Therapeutic drug monitoring may be helpful to ensure adequate concentrations and exclude toxicity (Discuss with ID). Send voriconazole trough level 30 min before dose is due. Nonlinear kinetics.

QTc interval in patients at elevated risk.

Always double check drug drug interactions.

Monitor hepatic profile.

• Drug interactions
• QTc prolongation
• Hepatic enzyme abnormalities
• Rash - up to 20%
• Visual disturbance
• Fluorosis
•  GI upset

Lots!!

•  CYP450 interactions ++.
•  Other QTc prolonging agents.
•  Recommend review of pt medications due to high frequency of significant interactions.

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