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Brand Name :
Vfend
Synonyms :
voriconazolum
Class :
Triazoles and Phenylpropanes
Brand Name :
Vfend
Synonyms :
voriconazolum
Class :
Triazoles and Phenylpropanes
Dosage Forms & StrengthsÂ
Oral SuspensionÂ
200mg/5mLÂ
TabletsÂ
50mg Â
200mgÂ
InjectionÂ
10mg/mLÂ
Dosage Forms & StrengthsÂ
Oral SuspensionÂ
200mg/5mLÂ
TabletsÂ
50mg Â
200mgÂ
InjectionÂ
10mg/mLÂ
Refer to the adult dosingÂ
It may diminish the effect when combined with phenobarbital by affecting the intestinal/hepatic enzyme CYP3A4
may enhance the serum concentration
may have an increased QTc-prolonging effect when combined with arsenic trioxide
azithromycin: they may increase the QTc-prolonging effect of QTc-prolonging Agents
clofazimine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
QTc-prolonging agents: they may increase the QTc-prolonging effect of clomipramine
midostaurin: they may increase the QTc-prolonging effect of QTc-prolonging Agents
olanzapine: they may enhance the QTc-prolonging effect of QTc-prolonging Agents
oxytocin: they may increase the QTc-prolonging effect of QTc-prolonging Agents
propofol: they may increase the QTc-prolonging effect of QTc-prolonging Agents
toremifene: they may increase the QTc-prolonging effect of QTc-prolonging Agents
afatinib: they may increase the QTc-prolonging effect of QTc-prolonging Agents
calcium chloride: it may increase the risk or severity of QTc prolongation
calcium gluconate: it may increase the risk or severity of QTc prolongation
alprazolam: it may increase the risk or severity of QTc prolongation
QTc-prolongers increase the effect of other QTc-prolonging agents
QTc-prolongers increase the effect of other QTc-prolonging agents
QTc-prolongers increase the effect of other QTc-prolonging agents
QTc-prolongers increase the effect of other QTc-prolonging agents
QTc-prolongers increase the effect of other QTc-prolonging agents
when both drugs are combined, there may be a decreased metabolism of vinblastine  
QTc interval is increased both by lenvatinib and voriconazole
the effect of voriconazole is increased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
CYP3A strong enhancers of the small intestine may reduce the bioavailability of voriconazole
voriconazole increases the effect of fedratinib by altering the intestinal/ hepatic CYP3A4 enzyme metabolism
voriconazole increases the effect or level of midostaurin by altering the CYP3A4 enzyme metabolism
voriconazole increases the effect or level of midostaurin by altering the CYP3A4 enzyme metabolism
it increases the effect or level of palbociclib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
it increases the effect or level of ruxolitinib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
may increase the Qtc prolonging effect
QTc-prolongers increase the effect of other QTc-prolonging agents
QTc-prolongers increase the effect of other QTc-prolonging agents
QTc-prolongers increase the effect of other QTc-prolonging agents
QTc-prolongers increase the effect of other QTc-prolonging agents
QTc-prolongers increase the effect of other QTc-prolonging agents
may have an increased QTc-prolonging effect when combined with citalopram
may have an increased QTc-prolonging effect when combined with domperidone
may increase the QTc-prolonging action of QT-prolonging agents (Highest Risk)
may have an increased QTc-prolonging effect when combined with levoketoconazole
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
thioridazine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
amiodarone: they may increase the QTc-prolonging effect of voriconazole
voriconazole: they may enhance the serum concentration of hormonal contraceptives
voriconazole: they may enhance the serum concentration of hormonal contraceptives
voriconazole: they may enhance the serum concentration of hormonal contraceptives
voriconazole: they may enhance the serum concentration of hormonal contraceptives
It may enhance the serum concentration when combined with asciminib
It may enhance the effect when combined with cannabidiol by affecting CYP3A4 metabolism
It may enhance QTc interval when combined with lithium
Hormonal contraceptives have the potential to elevate the concentration serum of voriconazole
Hormonal contraceptives have the potential to elevate the concentration serum of voriconazole
Hormonal contraceptives have the potential to elevate the concentration serum of voriconazole
Hormonal contraceptives have the potential to elevate the concentration serum of voriconazole
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
It could potentially amplify the QTc-prolonging effect of antipsychotic medications known for their QT-prolongation effects
It could potentially amplify the QTc-prolonging effect of antipsychotic medications known for their QT-prolongation effects
It could potentially amplify the QTc-prolonging effect of antipsychotic medications known for their QT-prolongation effects
It could potentially amplify the QTc-prolonging effect of antipsychotic medications known for their QT-prolongation effects
It could potentially amplify the QTc-prolonging effect of antipsychotic medications known for their QT-prolongation effects
voriconazole: they may enhance the serum concentration of diclofenac
voriconazole: they may enhance the serum concentration of CYP3A4 Inhibitors
voriconazole: they may enhance the serum concentration of CYP3A4 Inhibitors
voriconazole: they may enhance the serum concentration of CYP3A4 Inhibitors
voriconazole: they may enhance the serum concentration of CYP3A4 Inhibitors
voriconazole: they may enhance the serum concentration of CYP3A4 Inhibitors
when both drugs are combined, there may be a decreased metabolism of paclitaxel 
methotrexate may increase the photosensitizing effects of methotrexate
trimetrexate may increase the photosensitizing effects of trimetrexate
has a synergistic effect over brentuximab vedotin by showing altered intestinal/hepatic CYP3A4 enzyme metabolism.
