Voriconazole: A Comprehensive Monograph on its Pharmacology, Clinical Use, and Risk Management

Executive Summary & Drug Profile

Overview

Voriconazole is a second-generation, broad-spectrum triazole antifungal agent, representing a cornerstone in the management of severe, life-threatening invasive fungal infections.[1] As a synthetic derivative of fluconazole, it was engineered for an expanded spectrum of activity, particularly against molds.[4] It is established as the first-line therapy for invasive aspergillosis and is a critical agent for treating infections caused by fluconazole-resistant

Candida species and rare, often refractory, molds such as Scedosporium and Fusarium.[1]

The clinical utility of voriconazole is defined by a central paradox: its potent, life-saving efficacy is counterbalanced by a highly complex pharmacological profile. This profile is characterized by highly variable, non-linear pharmacokinetics, a narrow therapeutic window, and a significant potential for drug-drug interactions and notable toxicities.[3] Consequently, the successful clinical application of voriconazole demands a sophisticated understanding of its properties and a commitment to individualized patient management, including therapeutic drug monitoring, to navigate the fine line between efficacy and toxicity.

Chemical and Physical Identity

A comprehensive chemical and physical profile is essential for the identification, formulation, and research of voriconazole.

Nomenclature and Identifiers

Voriconazole is identified by a range of names and codes that reflect its development and regulatory history.