Voriconazole

A new triazole antifungal agent

Margaret M. Pearson, Phillip Rogers, John D. Cleary, Stanley W. Chapman, Carlos Da Camara, Marc M. Perreault

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

OBJECTIVE: To review the pharmacology, in vitro susceptibility, pharmacokinetics, clinical efficacy, and adverse effects of voriconazole, a triazole antifungal agent. DATA SOURCES: A MEDLINE search, restricted to English language, was conducted from 1990 to June 2002. Supplementary sources included program abstracts from the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America from 1996 to 2001 and manufacturer information available through the Food and Drug Administration's Web site. DATA EXTRACTION: All published and unpublished trials and abstracts citing voriconazole were selected. DATA SYNTHESIS: Voriconazole has shown in vitro activity against many yeasts and a variety of mold and dermatophyte isolates. Voriconazole can be administered either orally or parenterally. It exhibits good oral bioavailability, wide tissue distribution including distribution into the central nervous system, and hepatic metabolism. Drug interactions occur through inhibition of the CYP2C9, CYP2C19, and CYP3A4 isoenzymes, resulting in alterations in kinetic parameters of either voriconazole or the interacting agent. Efficacy has been illustrated in open, noncomparative studies of aspergillosis in immunocompromised patients. Human case reports describe successful treatment of rare fungal pathogens. The most commonly reported adverse events include visual disturbances and elevations in liver function tests. CONCLUSIONS: Voriconazole is at least as effective as amphotericin B in the treatment of acute invasive aspergillosis in immunocompromised patients. It has similar efficacy as fluconazole in treatment of esophageal candidiasis. Voriconazole did not achieve statistical non-inferiority to liposomal amphotericin B for empirical therapy in patients with neutropenia and persistent fever, diminishing enthusiasm for use in this indication until additional trials are completed. Based on case reports and in vitro efficacy, voriconazole may prove to be a clinically useful agent in the treatment of other fungal disease.

Original languageEnglish (US)
Pages (from-to)420-432
Number of pages13
JournalAnnals of Pharmacotherapy
Volume37
Issue number3
DOIs
StatePublished - Mar 1 2003

Fingerprint

Triazoles
Antifungal Agents
Aspergillosis
Immunocompromised Host
Therapeutics
Cytochrome P-450 CYP3A
Arthrodermataceae
Voriconazole
Mycoses
Fluconazole
Candidiasis
Liver Function Tests
Amphotericin B
Tissue Distribution
United States Food and Drug Administration
Neutropenia
Drug Interactions
MEDLINE
Biological Availability
Isoenzymes

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Pearson, M. M., Rogers, P., Cleary, J. D., Chapman, S. W., Da Camara, C., & Perreault, M. M. (2003). Voriconazole: A new triazole antifungal agent. Annals of Pharmacotherapy, 37(3), 420-432. https://doi.org/10.1345/aph.1C261

Voriconazole : A new triazole antifungal agent. / Pearson, Margaret M.; Rogers, Phillip; Cleary, John D.; Chapman, Stanley W.; Da Camara, Carlos; Perreault, Marc M.

In: Annals of Pharmacotherapy, Vol. 37, No. 3, 01.03.2003, p. 420-432.

Research output: Contribution to journalArticle

Pearson, MM, Rogers, P, Cleary, JD, Chapman, SW, Da Camara, C & Perreault, MM 2003, 'Voriconazole: A new triazole antifungal agent', Annals of Pharmacotherapy, vol. 37, no. 3, pp. 420-432. https://doi.org/10.1345/aph.1C261
Pearson MM, Rogers P, Cleary JD, Chapman SW, Da Camara C, Perreault MM. Voriconazole: A new triazole antifungal agent. Annals of Pharmacotherapy. 2003 Mar 1;37(3):420-432. https://doi.org/10.1345/aph.1C261
Pearson, Margaret M. ; Rogers, Phillip ; Cleary, John D. ; Chapman, Stanley W. ; Da Camara, Carlos ; Perreault, Marc M. / Voriconazole : A new triazole antifungal agent. In: Annals of Pharmacotherapy. 2003 ; Vol. 37, No. 3. pp. 420-432.
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