Drug Interaction Report

MONITOR: Coadministration with inducers of CYP450 isoenzymes may decrease the plasma concentrations of voriconazole, which is metabolized by CYP450 2C19, 2C9, and/or 3A4.

MANAGEMENT: The potential for diminished pharmacologic effects of voriconazole should be considered during coadministration with CYP450 inducers. Alternative treatments may be required if an interaction is suspected.

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.