voriconazole at a glance
Medicine class
Systemic triazole antifungal
Available forms
Film-coated tablets, oral suspension and intravenous infusion
Food
Oral forms are taken away from meals; timing differs between tablets and suspension
Sun protection
Avoid direct sunlight and use protective clothing and high-SPF sunscreen
Monitoring
Blood tests commonly include liver and kidney function; plasma concentrations may also be checked
What is voriconazole used for?
Licensed uses in adults and children aged 2 years and older include:
Invasive aspergillosis
Candida infection in the bloodstream in non-neutropenic patients
Serious invasive Candida infections resistant to fluconazole, including Candida krusei
Serious infections caused by Scedosporium or Fusarium species
Prevention of invasive fungal infections in high-risk recipients of an allogeneic haematopoietic stem-cell transplant
How does voriconazole work?
Fungi need ergosterol to build and maintain their cell membranes. Voriconazole blocks a fungal cytochrome P450 enzyme involved in ergosterol production, disrupting the membrane and stopping fungal growth or killing susceptible fungi.
voriconazole preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 200 mg
Oral suspension
Route: Oral
Strengths: 40 mg/mL
Tablet
Route: Oral
Strengths: 50 mg, 100 mg, 200 mg
How to take voriconazole
Follow the product-specific instructions and prescription label. Administration differs by formulation.
Swallow film-coated tablets whole with water, at least one hour before or one hour after food.
Take oral suspension at least one hour before or two hours after food.
Shake the suspension before use and measure it with the supplied oral syringe. Do not mix it with another medicine or dilute it further.
Intravenous voriconazole is prepared, diluted and administered by healthcare professionals.
Do not drive or use machinery while affected by blurred vision, altered vision or light sensitivity.
voriconazole side effects
Common or expected effects
- Temporary changes in vision, such as blurring, altered colour perception or light sensitivity
- Headache
- Nausea, vomiting, diarrhoea or abdominal pain
- Rash or itching
- Fever
- Swelling of the hands, ankles or feet
- Abnormal liver blood-test results
Get urgent medical advice
- Severe allergic reaction
- Severe blistering, peeling or widespread skin reaction
- Liver injury, which may present with jaundice
- Heart-rhythm disturbance or fainting
- Severe, prolonged or worsening visual problems
- Marked photosensitivity and premalignant or cancerous skin lesions, particularly with longer exposure
- Acute kidney injury
- Unexplained bone pain associated with periostitis
voriconazole in pregnancy
Human pregnancy data are inadequate, and animal studies found reproductive toxicity. Product information states that voriconazole should not be used during pregnancy unless the expected maternal benefit clearly outweighs the potential fetal risk. Effective contraception is required during treatment; discuss pregnancy or plans for pregnancy promptly with the specialist team.
voriconazole while breastfeeding
It is unknown whether voriconazole passes into human milk. Product information states that breastfeeding must stop when treatment begins; discuss the infection, treatment alternatives and an appropriate feeding plan with the prescriber.
voriconazole interactions
Voriconazole is affected by and strongly affects several CYP enzymes. A complete medicines check, including non-prescription and herbal products, is essential.
Rifampicin, carbamazepine, long-acting barbiturates and St John's wort
These can greatly lower voriconazole exposure and are contraindicated.
Sirolimus and selected sensitive CYP3A4 substrates
Voriconazole can produce dangerous concentration increases; several combinations are contraindicated.
Tacrolimus and ciclosporin
Concentrations can rise substantially, requiring specialist management and close level and toxicity monitoring.
Common questions about voriconazole
Answers are fully visible for fast scanning and source review.
Why must voriconazole be taken away from food?
Food can reduce oral absorption. Follow the instructions for the exact formulation because tablet and suspension timing differs.
Can voriconazole cause blurred or altered vision?
Yes. Temporary blurring, colour changes and light sensitivity are very common. Do not drive while affected, and report severe, persistent or worsening symptoms.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.