Voriconazole

Các tên gọi khác (6 ) :

(AlphaR,betas)-alpha-(2,4-difluorophenyl)-5-fluoro-beta-methyl-alpha(1H-1,2,4-triazol-1-ylmethyl)-4-pyrimidineethanol
(R-(R*,s*))-alpha-(2,4-difluorophenyl)-5-fluoro-beta-methyl-alpha-(1H-1,2,4-triazol-1-ylmethyl)-4-pyrimidineethanol
VCZ
Vfend
Voriconazol
Voriconazolum

antifungal agents, 14 alpha demethylase inhibitors

Thuốc Gốc

Small Molecule

CAS: 137234-62-9

ATC: J02AC03

ĐG : Cardinal Health , http://www.cardinal.com

CTHH: C₁₆H₁₄F₃N₅O

PTK: 349.3105

Voriconazole (Vfend®, Pfizer) is a triazole antifungal medication used to treat serious fungal infections. It is used to treat invasive fungal infections that are generally seen in patients who are immunocompromised. These include invasive candidiasis, invasive aspergillosis, and emerging fungal infections.

Nhận Dạng Quốc Tế & Đặc Tính Hóa Học

Công thức hóa học

C₁₆H₁₄F₃N₅O

Phân tử khối

349.3105

Monoisotopic mass

349.11504471

InChI

InChI=1S/C16H14F3N5O/c1-10(15-14(19)5-20-7-22-15)16(25,6-24-9-21-8-23-24)12-3-2-11(17)4-13(12)18/h2-5,7-10,25H,6H2,1H3/t10-,16+/m0/s1

InChI Key

InChIKey=BCEHBSKCWLPMDN-MGPLVRAMSA-N

IUPAC Name

(2R,3S)-2-(2,4-difluorophenyl)-3-(5-fluoropyrimidin-4-yl)-1-(1H-1,2,4-triazol-1-yl)butan-2-ol

Traditional IUPAC Name

voriconazole

SMILES

C[C@@H](C1=NC=NC=C1F)[C@](O)(CN1C=NC=N1)C1=C(F)C=C(F)C=C1

Độ tan chảy

127-130 °C

Độ hòa tan

Low

logP

logS

-3.5

pKa (strongest acidic)

12.71

pKa (Strongest Basic)

2.27

PSA

76.72 Å²

Refractivity

95.28 m³·mol^-1

Polarizability

30.54 Å³

Rotatable Bond Count

H Bond Acceptor Count

H Bond Donor Count

Physiological Charge

Number of Rings

Bioavailability

Rule of Five

true

Ghose Filter

true

Dược Lực Học : Voriconazole is a triazole antifungal agent indicated for use in the treatment of fungal infections including invasive aspergillosis, esophageal candidiasis, and serious fungal infections caused by Scedosporium apiospermum (asexual form of Pseudallescheria boydii) and Fusarium spp. including Fusarium solani. Fungal plasma membranes are similar to mammalian plasma membranes, differing in having the nonpolar sterol ergosterol, rather than cholesterol, as the principal sterol. Membrane sterols such as ergosterol provide structure, modulation of membrane fluidity, and possibly control of some physiologic events. Voriconazole effects the formation of the fungal plasma membrane by indirectly inhibiting the biosynthesis of ergosterol. This results in plasma membrane permeability changes and inhibition of growth.

Cơ Chế Tác Dụng : Voriconazole (Vfend®, Pfizer) is a triazole antifungal medication used to treat serious fungal infections. It is used to treat invasive fungal infections that are generally seen in patients who are immunocompromised. These include invasive candidiasis, invasive aspergillosis, and emerging fungal infections. Voriconazole binds and inhibits ergosterol synthesis by inhibiting CYP450-dependent 14-alpha sterol demethylase. The inhibition of 14-alpha sterol demethylase results in a depletion of ergosterol in fungal cell membrane.

Dược Động Học :

▧ Absorption :
The oral bioavailability is estimated to be 96% (CV 13%).
▧ Volume of Distribution :
* 4.6 L/kg
▧ Protein binding :
58%
▧ Metabolism :
Hepatic. The major metabolite of voriconazole is the N-oxide, which accounts for 72% of the circulating radiolabelled metabolites in plasma. Since this metabolite has minimal antifungal activity, it does not contribute to the overall efficacy of voriconazole.
▧ Route of Elimination :
Voriconazole is eliminated via hepatic metabolism with less than 2% of the dose excreted unchanged in the urine.

Độc Tính : The minimum lethal oral dose in mice and rats was 300 mg/kg (equivalent to 4 and 7 times the recommended maintenance dose (RMD), based on body surface area). At this dose, clinical signs observed in both mice and rats included salivation, mydriasis, titubation (loss of balance while moving), depressed behavior, prostration, partially closed eyes, and dyspnea. Other signs in mice were convulsions, corneal opacification and swollen abdomen.

