Voriconazole
Renal

Renal

In the setting of rapidly improving or worsening renal function, calculations of CrCl are inaccurate. Dosing should be based on estimated renal function instead.

If improving renal function, actual CrCl is likely higher than calculated CrCl.

If worsening renal function, actual CrCl is likely lower than calculated CrCl.

Not On Dialysis

CrCl 0 - 50

IV not recommended due to accumulation of cyclodextrin. If used, closely monitor Scr and change to PO ASAP

CrCl > 50

Usual dosing

Intermittent Dialysis

IV therapy not recommended after first loading dose due to accumulation of cyclodextrin.

Oral dosing does not require modification in renal failure.