title: Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy.
abstract: Voriconazole, a triazole antifungal agent, demonstrates wide interpatient variability in serum concentrations, due in part to variant CYP2C19 alleles. Individuals who are CYP2C19 ultrarapid metabolizers have decreased trough voriconazole concentrations, delaying achievement of target blood concentrations; whereas poor metabolizers have increased trough concentrations and are at increased risk of adverse drug events. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for the use of voriconazole for treatment based on CYP2C19 genotype (updates at https://cpicpgx.org/guidelines/ and www.pharmgkb.org).
authors.affiliation: National Institutes of Health Clinical Center Pharmacy Department, Bethesda, Maryland, USA.
authors.forename: B
authors.initials: B
authors.lastname: Moriyama
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Department of Pharmacy, The Mount Sinai Hospital, New York, New York, USA.|Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: A Owusu
authors.initials: AO
authors.lastname: Obeng
authors.affiliation: Department of Genetics, Stanford University, Stanford, California, USA.
authors.forename: J
authors.initials: J
authors.lastname: Barbarino
authors.affiliation: Department of Pharmacotherapy, University of North Texas, System College of Pharmacy, Fort Worth, Texas, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Penzak
authors.affiliation: National Institutes of Health Clinical Center Pharmacy Department, Bethesda, Maryland, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Henning
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Scott
authors.affiliation: Department of Pharmacology, University of Extremadura, Cáceres, Spain.
authors.forename: Jag
authors.initials: J
authors.lastname: Agúndez
authors.affiliation: University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Wingard
authors.affiliation: DeBartolo Family Personalized Medicine Institute, Division of Population Sciences, Moffitt Cancer Center, Tampa, Florida, USA.
authors.forename: H L
authors.initials: HL
authors.lastname: McLeod
authors.affiliation: Department of Genetics, Stanford University, Stanford, California, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: Klein
authors.affiliation: Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.|Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis, Tennessee, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Cross
authors.affiliation: Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Caudle
authors.affiliation: Transplantation-Oncology Infectious Diseases Program, Departments of Medicine, Pediatrics, and Microbiology and Infectious Diseases, Weill Cornell Medical Center of Cornell University, New York, New York, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Walsh
mesh_terms: D000935:Antifungal Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D065731:Cytochrome P-450 CYP2C19 / Q000235:genetics*; D004305:Dose-Response Relationship, Drug; D064420:Drug-Related Side Effects and Adverse Reactions / Q000378:metabolism / Q000517:prevention & control; D060005:Genotyping Techniques / Q000379:methods*; D006801:Humans; D008657:Metabolic Clearance Rate / Q000502:physiology*; D018579:Patient Selection; D000071184:Pharmacogenomic Variants / Q000235:genetics; D018570:Risk Assessment / Q000379:methods; D065819:Voriconazole / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D065819:Voriconazole