Chỉ Định : For the treatment of esophageal candidiasis, invasive pulmonary aspergillosis, and serious fungal infections caused by Scedosporium apiospermum and Fusarium spp.

Tương Tác Thuốc :

Abarelix Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Abiraterone Strong CYP3A4 inhibitors may increase levels of abiraterone. Monitor concomitant therapy closely.
Alfentanil Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of alfentanil by decreasing its metabolism. Monitor for increased anesthetic and respiratory depressant effects and consider using lower alfentanil doses or alternate anesthetic.
Alfuzosin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of alfuzosin by decreasing its metabolism. Use of alfuzosin with strong CYP3A4 inhibitors is contraindicated by the manufacturer.
Almotriptan Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of almotriptan by decreasing its metabolism. The initial and maximum doses should not exceed 6.25 mg and 12.5 mg, respectively during concomitant therapy. Concomitant therapy should be avoided in patients with impaired hepatic or renal function.
Alprazolam Voriconazole may increase the serum concentration of alprazolam by decreasing its metabolism. Monitor for alprazolam toxicity if voriconazole is initiated or dose increased.
ambrisentan Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ambrisentan by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of ambrisentan if voriconazole is initiated, discontinued or dose changed.
Amiodarone Additive QTc prolongation may occur. Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of amiodarone by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of amiodarone if voriconazole is initiated, discontinued or dose changed.
Amitriptyline Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Amlodipine Voriconazole may increase the serum concentration of amlodipine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of amlodipine if voriconazole is initiated, discontinued or dose changed.
Amobarbital Amobarbital may reduce serum concentrations and efficacy of voriconazole. Concomitant voriconazole and long-acting barbiturates therapy is contraindicated.
Amoxapine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Amprenavir Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of amprenavir by decreasing its metabolism. The serum concentration of voriconazole may be increased by amprenavir. Monitor for changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or if doses are changed.
Apixaban Avoid combination. Otherwise, voriconazole will likely increase apixaban serum concentration.
Apomorphine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Aprepitant Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of aprepitant by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of aprepitant if voriconazole is initiated, discontinued or dose changed.
Aripiprazole Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of aripiprazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of aripiprazole if voriconazole is initiated, discontinued or dose changed.
armodafinil Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of armodafinil by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of armodafinil if voriconazole is initiated, discontinued or dose changed.
Arsenic trioxide Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Artemether Additive QTc-prolongation may occur. Concomitant therapy should be avoided.
Asenapine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Astemizole Increased risk of cardiotoxicity and arrhythmias
Atazanavir Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of atazanavir by decreasing its metabolism. The serum concentration of voriconazole may be increased by atazanavir. Monitor for changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or if doses are changed.
Atorvastatin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of atorvastatin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of atorvastatin if voriconazole is initiated, discontinued or dose changed.
Benzphetamine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of benzphetamine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of benzphetamine if voriconazole is initiated, discontinued or dose changed.
Bisoprolol Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of bisoprolol by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of bisoprolol if voriconazole is initiated, discontinued or dose changed.
Bortezomib Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of bortezomib by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of bortezomib if voriconazole is initiated, discontinued or dose changed.
Bosentan Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of bosentan by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of bosentan if voriconazole is initiated, discontinued or dose changed.
Bromazepam Voriconazole may increase the serum concentration of bromazepam by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of bromazepam if voriconazole is initiated, discontinued or dose changed.
Bromocriptine Voriconazole may increase the serum concentration of bromocriptine likely by decreasing its metabolism. Concomitant therapy is contraindicated.
Budesonide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of budesonide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of budesonide if voriconazole is initiated, discontinued or dose changed.
Buprenorphine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of buprenorphine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of buprenorphine if voriconazole is initiated, discontinued or dose changed.
Buspirone Voriconazole may increase the serum concentration of buspirone likely by decreasing its metabolism via CYP3A4. Monitor for changes in the therapeutic and adverse effects of buspirone if voriconazole is initiated, discontinued or dose changed.
Busulfan Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of busulfan by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of busulfan if voriconazole is initiated, discontinued or dose changed.
Butabarbital Butabarbital may reduce serum concentrations and efficacy of voriconazole. Concomitant voriconazole and long-acting barbiturates therapy is contraindicated.
Butalbital Butalbital may reduce serum concentrations and efficacy of voriconazole. Concomitant voriconazole and long-acting barbiturates therapy is contraindicated.
Cabazitaxel Concomitant therapy with a strong CYP3A4 inhibitor may increase concentrations of cabazitaxel. Avoid concomitant therapy.
Cabergoline Voriconazole may increase the serum concentration of cabergoline likely by decreasing its metabolism. Concomitant therapy is contraindicated.
Calcitriol Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of calcitriol by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of calcitriol if voriconazole is initiated, discontinued or dose changed.
Capecitabine Capecitabine, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if capecitabine is initiated, discontinued or dose changed.
Carbamazepine Carbamazepine may reduce serum concentrations and efficacy of voriconazole likely by increasing its metabolism. Concomitant voriconazole and carbamazepine therapy is contraindicated.
Chlordiazepoxide Voriconazole may increase the serum concentration of chlordiazepoxide by decreasing its metabolism. Monitor for chlordiazepoxide toxicity if voriconazole is initiated or dose increased.
Chloroquine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of chloroquine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of chloroquine if voriconazole is initiated, discontinued or dose changed.
