Verify Voriconazole

Drug JSON

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{
  "slug": "voriconazole",
  "nameEn": "Voriconazole",
  "nameTh": "โวริโคนาโซล",
  "class": "Antifungal — second-generation triazole",
  "mechanism": "triazole รุ่นใหม่ ยับยั้ง fungal CYP450 (14-alpha-demethylase) ลดการสร้าง ergosterol; ออกฤทธิ์กว้างรวม Aspergillus และซึมเข้าระบบประสาท/ตาได้ดี",
  "brandNamesTh": [
    "Vfend"
  ],
  "indications": [
    {
      "text": "เชื้อรารุกราน โดยเฉพาะ aspergillosis (รวม sinonasal/CNS), เชื้อราที่ดื้อ itraconazole ในสุนัข; ใช้ในแมวได้แต่ต้องระวังพิษมาก",
      "cites": [
        "merck-azoles",
        "paper-voriconazole"
      ]
    }
  ],
  "contraindications": [
    {
      "text": "⚠️ แมวไวต่อพิษรุนแรง (ขนาดคน/สุนัข 5 mg/kg q12h ทำให้แมวตายได้ — visual abnormality, ataxia, arrhythmia) ใช้ขนาดต่ำ + therapeutic drug monitoring; พิษตับ; ปฏิกิริยายาหลายชนิด (CYP); narrow therapeutic window",
      "cites": [
        "paper-voriconazole",
        "merck-azoles"
      ]
    }
  ],
  "sideEffects": [
    {
      "text": "พิษตับ, ความผิดปกติการมองเห็น, ataxia/neurotoxicity, K+ ต่ำ, หัวใจเต้นผิดจังหวะ (เด่นในแมว)",
      "cites": [
        "paper-voriconazole"
      ]
    }
  ],
  "dosages": [
    {
      "species": "canine",
      "indication": "Aspergillosis / invasive mycosis",
      "route": "PO",
      "dose": "2.5–3.3 mg/kg PO ทุก 12 ชั่วโมง (ปรับด้วย TDM, trough 1–5 mg/L)",
      "cites": [
        "paper-voriconazole"
      ]
    },
    {
      "species": "feline",
      "indication": "Aspergillosis — extreme caution",
      "route": "PO",
      "dose": "⚠️ induction ~25 mg/ตัว PO ครั้งเดียว แล้ว 12.5 mg/ตัว PO ทุก 48 ชั่วโมง (≈ 2–2.7 mg/kg) — ระวังพิษ + TDM",
      "cites": [
        "paper-voriconazole"
      ]
    }
  ],
  "monitoring": [
    {
      "text": "therapeutic drug monitoring (trough 1–5 mg/L); ค่าตับ; electrolyte + ECG ในแมว",
      "cites": [
        "paper-voriconazole"
      ]
    }
  ],
  "citations": [
    {
      "id": "merck-azoles",
      "type": "textbook",
      "title": "Azoles for Use in Animals — MSD/Merck Veterinary Manual",
      "year": 2025,
      "url": "https://www.merckvetmanual.com/pharmacology/antifungal-agents/azoles-for-use-in-animals",
      "note": "Authoritative veterinary pharmacology reference. Copyrighted, cited not mirrored.",
      "cid": null
    },
    {
      "id": "paper-voriconazole",
      "type": "paper",
      "title": "Pharmacokinetics of voriconazole after IV and oral administration to healthy cats (AJVR)",
      "url": "https://avmajournals.avma.org/view/journals/ajvr/77/9/ajvr.77.9.931.xml",
      "year": 2023,
      "note": "Peer-reviewed feline voriconazole PK + toxicity study.",
      "cid": null
    },
    {
      "id": "wikipedia-voriconazole",
      "type": "monograph",
      "title": "Voriconazole — Wikipedia",
      "year": 2026,
      "url": "https://en.wikipedia.org/wiki/Voriconazole",
      "note": "Tertiary cross-check for class + mechanism. CC BY-SA 4.0. Not sole authority.",
      "cid": null
    }
  ],
  "mirroredFrom": [
    {
      "id": "who-atc",
      "name": "WHO ATC/DDD Index",
      "url": "https://www.whocc.no/atc_ddd_index/",
      "asOfDate": "2026-05-30",
      "license": "WHO publication, free for use with attribution"
    }
  ],
  "mirrorCIDs": [],
  "codes": {
    "atc": {
      "code": "J02AC03",
      "name": "Voriconazole",
      "level": 5
    }
  },
  "drafting": {
    "aiAssisted": false,
    "aiModel": null,
    "aiPromptHash": null,
    "humanReviewer": "palmzamak2547",
    "humanReviewedAt": "2026-05-30",
    "humanEditsRatio": null
  },
  "signatures": [],
  "reviewedBy": null,
  "lastUpdated": "2026-05-30",
  "version": 1,
  "changelog": [
    {
      "version": 1,
      "date": "2026-05-30",
      "summary": "New entry — clinical content compiled from cited authoritative sources (Merck Veterinary Manual / VSSO / CURATIVE / Tufts CardioRush / Today's Vet Practice / peer-reviewed), cross-checked. Every statement cited. Reviewed by palmzamak2547. Pending faculty canonical signature."
    }
  ]
}

Public keys used

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