when both drugs are combined, there may be an increased effect of abemaciclib by affecting hepatic or intestinal enzyme cyp3a4 metabolism
when both drugs are combined, there may be a reduced metabolism of erlotinib  
hormonal contraceptives increase the concentration of voriconazole serum
fingolimod may enhance the QTc-prolonging effect of QT-prolonging Agents
may increase the level by affecting the hepatic enzyme CYP3A4 metabolism
may enhance the Qtc prolonging effect
may enhance the QTc-prolonging effect of haloperidol
may increase the level by affecting the hepatic enzyme CYP3A4 metabolism
glycopyrrolate inhaled and formoterolÂ
may increase the QTc interval when combined
it increases by affecting the hepatic enzyme CYP3A4 metabolism
may enhance the serum concentration of CYP2C9 inhibitors
may increase the QTc prolonging effect
may increase the QTc-prolonging effects of QTc-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
QT-prolonging Miscellaneous Agents may increase the QTc-prolonging effect of chloroquine
the rate of metabolism of tocofersolan may be reduced with voriconazole
azatadine: it may increase the risk or severity of QTc prolongation
calcium acetate: it may increase the risk or severity of QTc prolongation
gallopamil: it may increase the risk or severity of QTc prolongation
berotralstat: it may increase the risk or severity of QTc prolongation agents
betahistine: it may increase the risk or severity of QTc prolongation agents
acrivastine: it may increase the risk or severity of QTc prolongation agents
bilastine: it may increase the risk or severity of QTc prolongation agents
bisoprolol: it may increase the risk or severity of QTc prolongation agents
bisoxatin: it may increase the risk or severity of QTc prolongation agents
amikacin: it may increase the risk or severity of QTc prolongation agents
sulfamethoxazole: it may increase the risk or severity of QTc prolongation agents
benazepril: it may increase the risk or severity of QTc prolongation agents
bendamustine: it may increase the risk or severity of QTc prolongation agents
voriconazole, when taken with ixazomib, alters the intestinal/hepatic CYP3A4 enzyme metabolism
QT-prolonging other agents (highest Risk) may intensify amiodarone's QTc-prolonging action
QT-prolonging agents (highest Risk) may increase clofazimine's ability to prolong QTc
Actions and Spectrum:Â
Actions:Â
voriconazole is an antifungal medication that primarily exerts its actions by inhibiting the activity of an enzyme called lanosterol 14-alpha-demethylase. This enzyme is crucial for the synthesis of ergosterol, a vital component of the fungal cell membrane.Â
voriconazole is a potent inhibitor of lanosterol 14-alpha-demethylase, a cytochrome P450 enzyme involved in the ergosterol biosynthesis pathway in fungi.Â
By inhibiting this enzyme, voriconazole disrupts the conversion of lanosterol to ergosterol, a critical step in the formation of the fungal cell membrane.Â
Spectrum:Â
voriconazole is a broad-spectrum antifungal medication, demonstrating efficacy against a wide range of fungal pathogens, including both yeasts and molds. Its spectrum of activity covers many clinically significant fungi.Â
YeastsÂ
Candida species: This includes Candida albicans, Candida glabrata, Candida parapsilosis, Candida krusei, and other Candida species.Â
Cryptococcus neoformans: voriconazole is effective against this yeast, which can cause severe respiratory and systemic infections, particularly in immunocompromised individuals.Â
Molds:Â
Aspergillus species: voriconazole is notably effective against Aspergillus species, such as Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, and Aspergillus niger. It is considered a first-line agent for the treatment of invasive aspergillosis.Â
Fusarium species: Fusarium infections can occur in immunocompromised individuals and those with chronic skin wounds.Â