Chlorphenamine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of chlorpheniramine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of chlorpheniramine if voriconazole is initiated, discontinued or dose changed.
Chlorpropamide Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Ciclesonide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ciclesonide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of ciclesonide if voriconazole is initiated, discontinued or dose changed.
Cilostazol Voriconzole may increase the serum concentration of cilostazol by decreasing its metabolism. Monitor for increased therapeutic/adverse effects of cilostazol and consider reducing the dose during concomitant therapy.
Cinacalcet Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of cinacalcet by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of cinacalcet if voriconazole is initiated, discontinued or dose changed.
Cisapride Voriconazole may increase the serum concentration and toxicity of cisapride likely by decreasing its metabolism. Additive QTc prolongation may also occur. Concomitant therapy is contraindicated.
Citalopram Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of citalopram by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of citalopram if voriconazole is initiated, discontinued or dose changed.
Clarithromycin Additive QTc prolongation may occur. Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of clarithromycin by decreasing its metabolism. Clarithromycin may increase the serum concentration of voriconazole by decreasing its metabolism. Consider alternate therapy or monitor for QTc prolongation and changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or dose changed.
Clobazam Voriconazole may increase the serum concentration of clobazam by decreasing its metabolism. Monitor for clobazam toxicity if voriconazole is initiated or dose increased.
Clomipramine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Clonazepam Voriconazole may increase the serum concentration of clonazepam by decreasing its metabolism. Monitor for clonazepam toxicity if voriconazole is initiated or dose increased.
Clorazepate Voriconazole may increase the serum concentration of clorazepate by decreasing its metabolism. Monitor for clorazepate toxicity if voriconazole is initiated or dose increased.
Cocaine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of cocaine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of cocaine if voriconazole is initiated, discontinued or dose changed.
Colchicine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of colchicine by decreasing its metabolism. A dose reduction of colchicine is recommended along with increased monitoring for colchicine toxicity. Concomitant therapy is contraindicated in patients with renal and/or hepatic impairment.
Conivaptan Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of conivaptan by inhibiting its metabolism. Concomitant therapy is contraindicated.
Cyclosporine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of cyclosporine by decreasing its metabolism. Consider reducing the dose of cyclosporine. Monitor cyclosporine serum concentrations and therapeutic and toxic effects if initiating, discontinuing or adjusting voriconazole therapy.
Dantrolene Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of dantrolene by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of dantrolene if voriconazole is initiated, discontinued or dose changed.
Dapsone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of dapsone by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of dapsone if voriconazole is initiated, discontinued or dose changed.
Darifenacin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of darifenacin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of darifenacin if voriconazole is initiated, discontinued or dose changed.
Darunavir Darunavir may reduce serum concentrations and efficacy of voriconazole. This combination should be avoided unless the potential benefits outweigh the risk of reduced voriconazole efficacy.
Dasatinib Additive QTc prolongation may occur. Voriconazole, a strong CYP3A4 inhibitor, may also increase the serum concentration of dasatinib by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of dasatinib if voriconazole is initiated, discontinued or dose changed.
Delavirdine Delavirdine, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if delavirdine is initiated, discontinued or dose changed.
Desipramine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Dexamethasone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of dexamethasone by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of dexamethasone if voriconazole is initiated, discontinued or dose changed.
Diazepam Voriconazole may increase the serum concentration of diazepam by decreasing its metabolism. Monitor for diazepam toxicity if voriconazole is initiated or dose increased.
Diclofenac Voriconazole, a strong CYP2C9 inhibitor, may increase the serum concentration of diclofenac by decreasing its metabolism. Renal impairment may increase the risk of diclofenac adverse effects. Monitor for changes in therapeutic and adverse effects of diclofenac if voriconazole is initiated, discontinued or dose changed.
Didanosine Didanosine may interfere with the absorption of orally administered voriconazole. Enteric coated didanosine does not exert this effect. Didanosine buffered formulations should be administered at least 2 hours from oral voriconazole administration.
Digitoxin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of digitoxin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of digitoxin if voriconazole is initiated, discontinued or dose changed.
Digoxin Voriconazole may increase the serum concentration of digoxin. Monitor for increased serum concentrations and toxic effects of digoxin if voriconazole is initiated or dose increased.
Dihydroergotamine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of dihydroergotamine by decreasing its metabolism. Concomitant therapy is contraindicated.
Diltiazem Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of diltiazem by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of diltiazem if voriconazole is initiated, discontinued or dose changed.
Disopyramide Additive QTc prolongation may occur. Voriconazole, a strong CYP3A4 inhibitor, may also increase the serum concentration of disopyramide by decreasing its metabolism. Consider alternate therapy or monitor for QTc prolongation and changes in the therapeutic and adverse effects of disopyramide if voriconazole is initiated, discontinued or dose changed.
Docetaxel Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of docetaxel by decreasing its metabolism. Consider using a non-interacting antifungal or monitor for changes in the therapeutic and adverse effects of docetaxel if voriconazole is initiated, discontinued or dose changed.
Dofetilide Voriconazole may increase the serum concentration of dofetilide by decreasing its metabolism. Concomitant therapy is contraindicated.
Dolasetron Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Doxepin Additive QTc prolongation may occur. Voriconazole, a strong CYP3A4 inhibitor, may also increase the serum concentration of doxepin by decreasing its metabolism. Consider alternate therapy or monitor for QTc prolongation and changes in the therapeutic and adverse effects of doxepin if voriconazole is initiated, discontinued or dose changed.
Doxorubicin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of doxorubicin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of doxorubicin if voriconazole is initiated, discontinued or dose changed.
