Voriconazole (Vfend), as a broad-spectrum antifungal drug, should be adjusted in dosage and administration according to the type of infection and individual patient conditions. Special attention should be paid to liver function monitoring and dosage adjustment when using it in special populations. The following provides detailed explanations from two aspects: standard usage and dosage, as well as medication for special populations.

1. Standard usage and dosage

(1) Adult standard dosage

On the first day of intravenous administration, the loading dose was 6mg/kgq12h, and the maintenance dose was 4mg/kgq12h; On the first day of oral administration, 400mg q12h was administered, and the maintenance dose was 200mg q12h.

(2) Child dose

On the first day of intravenous administration of 6mg/kgq12h in children aged 2-12, the maintenance dose is 4mg/kgq12h; The oral dose is calculated as twice the intravenous dose.

(3) Course adjustment

Invasive aspergillosis for at least 6-12 weeks; Candidiaemia requires continuous treatment for 14 days after the symptoms disappear.

2. Medication for special populations

(1) Liver dysfunction

Half the maintenance dose for Child Pugh A/B grade patients; Child Pugh Class C patients should only use it when the benefits outweigh the risks.

(2) Renal insufficiency

Avoid intravenous preparations when creatinine clearance rate is less than 50mL/min, as the excipient sulfonamide betacyclodextrin sodium may accumulate.

(3) Elderly people

The incidence of adverse reactions in patients aged 65 and above has increased by 30%. It is recommended to start with low doses and strengthen monitoring.

(4) Pregnancy period

Animal experiments have shown teratogenicity, and pregnant women should avoid using it. Effective contraceptive measures should be taken during the treatment period for women of childbearing age.

(5) Lactation period

Medications can be secreted into breast milk, and lactating women should stop breastfeeding or discontinue medication.

3. Medication precautions

Liver function should be checked before treatment; Avoid co administration with strong inducers/inhibitors of CYP3A4; When encountering visual impairments, one should avoid driving or operating machinery.