DiagnosticsPBS Listing Of Antifungal Suspension Welcomed By Paediatricians
General Practitioners and specialists will be able to prescribe VFEND® (voriconazole) oral suspension for immuno-suppressed adolescents and children following its listing on the Pharmaceutical Benefits Scheme (PBS) from 1 August 2009.
VFEND® is a broad-spectrum antifungal agent for the treatment and maintenance therapy of definite or probable invasive aspergillosis, including disseminated disease and aspergillosis which has been unresponsive to other therapies.1,2
Invasive aspergillosis is an important cause of morbidity and mortality in transplant recipients and immuno-compromised patients with haematological malignancies.Âð Dr Anne Thomas, Associate Medical Director, Specialty Care, Pfizer believes: "The listing of VFEND® oral suspension provides easier access to medication in a form suitable to children, while easing pressure off hospitals as the only of this medicine."
Associate Professor David Ellis, Head of Mycology, Women"s and Children"s Hospital agrees stating the "PBS listing of voriconazole oral suspension will provide further flexibility in patient care, an important component in the successful management of invasive fungal infections; especially for pediatric and other patients who may have difficulty swallowing tablets".
Previously, this antifungal - a first-line therapy also used for scedosporium or fusarium fungal infections, and a second line therapy for both candida and other serious invasive mycosis - was only available through hospitals.1,2
Professor Peter Shaw, Head of Bone Marrow Transplant Unit, The Children"s Hospital Westmead explains that VFEND® Suspension has been much anticipated by paediatricians.
"Voriconazole is a standard drug used in many of our patients undergoing Blood and Marrow Transplant. These patients are all children undergoing unrelated or mismatched procedures and often come to BMT with pre-existing invasive fungal infection. Our ability to give them multiple medications in the early months post BMT, as well as adequate nutrition and fluid, is often hampered by the tolerability of all the drugs.
We have extensive experience with the use of Voriconazole suspension and find it well tolerated and can achieve acceptable blood levels in most patients. These patients often require maintenance treatment for several months and the ability to give younger out-patients Voriconazole suspension certainly makes it easier to manage them" said Professor Shaw.
VFEND® is also a treatment option for other life-threatening fungal infections such as cryptococcosis.2
Additionally, VFEND® is used to treat serious candida infections such as invasive candidiasis and candidaemia - increasingly common, costly and potentially fatal yeast infections, particularly affecting the immuno-compromised and critically ill.1,2
The most common side effects of VFEND® are visual disturbances, fever, rash, vomiting, nausea, diarrhoea, headache, peripheral oedema and abdominal pain2. The severity is generally mild to moderate. VFEND® is contraindicated with the simultaneous use of cisapride, pimozide, quinidine, rifampicin, carbamazepine, long-acting barbiturates, ergot alkaloids, sirolimus and St John"s Wort. It should also be used with caution in patients with hypersensitivity to azoles and proarrhythmic conditions2. Prior to prescribing, please review full Product Information for VFEND®, is available at http://www.pfizer.com.au.
VFEND® is available in tablets, oral suspension and intravenous injections and is PBS listed for adults as well. The most recent PBS listing is specifically for oral suspension (40mg/mL 70mL) for adolescents and children aged 2 and over. VFEND® Tablets (50mg or 200mg) are also available on the PBS but VFEND® intravenous injections are still only accessible through hospitals.
Health professionals with questions about VFEND® should contact Pfizer Medical Affairs on 1800 675 229.
References
Âð Thursky KA, Playford EG, Seymour JF et al. Intern Med J 2008; 38(6b): 496-520
² VFEND® (voriconazole) Product Information.
Pfizer Australia