Dronedarone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration by decreasing its metabolism. Additive QTc prolongation may also occur. Concomitant therapy is contraindicated.
Dronedarone Voriconazole is a strong CYP3A4 inhibitor in which concomitant use with dronedarone will significantly increase its exposure. Avoid concomitant use.
Droperidol Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Efavirenz Efavirenze may decrease the serum concentration of voriconazole likely by increasing its metabolism. Voriconazole may increase the serum concentration of efavirenz by decreasing its metabolism. Consider alternate therapy or adjust doses and monitor for reduced voriconazole efficacy and increased efavirenz adverse effects during concomitant therapy.
Eletriptan Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of eletriptan by decreasing its metabolism. Consider avoiding administration of the two agents within 72 hours of each other. Monitor for changes in the therapeutic and adverse effects of eletriptan if voriconazole is initiated, discontinued or dose changed.
Eplerenone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of eplerenone by decreasing its metabolism. Concomitant therapy is contraindicated.
Ergoloid mesylate Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ergoloid mesylates by decreasing their metabolism. Concomitant therapy is contraindicated.
Ergonovine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ergonovine by decreasing its metabolism. Concomitant therapy is contraindicated.
Ergotamine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ergotamine by decreasing its metabolism. Concomitant therapy is contraindicated.
Erlotinib Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of erlotinib by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of erlotinib if voriconazole is initiated, discontinued or dose changed.
Erythromycin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of erythromycin by decreasing its metabolism. Erythromycin may increase the serum concentration of voriconazole by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for QTc prolongation and changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or dose changed.
Escitalopram Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of escitalopram by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of escitalopram if voriconazole is initiated, discontinued or dose changed.
Estazolam Voriconazole may increase the serum concentration of estazolam by decreasing its metabolism. Monitor for estazolam toxicity if voriconazole is initiated or dose increased.
Eszopiclone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of eszopiclone by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of eszopiclone if voriconazole is initiated, discontinued or dose changed.
Ethosuximide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ethosuximide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of ambrisentan if voriconazole is initiated, discontinued or dose changed.
Etoposide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of etoposide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of etoposide if voriconazole is initiated, discontinued or dose changed.
Etravirine Etravirine, when used concomitantly with variconazole, may experience an increase in serum concentration due to decreased metabolism of etravirine. Voriconazole, when used concomitantly with etravirine (a CYP2C19 inhibitor), may experience a decrease in serum concentration. Monitor for changes in efficacy and toxicity of both agents if concomitant therapy is initiated, modified or discontinued.
Everolimus Voriconzole, a strong CYP3A4 inhibitor, may increase the serum concentration of everolimus by decreasing its metabolism. Concurrent therapy should be avoided.
Felbamate Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of felbamate by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of felbamate if voriconazole is initiated, discontinued or dose changed.
Felodipine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of felodipine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of felodipine if voriconazole is initiated, discontinued or dose changed.
Fentanyl Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of fentanyl by decreasing its metabolism. Adverse effects include life-threatening respiratory depression. Monitor for changes in the therapeutic and adverse effects of fentanyl if voriconazole is initiated, discontinued or dose changed.
Flecainide Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Floxuridine Floxuridine, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if floxuridine is initiated, discontinued or dose changed.
Fluconazole Fluconazole, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for QTc prolongation and changes in the therapeutic and adverse effects of voriconazole if fluconazole is initiated, discontinued or dose changed.
Flunisolide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of flunisolide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of flunisolide if voriconazole is initiated, discontinued or dose changed.
Fluorouracil Fluorouracil, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if fluorouracil is initiated, discontinued or dose changed.
Fluoxetine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Flupentixol Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Flurazepam Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of flurazepam by decreasing its metabolism. Monitor for flurazepam toxicity if voriconazole is initiated or dose increased.
Flurbiprofen Flurbiprofen, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if flurbiprofen is initiated, discontinued or dose changed.
Flutamide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of flutamide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of flutamide if voriconazole is initiated, discontinued or dose changed.
Fluticasone Propionate Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of fluticasone by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of fluticasone if voriconazole is initiated, discontinued or dose changed.
Fosamprenavir Voriconazole may increase the serum concentration of fosamprenavir by decreasing its metabolism. Fosamprenavir may increase the serum concentration of voriconazole. Monitor for changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or if doses are changed.
Foscarnet Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Fosphenytoin The hydantoin decreases the effect of voriconazole
Gatifloxacin Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Gefitinib Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of gefitinib by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of gefitinib if voriconazole is initiated, discontinued or dose changed.
Gemfibrozil Gemfibrozil, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if gemfibrozil is initiated, discontinued or dose changed.
Halofantrine Voriconazole may increase the serum concentration of halofantrine by decreasing its metabolism by CYP3A4. Concomitant therapy should be avoided due to the concentration-dependent risk of QTc prolongation related to halofantrine.
Haloperidol Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of haloperidol by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of haloperidol if voriconazole is initiated, discontinued or dose changed.
Ibuprofen Ibuprofen, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if ibuprofen is initiated, discontinued or dose changed.
Ibutilide Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Ifosfamide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ifosfamide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of ifosfamide if voriconazole is initiated, discontinued or dose changed.
