Abstract
Voriconazole is an important agent in the antifungal armamentarium. It is the treatment
of choice for invasive aspergillosis, other hyaline molds, and many brown-black molds.
It is also effective for infections caused by Candida species, including those that are fluconazole resistant, and for infections caused
by the endemic mycoses, including those that occur in the central nervous system.
It has the advantage of being available in both an intravenous and an oral formulation
that is well absorbed. Drawbacks to the use of voriconazole are that it has unpredictable,
nonlinear pharmacokinetics with extensive interpatient and intrapatient variation
in serum levels. Some of the adverse effects seen with voriconazole are related to
high serum concentrations, and, as a result, therapeutic drug monitoring is essential
when using this agent. Drug–drug interactions are common, and possible interactions
must be sought before voriconazole is prescribed. With prolonged use, newly described
adverse effects, including periostitis, alopecia, and development of skin cancers,
have been noted.
Keywords
voriconazole - aspergillosis - candidiasis - drug–drug interactions - therapeutic
drug monitoring - periostitis - alopecia
