Pharmacology and clinical use of voriconazole

Importance of the field. 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. Areas covered in this review. 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. What the reader will gain: The reader will gain further knowledge of the unique aspects of voriconazole compared to other currently available antifungal agents. Take home message: 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.