title: Intravenous voriconazole after toxic oral administration.
abstract: In a male patient with rhinocerebral invasive aspergillosis, prolonged high-dosage oral administration of voriconazole led to hepatotoxicity combined with a severe cutaneous reaction while intravenous administration in the same patient did not. High concentrations in the portal blood precipitate liver enzyme abnormalities, and therefore, oral administration of voriconazole may have a hepatotoxicity profile different from that of intravenous (i.v.) administration. Intravenously administered voriconazole might still be an option after oral-voriconazole-induced toxicity has resolved.
authors.affiliation: University Medical Center Groningen, Department of Hospital and Clinical Pharmacy, RB Groningen, The Netherlands. j.w.c.alffenaar@apoth.umcg.nl
authors.forename: J W C
authors.initials: JW
authors.lastname: Alffenaar
authors.forename: S
authors.initials: S
authors.lastname: van Assen
authors.forename: J G R
authors.initials: JG
authors.lastname: de Monchy
authors.forename: D R A
authors.initials: DR
authors.lastname: Uges
authors.forename: J G W
authors.initials: JG
authors.lastname: Kosterink
authors.forename: T S
authors.initials: TS
authors.lastname: van der Werf
mesh_terms: D000284:Administration, Oral; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects* / Q000097:blood; D003875:Drug Eruptions / Q000209:etiology / Q000473:pathology; D006801:Humans; D007275:Injections, Intravenous; D008099:Liver / Q000187:drug effects / Q000201:enzymology / Q000293:injuries; D008297:Male; D008875:Middle Aged; D020953:Neuroaspergillosis / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects* / Q000097:blood; D015524:Sphenoid Sinusitis / Q000188:drug therapy*; D014230:Triazoles / Q000008:administration & dosage* / Q000009:adverse effects* / Q000097:blood; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole
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