Imatinib Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of imatinib by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of imatinib if voriconazole is initiated, discontinued or dose changed.
Imipramine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Indapamide Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Indinavir Voriconazole may increase the serum concentration of indinavir by decreasing its metabolism. Indinavir may increase the serum concentration of voriconazole. Monitor for changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or if doses are changed.
Indomethacin Indomethacin, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if indomethacin is initiated, discontinued or dose changed.
Irinotecan Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of irinotecan by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of irinotecan if voriconazole is initiated, discontinued or dose changed.
Isosorbide Dinitrate Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of isosorbide dinitrate by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of isosorbide dinitrate if voriconazole is initiated, discontinued or dose changed.
Isosorbide Mononitrate Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of isosorbide mononitrate by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of isosorbide mononitrate if voriconazole is initiated, discontinued or dose changed.
Isradipine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of isradipine by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of isradipine if voriconazole is initiated, discontinued or dose changed.
Ivacaftor Strong CYP3A4 inhibitors may increase levels of ivacaftor. Monitor concomitant therapy closely.
Ixabepilone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ixabepilone by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of ixabepilone if voriconazole is initiated, discontinued or dose changed.
Ketamine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ketamine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of ketamine if voriconazole is initiated, discontinued or dose changed.
Ketoconazole Ketoconazole, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if ketoconazole is initiated, discontinued or dose changed.
Lapatinib Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of lapatinib by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of lapatinib if voriconazole is initiated, discontinued or dose changed.
Levofloxacin Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Lidocaine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of lidocaine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of lidocaine if voriconazole is initiated, discontinued or dose changed.
Lopinavir Lopinavir may reduce serum concentration and efficacy of voriconazole. This combination should be avoided unless the potential benefits outweigh the risk of reduced voriconazole efficacy.
Lovastatin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of lovastatin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of lovastatin if voriconazole is initiated, discontinued or dose changed.
Loxapine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Lumefantrine Additive QTc-prolongation may occur. Concomitant therapy should be avoided.
Maprotiline Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Maraviroc Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of maraviroc by decreasing its metabolism. A dose reduction in maraviroc is warranted. Monitor for changes in the therapeutic and adverse effects of maraviroc if voriconazole is initiated, discontinued or dose changed.
Mefenamic acid Mefanamic acid, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if mefanamic acid is initiated, discontinued or dose changed.
Mefloquine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of mefloquine by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of mefloquine if voriconazole is initiated, discontinued or dose changed.
Meloxicam Voriconazole may increase the serum concentration of meloxicam by decreasing its metabolism via CYP2C9 and CYP3A4. Monitor for changes in the therapeutic and adverse effects of meloxicam if voriconazole is initiated, discontinued or dose changed.
Mesoridazine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Methadone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of methadone by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of methadone if voriconazole is initiated, discontinued or dose changed.
Methotrimeprazine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Methylergometrine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of methylergonovine by decreasing its metabolism. Concomitant therapy is contraindicated.
Miconazole Miconazole, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if miconazole is initiated, discontinued or dose changed.
Midazolam Voriconazole may increase the serum concentration of midazolam by decreasing its metabolism. Monitor for midazolam toxicity if voriconazole is initiated or dose increased.
Mirtazapine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of mirtazapine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of mirtazapine if voriconazole is initiated, discontinued or dose changed.
Modafinil Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of modafinil by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of modafinil if voriconazole is initiated, discontinued or dose changed.
Moricizine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of moricizine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of moricizine if voriconazole is initiated, discontinued or dose changed.
Moxifloxacin Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Nateglinide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of nateglinide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of nateglinide if voriconazole is initiated, discontinued or dose changed.
Nefazodone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of nefazodone by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of nefazodone if voriconazole is initiated, discontinued or dose changed.
Nelfinavir Nelfinavir may decrease the serum concentration of voriconazole likely by increasing its metabolism. Voriconazole may increase the serum concentration of nelfinavir by decreasing its metabolism. Consider alternate therapy or adjust doses and monitor for reduced voriconazole efficacy and increased nelfinavir adverse effects during concomitant therapy.
Nicardipine Nicardipine, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of nicardipine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole and nicardipine if concomitant therapy is initiated, discontinued or doses are changed.
Nifedipine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of nifedipine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of nifedipine if voriconazole is initiated, discontinued or dose changed.
Nilotinib Voriconazole may increase the serum concentration of nilotinib by inhibiting its metabolism by CYP3A4. Additive QTc prolongation may also occur. Concomitant therapy should be avoided.
Nimodipine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of nimodipine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of nimodipine if voriconazole is initiated, discontinued or dose changed.
Nisoldipine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of nisoldipine by decreasing its metabolism. Concomitant therapy should be avoided.
Nitrendipine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of nitrendipine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of nitrendipine if voriconazole is initiated, discontinued or dose changed.
