Published: 2020-02-24

Safety of voriconazole in treatment of fungal infections

Shobhit Mohan, Lalit Mohan, Renu Sangal Sangal, Neelu Singh


Immunocompromised patients are at more risk in developing fungal infections particularly with Candida and Aspergillus species being the mycoses most commonly identified. Previously, amphotericin-B is the drug of choice for the treatment of systemic infections caused by Candida and Aspergillus species. Due to its high incidence of toxicity, its use has been limited in many cases. Voriconazole is the newest triazole synthesized against fungal infections and was approved by FDA in 2002 for the treatment of invasive aspergillosis and refractory infections of Scedosporium apiospermum and Fusarium spp.


Voriconazole, Antifungal agent, Safety

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Pearson MM, Rogers PD, Cleary JD, Chapman SW. Voriconazole: a new triazole antifungal agent. ANN Pharmacother. 2003;37:420-32.

Bes DF, Rosanova MT, Sberna N, Arrizurieta E. Deoxycholate amphotericin B nad nephrotoxicity in the pediatric setting. Pediatr Infect Dis J. 2014;33:198-206.

Xing Y, Chen L, Feng Y, Zhou Y, Zhai Y, Lu J. Meta-analysis of the safety of voriconazole in definitive, empirical, and prophylactic therapies for invasive fungal infections. BMC Infect Dis. 2017;17(1):798.

Shang W, Feng G, Sun R, Wang X, Liu W, Zhang S, et al. Comparison of micafungin and voriconazole in the treatment of invasive fungal infections in kidney transplant recipient. J Clin Pharm Ther. 2012;37:652-56.

Cornely OA, Ullmann AJ, Karthaus M. Evidence-based assessment of primary antifungal prophylaxis in patients with hematologic malignancies. Blood. 2003;101:3365-72.

Michael C, Bierbach U, Frenzel K, Lange T, Basara N, Niederwieser D, et al. Voriconazole pharmacokinetics and safety in immunocompromised children compared to adult patients. Antimicrob Agents Chemother. 2010;54:3225-32.

Potter M, Donnelly JP. The role of itraconazole in preventing and treating systemic fungal infections in immunocompromised patients. Acta Haematol. 2004;111:175-80.

Doring M, Blume O, Haufe S, Hartmann U, Kimmig A, Schwarze CP, et al. Comparison of itraconazole, voriconazole, and posaconazole as oral antifungal prophylaxis in pediatric patients following allogeneic hematopoietic stem cell transplantation. Eur J Clin Microbiol Infect Dis. 2014;33:629-38.

Sienkiewicz BM, Łapiński Ł, Wiela-Hojeńska A. Comparison of clinical pharmacology of voriconazole and posaconazole. Contemp Oncol (Pozn). 2016;20(5):365-73.

Ben-Ami R, Lewis RE, Kontoyiannis DP. Immunocompromised hosts: immunopharmacology of modern antifungals. Clin Infect Dis. 2008;47:226-35.

Adamski Z. Nowości i przyszłość w terapii przeciwgrzybiczej. Mikol Lek. 2005;12:115-21.

Sandherr M, Maschmeyer G. Pharmacology and metabolism of voriconazole and Posaconazole in the treatment of invasive aspergillosis: review of the literature. Eur J Med Res. 2011;16:139-44.

Lewis RE. Current concepts in antifungal pharmacology. Mayo Clin Proc. 2011;86:805-17.

Passowicz-Muszyńska E, Jankowska R, Weryńska B. Nowe leki przeciwgrzybicze stosowane w terapii grzybic głębokich. Mikol Lek. 2007;14:137-41.

Grudzień M, Pałka K, Pluciński F, Mazurek A. Molecular proprerties impact on bioavailability of second generation triazoles antifungal agents. Acta Pol Pharm. 2013;70:869-72.

Morris A. Review: Voriconazole for prevention or treatment of invasive fungal infections in cancer with neutropenia. ACP J Club. 2014;161:8.

Szymankiewicz M, Dancewicz M. Aktywność in vitro worikonazolu i kaspofunginy wobec szczepow Candida spp. oceniana metodą E-testu. Mikol Lek. 2008;15:13-5.

Aneks i charakterystyka produktu leczniczego VFEND, data zatwier-dzenia. 2012.

VFEND (voriconazole) tablets and injection [package insert] New York: Pfizer, Inc; 2002.

Pfizer Global Research and Development. Background document for the Antiviral Drug Products Advisory Committee meeting Oc tober 4, 2001: voriconazole tablets and voriconazole injection, Available at: dockets/ac/01/briefing/3792b2_02_FDA-voriconazole.pdf. Accessed on 20 September 2002.

Greer ND. Voriconazole: the newest triazole antifungal agent. Proc (Bayl Univ Med Cent). 2003;16(2):241-8.

Florea NR, Kuti JL, Quintiliani R. Voriconazole: a novel azole an-tifungal. Formulary. 2002;37:389-99.

Marks DI, Pagliuca A, Kibbler CC, Glasmacher A, Heussel CP, Kantecki M, et al. Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation. Br J Hematol. 2011;155:318-27.

Vehreschild JJ, B€ohme A, Buchheidt D, et al. A double-blind trial on prophylactic voriconazole (VRC) or placebo during induction chemotherapy for acute myelogenous leukaemia (AML). J Infect. 2007;55:445-9.

Andes D, Pascua A, Marchetti O. Antifungal therapeutic drug monitoring: Established and emerging indications. Antimicrob Agents Chemother. 2009;53:24-34.