g. Orap), a medicine used to treat mental illness.
  • quinidine (e.g. Kinidin Durules), a medicine for irregular heartbeat.
  • rifampicin (e.g. Rifadin, Rimycin), a medicine used to treat tuberculosis and other infections.
  • carbamazepine (e.g. Tegretol, Teril), a medicine used to treat seizures.
  • long-acting barbiturates such as phenobarbitone, medicines used to treat severe insomnia and seizures.
  • rifabutin (e.g. Mycobutin) an antibiotic.
  • ergotamine (e.g. Cafergot) or dihydroergotamine (e.g. Dihydergot), medicines used to treat migraine.
  • sirolimus (e.g. Rapamune) a medicine used in transplant patients.
  • efavirenz (Stocrin) (a medicine used to treat HIV infection) in doses of 400 mg or more once a day.
  • ritonavir (e.g. Norvir, Kaletra) (a medicine used to treat HIV infection) in doses of 400 mg or more twice a day.
  • St John's Wort, (a herbal medicine).

Some medicines and Voriconazole MYX may interfere with each other. These include (not all brands given):

  • efavirenz (Stocrin) (a medicine used to treat HIV infection) in doses below 400 mg once a day.
  • ritonavir (Norvir, Kaletra) (a medicine used to treat HIV infection) in doses of 100 mg twice a day.
  • warfarin (e.g. Marevan, Coumadin), a medicine used to stop blood clots.
  • everolimus (e.g. Afinitor, Certican), a medicine used to treat cancer.
  • fluconazole (e.g. Diflucan), a medicine used to treat fungal infections.
  • phenytoin (e.g. Dilantin), a medicine used to treat epilepsy.
  • cyclosporin (e.g. Sandimmun, Neoral), a medicine used to prevent organ transplant rejection or to treat certain problems with the immune system.
  • sulphonylureas, medicines used to treat diabetes such as glibenclamide, gliclazide and glipizide (e.g. Daonil, Diamicron, Minidiab).
  • some antihistamines, medicines used to treat hayfever, allergic skin reactions, itching.
  • theophylline (e.g. Nuelin), a medicine used to treat asthma.
  • benzodiazepines (e.g. Valium), medicines used to treat insomnia or anxiety.
  • statins (e.g. Zocor, Lipitor, Crestor), medicines used for lowering cholesterol.
  • tacrolimus (e.g. Prograf), a medicine used in patients who have had a liver or kidney transplant.
  • indinavir (e.g. Crixivan) and some other medicines used to treat HIV infection.
  • omeprazole (e.g. Losec), a medicine used to treat indigestion, reflux and stomach or duodenal ulcers.
  • methadone (used to treat heroin addiction).
  • oral contraceptives (the Pill).
  • vincristine, vinblastine or vinorelbine, medicines used in treating cancer (e.g.Vepesid).
  • strong pain killers such as alfentanil (e.g. Rapifen), fentanyl (e.g. Durogesic, Actiq, Sublimaze) and oxycodone (e.g. Endone, Proladone).
  • non-steroidal anti-inflammatory drugs, medicines used to treat pain and inflammation such as ibuprofen and diclofenac (e.g. Nurofen, Advil, Voltaren).

These medicines may be affected by Voriconazole MYX or may affect how well it works. You may need different amounts of your medicines or you may need to take different medicines.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking this medicine.

How Voriconazole MYX is given

It is recommended that treatment with Voriconazole MYX begin in a hospital.

Voriconazole MYX will be given to you or your child by the doctor or nurse.

Voriconazole MYX is a liquid which is given by slow injection into the blood (known as an intravenous infusion or "drip").

You or your child may be changed from Voriconazole MYX injection to an oral preparation of linezolid (such as tablets or oral suspension) to complete your course of treatment.

How much is given

Adults

Treatment of invasive fungal infections

The usual dose ofVoriconazole MYX is 6 mg/kg every 12 hours for the first day, given by injection. The dose is then adjusted to 3 mg/kg or 4 mg/kg every 12 hours, depending on the type of infection you have.

Prevention of invasive fungal infections

The usual dose of Voriconazole MYX is 6 mg/kg every 12 hours for the first day, given by injection. The dose is then adjusted to 4 mg/kg every 12 hours by injection or, in adults weighing 40 kg and greater, one 200 mg voriconazole tablet twice a day or 5 mL voriconazole oral suspension twice a day.

In adults weighing less than 40 kg the dose of voriconazole Tablets and Oral Suspension is halved.

Note: Voriconazole oral suspension and tablet formulations are unavailable in this MYX brand.

Children

Voriconazole MYX should not be given to a child under the age of 2 years.

Your doctor will determine the dose of Voriconazole MYX required for your child.

Depending on how serious the infection is and how your child reacts to the medicine, your doctor may increase or decrease the dose.

Adolescents (12-16 years of age)

Adolescents aged 12-16 years of age are usually given the same dose as adults.

