Voriconazole Impurities

Voriconazole is used to treat serious invasive and refractory fungal infections including invasive aspergillosis, candidemia in nonneutropenic patients, esophageal candidiasis and certain other severe mycoses where the pathogen is susceptible or alternative treatments are ineffective. Use should be guided by culture, susceptibility data and clinical judgment.

Duration of therapy depends on the infection type, site, pathogen and clinical response. Examples include multiweek to several month courses for invasive aspergillosis, at least 14 days for candidemia after clearance of bloodstream infection, and typically 7 to 14 days for esophageal candidiasis. Treatment length must be individualized and determined by the treating clinician with consideration for therapeutic drug monitoring and clinical response.

Serious adverse effects include hepatotoxicity with transaminase elevations and liver dysfunction, QT interval prolongation that can predispose to arrhythmia, severe skin reactions including photosensitivity and rare progression to cutaneous malignancy with long term exposure, visual disturbances and transient photopsia, central nervous system effects such as hallucinations and confusion, and infusion-related renal concerns related to the IV vehicle in patients with renal impairment. Monitoring of liver enzymes, electrolytes, ECG when indicated, and vigilance for neurological or dermatologic symptoms is recommended.

No. Voriconazole is not a steroid. It is an antifungal triazole that inhibits fungal CYP51 enzyme to impair ergosterol synthesis. Steroids are corticosteroid drugs with anti-inflammatory and immunosuppressive actions and have a different chemical class and mechanism of action.