Norfloxacin Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Nortriptyline Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Octreotide Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Omeprazole Voriconazole increases the effect and toxicity of omeprazole
Paclitaxel Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of paclitaxel by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of paclitaxel if voriconazole is initiated, discontinued or dose changed.
Pentamidine Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Perflutren Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Pergolide Voriconazole may increase the serum concentration of pergolide likely by decreasing its metabolism. Concomitant therapy is contraindicated.
Phencyclidine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of phencyclidine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of phencyclidine if voriconazole is initiated, discontinued or dose changed.
Phenobarbital Phenobarbital may reduce serum concentrations and efficacy of voriconazole. Concomitant voriconazole and long-acting barbiturates therapy is contraindicated.
Phenytoin Voriconazole may increase the serum concentration of phenytoin by decreasing its metabolism. Phenytoin may increase the serum concentration of voriconazole by increasing its metabolism. Consider alternate antifungal therapy or monitor for voriconazole therapy failure and phenytoin toxicity.
Pimozide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of pimozide by decreasing its metabolism. Increased risk of QTc prolongation and development arrhythmias. Concomitant use is contraindicated.
Pipotiazine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of pipotiazine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of pipotiazine if voriconazole is initiated, discontinued or dose changed.
Piroxicam Piroxicam, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if piroxicam is initiated, discontinued or dose changed.
Ponatinib Strong CYP3A4 inhibitors may increase levels of ponatinib. Monitor concomitant therapy closely.
Prazepam Voriconazole may increase the serum concentration of prazepam by decreasing its metabolism. Monitor for prazepam toxicity if voriconazole is initiated or dose increased.
Praziquantel Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of praziquantel by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of praziquantel if voriconazole is initiated, discontinued or dose changed.
Primidone The barbiturate, primidone, decreases the effect of voriconazole.
Probucol Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Procainamide Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Propafenone Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Protriptyline Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Quetiapine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of quetiapine by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of quetiapine if voriconazole is initiated, discontinued or dose changed.
Quinidine Voriconazole may increase the serum concentration of quinidine likely by inhibiting its metabolism by CYP3A4. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the serum concentration and toxic effects of quinidine if voriconazole is initiated, discontinued or dose changed.
Quinine Additive QTc prolongation may occur. Concomitant therapy should be avoided.
Ranolazine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of ranolazine by decreasing its metabolism. Additive QTc prolongation may also occur. Concomitant therapy is contraindicated.
Regorafenib Strong CYP3A4 inhibitors may increase levels of regorafenib.
Repaglinide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of repaglinide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of repaglinide if voriconazole is initiated, discontinued or dose changed.
Rifabutin Rifabutin may decrease the serum concentration of voriconazole likely by increasing its metabolism via CYP3A enzymes. Voriconazole may increase the serum concentration of rifabutin likely by inhibiting its metabolism via CYP3A. Concomitant therapy is contraindicated.
Rifampicin Rifampin may decrease the serum concentration of voriconazole likely by increasing its metabolism via CYP3A enzymes. Voriconazole may increase the serum concentration of rifampin likely by inhibiting its metabolism via CYP3A. Concomitant therapy is contraindicated.
Rifapentine Rifapentine may decrease the serum concentration of voriconazole likely by increasing its metabolism via CYP3A enzymes. Voriconazole may increase the serum concentration of rifapentin likely by inhibiting its metabolism via CYP3A. Concomitant therapy is contraindicated.
Risperidone Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Ritonavir Ritonavir may decrease the serum concentration of voriconazole by increasing its metabolism. Concomitant therapy with high dose ritonavir is contraindicated. Caution should be used with lower doses as decreased voriconazole efficacy may occur.
Rivaroxaban Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of rivaroxaban by decreasing its metabolism. Increased bleed risks may occur. Consider alternate therapy.
Ruxolitinib Strong CYP3A4 inhibitors may increase levels of ruxolitinib. Consider alternate therapy.
Salmeterol Voriconazole, a strong CYP3A4 inhibitor may increase the serum concentration of salmeterol by decreasing its metabolism. Consider alternate therapy.
Saquinavir Voriconazole may increase the serum concentration of saquinavir by decreasing its metabolism. Saquinavir may increase the serum concentration of voriconazole. Monitor for changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or if doses are changed.
Saxagliptin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of saxagliptin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of saxagliptin if voriconazole is initiated, discontinued or dose changed.
Sibutramine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of sibutramine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of sibutramine if voriconazole is initiated, discontinued or dose changed.
Sildenafil Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of sildenafil by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of sildenafil if voriconazole is initiated, discontinued or dose changed.
Silodosin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of silodosin by decreasing its metabolism. Concomitant therapy is contraindicated.
Simvastatin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of simvastatin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of simvastain if voriconazole is initiated, discontinued or dose changed.
Sirolimus Voriconazole may increase the serum concentration of sirolimus likely by inhibition of CYP3A4-mediated metabolism or p-glyprotein transport of sirolimus. Consider alternate therapy or reduce the dose of sirolimus and monitor serum levels during concomitant therapy.
Sitaxentan Sitaxsentan, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if sitaxsentan is initiated, discontinued or dose changed.
Solifenacin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of solifenacin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of solifenacin if voriconazole is initiated, discontinued or dose changed.
Sotalol Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Sparfloxacin Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Spiramycin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of spiramycin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of spiramycin if voriconazole is initiated, discontinued or dose changed.
St. John's Wort St. John's Wort may decrease the serum concentration of voriconazole by increasing its elimination. Concomitant therapy is contraindicated.
