Pharmacology and clinical use of voriconazole.
BACKGROUND
Voriconazole is an extended-spectrum triazole developed specifically to target Aspergillus spp. and is now indicated as primary therapy in this circumstance. However, it has a broad spectrum of activity against both yeasts and molds and is also a viable treatment option in the treatment of other mycoses.


METHODS
This review discusses the mechanism of action, the pharmacodynamics and pharmacokinetics and the most common mechanisms of resistance to this agent. An overview of therapeutic drug monitoring, drug-drug interactions and pivotal trials are also reviewed.


RESULTS
The reader will gain further knowledge of the unique aspects of voriconazole compared to other currently available antifungal agents.


CONCLUSIONS
Voriconazole offers distinct advantages over several other antifungals. The side effect profile of voriconazole is unique compared to other triazole agents. Concern for drug-drug interactions due to a frequently shared common metabolic pathway has prompted heightened interest in the use of therapeutic drug monitoring for concerns of toxicity, drug-drug interactions and in attempts to ensure efficacy. These aspects as well as a review of important clinical information pertaining to voriconazole are discussed here.
Thompson
George R
GR
University of Texas, Health Science Center at San Antonio, Division of Infectious Diseases, Department of Medicine, San Antonio, TX 78229-3900, USA. thompsong2@uthscsa.edu
Lewis
James S
JS
D000818:Animals; D000935:Antifungal Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D004347:Drug Interactions; D016903:Drug Monitoring; D025141:Drug Resistance, Fungal; D005658:Fungi / Q000187:drug effects*; D006801:Humans; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D011743:Pyrimidines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D014230:Triazoles / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole