We describe two patients with fungal keratitis refractory to standard antifungal therapy whose conditions were managed with voriconazole. The first case is a patient with endophthalmitis and corneal ulcer due to Candida parapsilosis after receiving a corneal transplant. The patient was treated with amphotericin but showed no signs of improvement. Topical voriconazole, oral voriconazole, and int...

Background Voriconazole therapy for fungal infections usually continues several years and is often administered on an outpatient basis. Maintaining the voriconazole plasma concentration in therapeutic range highly important effective therapy; however, it difficult to obtain sufficient information assess outpatients. Therefore, we developed a method simultaneously measure concentrations of its m...

BACKGROUND Voriconazole is the therapy of choice for aspergillosis and a new treatment option for candidiasis. Liver disease, age, genetic polymorphism of the cytochrome CYP2C19, and comedications influence voriconazole metabolism. Large variations in voriconazole pharmacokinetics may be associated with decreased efficacy or with toxicity. METHODS This study was conducted to assess the utilit...

There are limited data on the relationship between voriconazole levels and clinical outcomes relative to invasive aspergillosis (IA). We therefore analyzed the association between initial voriconazole trough blood levels and clinical responses of IA in patients with hematologic malignancies. All adult patients treated with voriconazole in a tertiary care hospital in Seoul, South Korea, between ...

Voriconazole increases tacrolimus blood concentration significantly when coadministrated. The recommendation of reducing to 1/3 in voriconazole package insert seems not be satisfactory clinical practice. In vitro studies demonstrated that the magnitude inhibition depends on voriconazole, while exposure is determined by genotype status CYP2C19. CYP2C19 gene polymorphism challenges management dru...

We evaluated the efficacy of voriconazole, a new broad-spectrum triazole antifungal compound, in the treatment of murine pulmonary blastomycosis. Since mice metabolize voriconazole rapidly, we took advantage of our previous observation that administration of grapefruit juice to mice resulted in suitable serum voriconazole concentrations so that treatment studies with mice could be done (A. M. S...

BACKGROUND Voriconazole concentrations display a large variability, which cannot completely be explained by known factors. We investigated the relationships of voriconazole concentration with patient-specific variables and concomitant medication to identify clinical factors affecting voriconazole clearance. METHODS A retrospective chart review of voriconazole trough concentration, laboratory ...

This study aimed to determine the influence of proton pump inhibitors (PPIs) on the pharmacokinetics of voriconazole and to characterise potential drug-drug interactions (DDIs) between voriconazole and various PPIs (omeprazole, esomeprazole, lansoprazole and rabeprazole). Using adjusted physicochemical data and the pharmacokinetic (PK) parameters of voriconazole and PPIs, physiologically based ...

BACKGROUND Prospective evaluation of the antifungal drug, voriconazole, is needed to determine whether drug toxicity correlates with CYP2C19 genotype or serum concentrations of voriconazole or its metabolites. METHODS We conducted a prospective study of 95 patients to determine voriconazole toxicity and its relationship to genotype and serum levels of voriconazole and its two metabolites. Eff...

OBJECTIVES Voriconazole exhibits highly variable, non-linear pharmacokinetics and is associated with a narrow therapeutic range. This study aimed to investigate the population pharmacokinetics of voriconazole in adults, including the effect of CYP2C19 genotype and drug-drug interactions. METHODS Non-linear mixed effects modelling (NONMEM) was undertaken of six voriconazole studies in healthy ...