Sufentanil Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of sufentanil by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of sufentanil if voriconazole is initiated, discontinued or dose changed.
Sulfisoxazole Sulfisoxazole, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if sulfisoxazole is initiated, discontinued or dose changed.
Sunitinib Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of sunitinib by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of sunitinib if voriconazole is initiated, discontinued or dose changed.
Tacrolimus Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of tacrolimus by decreasing its metabolism. Additive QTc prolongation may also occur. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of tacrolimus if voriconazole is initiated, discontinued or dose changed.
Tadalafil Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of tadalafil by decreasing its metabolism. Concomitant therapy should be avoided if possible due to high risk of tadalafil toxicity.
Tamoxifen Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of tamoxifen by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of tamoxifen if voriconazole is initiated, discontinued or dose changed.
Tamsulosin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of tamsulosin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of tamsulosin if voriconazole is initiated, discontinued or dose changed.
Telithromycin Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of telithromycin by decreasing its metabolism. Telithromycin may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or dose changed. QTc interval prolongation may also occur.
Temsirolimus Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of temsirolimus and its active metabolite, sirolimus, by decreasing their metabolism. Concomitant therapy should be avoided.
Teniposide The strong CYP3A4 inhibitor, Voriconazole, may decrease the metabolism and clearance of Teniposide, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Teniposide if Voriconazole is initiated, discontinued or dose changed.
Terfenadine Increased risk of cardiotoxicity and arrhythmias
Tetrabenazine Additive QTc prolongation may occur. Concomitant therapy should be avoided.
Theophylline Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of theophylline by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of theophylline if voriconazole is initiated, discontinued or dose changed.
Thioridazine Additive QTc prolongation may occur. Concomitant use is contraindicated.
Thiothixene Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Tiagabine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of tiagabine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of tiagabine if voriconazole is initiated, discontinued or dose changed.
Tipranavir Voriconazole may increase the serum concentration of tipranavir by decreasing its metabolism. Tipranavir may increase the serum concentration of voriconazole. Monitor for changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or if doses are changed.
Tolbutamide Tolbutamide, a strong CYP2C9 inhibitor, may decrease the metabolism and clearance of Voriconazole. Consider alternate therapy or monitor for changes in Voriconazole therapeutic and adverse effects if Tolbutamide is initiated, discontinued or dose changed.
Tolterodine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of tolterodine by decreasing its metabolism. Tolterodine is mainly metabolized via the CYP2D6 pathway. This interaction is likely only a concern in patients who are poor CYP2D6 metabolizers. Monitor for changes in the therapeutic and adverse effects of tolterodine if voriconazole is initiated, discontinued or dose changed.
Tolvaptan Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of Tolvaptan by decreasing its metabolism. Concomitant therapy is contraindicated.
Toremifene Additive QTc-prolongation may occur, increasing the risk of serious ventricular arrhythmias. Consider alternate therapy. A thorough risk:benefit assessment is required prior to co-administration.
Tramadol Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of tramadol by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of tramadol if voriconazole is initiated, discontinued or dose changed.
Trazodone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of trazodone by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of trazodone if voriconazole is initiated, discontinued or dose changed.
Triazolam Voriconazole may increase the serum concentration of triazolam by decreasing its metabolism. Monitor for triazolam toxicity if voriconazole is initiated or dose increased.
Trimipramine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of trimipramine by decreasing its metabolism. Additive QTc prolongation may also occur. Monitor for changes in the therapeutic and adverse effects of trimipramine if voriconazole is initiated, discontinued or dose changed.
Vardenafil Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of vardenafil by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of vardenafil if voriconazole is initiated, discontinued or dose changed.
Vemurafenib Strong CYP3A4 inhibitors may increase levels of vemurafenib. Monitor concomitant therapy closely.
Venlafaxine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of venlafaxine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of venlafaxine if voriconazole is initiated, discontinued or dose changed.
Verapamil Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of verapamil by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of verapamil if voriconazole is initiated, discontinued or dose changed.
Vilazodone CYP3A4 Inhibitors (Strong) may increase the serum concentration of Vilazodone. imit maximum adult vilazodone dose to 20 mg/day in patients receiving strong CYP3A4 inhibitors.
Vinblastine Voriconazole, a strong CYP3A4 inhibitor, may decrease the metabolism of Vinblastine. Consider alternate therapy to avoid Vinblastine toxicity. Monitor for changes in the therapeutic/adverse effects of Vinblastine if Voriconazole is initiated, discontinued or dose changed.
Vincristine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of Vincristine by decreasing its metabolism. Consider alternate therapy to avoid Vincristine toxicity. Monitor for changes in the therapeutic and adverse effects of Vincristine if Voriconazole is initiated, discontinued or dose changed.
Vinorelbine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of Vinorelbine by decreasing its metabolism. Consider alternate therapy to avoid Vinorelbine toxicity. Monitor for changes in the therapeutic and adverse effects of Vinorelbine if Voriconazole is initiated, discontinued or dose changed.
Vorinostat Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Ziprasidone Additive QTc-prolonging effects may increase the risk of severe arrhythmias. Concomitant therapy should be avoided.
Zolpidem Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of zolpidem by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zolpidem if voriconazole is initiated, discontinued or dose changed.
Zonisamide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of zonisamide by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zonisamide if voriconazole is initiated, discontinued or dose changed.
Zopiclone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of zopiclone by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zopiclone if voriconazole is initiated, discontinued or dose changed.
Zuclopenthixol Additive QTc prolongation may occur. Consider alternate therapy or use caution and monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).