How it is given

Voriconazole MYX is given as an injection by a doctor or trained nurse. Voriconazole MYX is a powder which is mixed with Water for Injections and then diluted by your pharmacist or doctor. It is then given by injection into a vein.

How long the treatment of Voriconazole MYX is

The length of time you are given Voriconazole MYX will depend on the type of infection you have.

If you have a weakened immune system or a difficult infection, you may need long-term treatment to prevent the infection from returning.

You may be switched from the injection to voriconazole Tablets or Oral Suspension once your condition improves.

If you forget to take it

Voriconazole MYX will be given to you under close medical supervision. It is unlikely that a dose would be missed.

In case of overdose

Overdose is unlikely as treatment will be given by the doctor or nurse.

Symptoms of an overdose may include upset stomach, diarrhoea, headache and sensitivity to light.

Tell the doctor or nurse immediately if you or your child have any of these effects or if you or your child feel worse during or after treatment with Voriconazole MYX.

While you are using Voriconazole MYX

Things you must do

Tell your doctor immediately if you develop a rash or blisters while taking Voriconazole MYX. If this rash worsens, Voriconazole MYX may need to be stopped.

Avoid going out in the sun for long periods of time while you are being treated with Voriconazole MYX. Voriconazole MYX can cause sensitivity to light.

Tell your doctor if you notice any changes to your skin while you are being treated with Voriconazole MYX.

If the symptoms of your infection do not improve within a few days, or if they become worse, tell your doctor.

Make sure you follow your doctor's instructions and keep all appointments, including blood tests. Your doctor should monitor the function of your liver and kidneys using blood tests. If you have liver disease, your doctor might lower your dose of Voriconazole MYX or stop your Voriconazole MYX treatment. Your doctor might also monitor the function of your pancreas.

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are being treated with Voriconazole MYX.

Tell any other doctors, dentists, and pharmacists who treat you that you are being treated with this medicine.

If you are going to have surgery, tell the surgeon or anaesthetist that you are being treated with this medicine. It may affect other medicines used during surgery.

If you are a woman of childbearing age, you should avoid becoming pregnant while being treated with Voriconazole MYX. If you become pregnant while being treated with Voriconazole MYX, tell your doctor immediately.

If you are about to have any blood tests, tell your doctor that you are being treated with this medicine. It may interfere with the results of some tests.

Things to be careful of

Be careful driving or operating machinery until you know how Voriconazole MYX affects you.

You may experience changes to your vision, such as blurriness, colour changes or uncomfortable sensitivity to light.

If you have any of these symptoms, do not drive, operate machinery or do anything else that could be dangerous. Do not drive at night.

Children should be careful when riding bicycles or climbing.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are being treated with Voriconazole MYX.

This medicine helps most people with fungal infections, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. If they occur, most are likely to be minor and temporary. However, some may be serious and need medical attention.

Do not be alarmed by the following lists of possible side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

  • changes to your vision, such as blurred vision, colour changes or sensitivity to light
  • irregular heartbeat
  • nausea or feeling sick, vomiting
  • headache
  • stomach pain, indigestion, diarrhoea
  • back pain in middle or upper back
  • swelling of the arms or legs
  • rash
  • changes to your skin, such as skin eruptions or small lumps on the skin
  • soreness at the injection site.

If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

  • swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing
  • asthma, wheezing, shortness of breath
  • sudden or severe itching, skin rash, hives or blisters
  • fainting, seizures or fits
  • flaking of the skin
  • yellowing of the skin or eyes, also called jaundice
  • signs of frequent or worsening infections such as fever, severe chills, sore throat or mouth ulcers
  • blood in urine
  • signs of kidney failure such as tiredness, lack of appetite and reduced or greatly increased amount of urine
  • convulsions, fits

These may be signs of a serious allergic reaction or side effect. You may need urgent medical attention or hospitalisation. These side effects are rare.

Tell your doctor if you notice any other side effects.

Other side effects not listed above may also occur in some people.

After using Voriconazole MYX

Storage

Voriconazole MYX will normally be stored in the pharmacy or on the hospital ward and is kept below 25°C.

After sterile Water for Injections is added to this medicine, it may be stored in a fridge at 2°C to 8°C for up to 24 hours prior to use. Do not freeze.

Hospital staff will make sure the medicine is not used after the expiry date printed on the bag.

Product description

What it looks like

Voriconazole MYX comes as a white powder in a clear, colourless, glass vial which contains 200 mg of voriconazole.

Ingredients

Active Ingredients

Voriconazole MYX contains 200 mg of voriconazole as the active ingredient in each 30 mL vial.

Inactive Ingredients

Voriconazole MYX contains the following other ingredients:

  • Water for Injections
  • Lactose monohydrate
  • Hydroxypropylbetadex

Supplier

Mayne Pharma International Pty Limited
ABN 88 007 870 984
1538 Main North Road
Salisbury South SA 5106

Australian Registration Numbers

AUST R 280240

This leaflet was prepared in September 2017.

MYX is a registered trade mark of Mayne Pharma International Pty Limited.

Published by MIMS November 2017

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