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Drug Interactions between letermovir and voriconazole

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

voriconazole letermovir

Applies to: voriconazole and letermovir

MONITOR CLOSELY: Coadministration with letermovir may significantly decrease the plasma concentrations and efficacy of voriconazole. The proposed mechanism is induction of CYP450 2C9 and/or 2C19, isoenzymes primarily responsible for the metabolic clearance of voriconazole. According to the product labeling, voriconazole peak plasma concentration (Cmax), systemic exposure (AUC) and concentration at 12 hours post-dose (C12hr) decreased by an average of 39%, 44% and 51%, respectively, when voriconazole 200 mg orally twice daily was coadministered with letermovir 480 mg orally once daily. Subtherapeutic levels of voriconazole may occur.

MANAGEMENT: Close clinical and laboratory monitoring are advised if letermovir is used concomitantly with voriconazole. Some authorities recommend avoiding this combination. Dosage adjustments may be appropriate for voriconazole whenever letermovir is added to or withdrawn from therapy.

References (9)
  1. (2017) "Product Information. Prevymis (letermovir)." Merck & Co., Inc
  2. (2023) "Product Information. Prevymis (letermovir)." Merck Sharp & Dohme LLC, SUPPL-11
  3. (2020) "Product Information. Prevymis (letermovir)." Merck Sharp & Dohme (Australia) Pty Ltd
  4. (2023) "Product Information. Prevymis (letermovir)." Merck Sharp & Dohme (UK) Ltd
  5. (2022) "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals Group, SUPPL-63/53/42
  6. (2024) "Product Information. Vfend (voriconazole)." Pfizer Australia Pty Ltd, pfpvfend10624
  7. (2024) "Product Information. VFEND (voriconazole)." Pfizer Ltd, VF 62_1
  8. (2024) "Product Information. VFEND (voriconazole)." Pfizer Ltd
  9. (2024) "Product Information. Vfend (voriconazole)." Pfizer Australia Pty Ltd, pfpvfend11024

Drug and food interactions

Moderate

voriconazole food

Applies to: voriconazole

ADJUST DOSING INTERVAL: Food reduces the oral absorption and bioavailability of voriconazole. According to the product labeling, administration of multiple doses of voriconazole with high-fat meals decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 34% and 24%, respectively, when the drug is administered as a tablet, and by 58% and 37%, respectively, when administered as the oral suspension.

MANAGEMENT: To ensure maximal oral absorption, voriconazole tablets and oral suspension should be taken at least one hour before or after a meal.

References (2)
  1. (2002) "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals
  2. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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