Liều Lượng & Cách Dùng : Solution - Intravenous
Tablet - Oral

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Biệt dược thương mại : Vfend 50 mg tablet

Giá bán buôn : USD >12.43

Đơn vị tính : tablet
Biệt dược thương mại : Vfend 200 mg tablet

Giá bán buôn : USD >49.74

Đơn vị tính : tablet
Biệt dược thương mại : Vfend iv 200 mg vial

Giá bán buôn : USD >143.5

Đơn vị tính : vial
Biệt dược thương mại : Vfend 40 mg/ml Suspension 75ml Bottle

Giá bán buôn : USD >870.72

Đơn vị tính : bottle

Nhà Sản Xuất

Công ty :

Sản phẩm biệt dược : Vfend

Đóng gói

Công ty : Cardinal Health

Website : http://www.cardinal.com
Công ty : DSM Corp.

Website : http://www.dsm.com
Công ty : Pfizer Inc.

Website : http://www.pfizer.com

Tài Liệu Tham Khảo Thêm

drugbank

http://www.drugbank.ca/drugs/DB00582

PubChem Compound

http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?sid=71616

PubChem Substance

http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?sid=46506421

KEGG Compound

http://www.genome.jp/dbget-bin/www_bget?cpd:C07622

KEGG Drug

http://www.genome.jp/dbget-bin/www_bget?drug:D00578

ChemSpider

http://www.chemspider.com/Chemical-Structure.64684.html

National Drug Code Directory

http://www.hipaaspace.com/Medical_Billing/Coding/National.Drug.Codes/PDF/0049-3190-28

PharmGKB

http://www.pharmgkb.org/drug/PA10233

Wikipedia

http://en.wikipedia.org/wiki/Voriconazole

RxList

http://www.rxlist.com/cgi/generic/vfend.htm

Drugs.com

http://www.drugs.com/cdi/voriconazole.html

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