Home › Compound Library › Voriconazole (Vfend)

Voriconazole (Vfend)

Antibioticprescriptionoral · inferred

Second-generation triazole antifungal with broad activity including invasive aspergillosis (first-line), Fusarium, Scedosporium, and Candida (including some fluconazole-resistant). 6 mg/kg IV q12h x2 loading then 4 mg/kg IV q12h or 200 mg PO BID. Exhibits nonlinear (saturable) PK with large interpatient variability; therapeutic drug monitoring recommended (trough 1-5 mg/L). Oral bioavailability ~96% fasted. Extensive CYP interactions (2C19, 2C9, 3A4). Notable AEs: visual disturbances, phototoxicity/skin-cancer risk, hepatotoxicity, periostitis on long courses.

Projected serum levels — 200 mg, twice daily

Voriconazole (Vfend)
Voriconazole (Vfend) modeled serum levels, 200 mg twice daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 62.5 125 188 250 Day 0 Day 4 Day 7 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1
Voriconazole (Vfend) modeled serum levels with a loading dose of 271 mg, then 200 mg twice daily The first dose is larger so levels approach steady state faster. 0 62.5 125 188 250 Day 0 Day 4 Day 7 Day 11 Day 15 Time on a regular schedule

Maintenance schedule: 200 mg twice daily (oral).

Loading schedule: 271 mg on day 1, then 200 mg twice daily — reaching therapeutic levels sooner.

Modeled steady state after ~1 days: peak ≈ 221 mg, trough ≈ 67.8 mg body load. Population-based estimate over 15 days for a 200 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Antibiotic
Route modeled
Oral
Model confidence
inferred
Half-life
6 h
Common dose
200 mg
Suggested maximum
400 mg/day
Reference dose range
100–400 mg (single dose)
Suggested cadence
twice daily
Validated against
200 mg oral — Cmax 2.3 mg/L at 1.5 h

Documented interactions

  • danger
    7-Hydroxymitragynine (7-OH) + Voriconazole (Vfend) CYP inhibition

    Voriconazole (Vfend) reversible_inhibitor of CYP3A4 predicted to change 7-Hydroxymitragynine (7-OH) AUC by ~2.20x

  • danger
    Alfuzosin (Uroxatral) + Voriconazole (Vfend) CYP inhibition

    Voriconazole (Vfend) reversible_inhibitor of CYP3A4 predicted to change Alfuzosin (Uroxatral) AUC by ~3.33x

  • danger
    Alprazolam (Xanax) + Voriconazole (Vfend) CYP inhibition

    Voriconazole (Vfend) reversible_inhibitor of CYP3A4 predicted to change Alprazolam (Xanax) AUC by ~3.33x

  • danger
    Amlodipine (Norvasc) + Voriconazole (Vfend) CYP inhibition

    Voriconazole (Vfend) reversible_inhibitor of CYP3A4 predicted to change Amlodipine (Norvasc) AUC by ~3.33x

  • danger
    Anastrozole (Arimidex) + Voriconazole (Vfend) CYP inhibition

    Voriconazole (Vfend) reversible_inhibitor of CYP3A4 predicted to change Anastrozole (Arimidex) AUC by ~2.68x

  • danger
    Astaxanthin + Voriconazole (Vfend) CYP inhibition

    Voriconazole (Vfend) reversible_inhibitor of CYP3A4 predicted to change Astaxanthin AUC by ~3.33x

Serum checks 314 modeled interaction pairings for voriconazole (vfend) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Pharmacokinetic/pharmacodynamic profile of voriconazole Theuretzbacher U et al. · Clinical Pharmacokinetics, 2006 DOI

    PK/PD review establishing voriconazole's nonlinear disposition, CYP2C19 polymorphism impact, high oral bioavailability, and basis for therapeutic drug monitoring.

  2. Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes Pascual A et al. · Clinical Infectious Diseases, 2008 DOI

    Prospective cohort demonstrating voriconazole TDM (targeting troughs 1-5.5 mg/L) improved efficacy and reduced hepatotoxicity and neurotoxicity in invasive fungal infections.

2 published studies referenced in the app, each with a plain-language summary.