Scedosporium species: Scedosporium species are opportunistic molds that can cause localized or disseminated infections, particularly in immunocompromised patients.Â
Zygomycetes (Mucorales): voriconazole exhibits some activity against certain Zygomycetes, although it may be less effective compared to its activity against Aspergillus.Â
Frequency not definedÂ
FeverÂ
RashesÂ
NauseaÂ
Abdominal painÂ
SepsisÂ
HeadacheÂ
Black Box Warning:Â
None
Contraindication/Caution:Â
ContraindicationsÂ
CautionsÂ
Pregnancy consideration:Â Â
Pregnancy category:Â Â
AU TGA pregnancy category: B3Â
US FDA pregnancy category: N/AÂ Â
Lactation:Â Â
excreted into human milk: unknownÂ
Pregnancy category:Â
Pharmacology:Â
voriconazole is an antifungal medication that belongs to the class of drugs known as triazole antifungals. Its mechanism of action involves inhibition of the fungal enzyme lanosterol 14-alpha-demethylase, which is a crucial enzyme in the ergosterol biosynthesis pathway.Â
Pharmacodynamics:Â
voriconazole inhibits the activity of an enzyme called lanosterol 14-alpha-demethylase, which is a cytochrome P450 enzyme found in fungi. This enzyme is essential for the conversion of lanosterol to ergosterol, a key component of the fungal cell membrane.Â
Here are the key pharmacodynamic aspects of voriconazole:
Ergosterol is a vital component of the fungal cell membrane, where it plays a role in maintaining membrane structure and function. By inhibiting lanosterol 14-alpha-demethylase, voriconazole disrupts the synthesis of ergosterol, resulting in decreased ergosterol levels in the fungal cell membrane.Â
The reduction in ergosterol levels disrupts the structure and function of the fungal cell membrane. This disruption increases membrane permeability and compromises its integrity, affecting various essential cellular processes.Â
Pharmacokinetics:Â
Absorption Â
voriconazole is available in both oral and intravenous (IV) formulations. The oral form is well absorbed from the gastrointestinal tract.Â
Food can affect the absorption of voriconazole; it is recommended to take the oral formulation on an empty stomach.. Â
Bioavailability is 96%. Â
Distribution Â
voriconazole is extensively distributed throughout the body, and it penetrates well into various tissues and body fluids, including the skin, lung tissue, cerebrospinal fluid (CSF), and eye. Â
Protein Binding-58% to 59%Â
MetabolismÂ
voriconazole is primarily metabolized in the liver.Â
Elimination and ExcretionÂ
voriconazole follows non-linear kinetics and has a terminal half-life of elimination which is dose-dependent.Â
voriconazole and its metabolites are primarily eliminated via the hepatic route.Â
Administration:Â
voriconazole is available as tablets for oral administration. The tablets should be swallowed whole with a full glass of water.Â
voriconazole is also available as an oral suspension, which is especially useful for patients who have difficulty swallowing tablets, such as pediatric patients or individuals with esophageal issues.Â
voriconazole is available in a solution for IV infusion. It is administered as a slow infusion over a specified period.Â
Patient information leafletÂ
Generic Name: voriconazoleÂ
Pronounced: vor-i-KON-uh-zoleÂ
Why do we use voriconazole?Â
voriconazole is considered a first-line treatment for invasive aspergillosis, a fungal infection caused by the Aspergillus species. Aspergillus infections are often severe and occur more frequently in immunocompromised individuals.Â
voriconazole is used to treat candidemia, which is a bloodstream infection caused by Candida species. It’s also effective against other invasive Candida infections, including infections in the organs or deep-seated tissue.Â
voriconazole is used to treat fungal pneumonia, particularly caused by Candida or Aspergillus species.Â
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