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Overview: Voriconazole is used to treat certain types of serious fungal infections. It stops the fungus from growing. Common side effects include rash and headache. Notify your healthcare provider if you have blurry vision or a fast or skipping heart beat. Voriconazole comes as a tablet, oral liquid, and injection.

Uses

What is voriconazole used for?

Voriconazole is an antifungal medicine commonly used to treat the following fungal infections.

  • Invasive aspergillosis or candidiasis, which is an infection in your blood or throughout your body
  • Esophageal candidiasis, which is an infection in your esophagus
  • Other serious fungal infections

Voriconazole may not be appropriate for some fungal infections, depending on which germs are causing the infection. Fungi or yeast in some locations may have developed resistance to voriconazole, which will make it not work as well.

Voriconazole may also be used for other conditions as determined by your healthcare provider.

How does voriconazole work (mechanism of action)?

Voriconazole works by stopping the growth of the fungus causing the infection. 

How is voriconazole supplied (dosage forms)?

Brand and other names

  • Vfend

Dosage forms and strengths

  • 50 mg, 200 mg oral tablets
  • 40 mg/mL (200 mg/5 mL) oral suspension

Voriconazole is also available in injectable forms.

How should I store voriconazole?

Injection Liquid. Voriconazole injection is usually given by a healthcare provider in a hospital or clinic. You will not store it at home.

Oral Tablet. Voriconazole tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. 

Oral Liquid. Voriconazole liquid should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Do not refrigerate or freeze it. Keep the container tightly closed. Throw away any liquid left in the bottle after 14 days.

Side Effects

What are the most common side effects of voriconazole?

The most common side effects of voriconazole are listed below. Side effects can vary based on age. Tell your healthcare provider if you have any of these side effects that bother you.

  • Eye problems, including sensitivity to light (see below)
  • Fever or chills
  • Nausea, vomiting, diarrhea, constipation, swelling of your stomach area, or stomach pain
  • Rash
  • Headache
  • Liver damage (see below)
  • Fast heart rate
  • Seeing or hearing things that others do not see or hear (hallucinations)
  • Nosebleeds
  • High blood pressure
  • Fluid retention (edema), especially in your hands, legs, and feet
  • Cough, infection in the nose or throat, sore throat, or common cold symptoms
  • Low platelet levels (thrombocytopenia)
  • Trouble breathing
  • High blood sugar levels
  • Kidney damage (see below)
  • Electrolyte changes, such as with potassium, calcium, magnesium, and phosphate 
  • Mouth sores

There may be other side effects of voriconazole that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of voriconazole?

While less common, the most serious side effects of voriconazole are described below, along with what to do if they happen.

Severe Allergic Reactions. Voriconazole may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop using the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using voriconazole. Keep all appointments, including lab appointments, while using voriconazole. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Heart Rhythm Changes. Voriconazole may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take some medicines for other heart rhythm problems. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Infusion Reactions. Infusion reactions may occur in people receiving voriconazole injection. If this happens, the infusion will be stopped right away. Tell your healthcare provider right away if you have any of the following symptoms while receiving voriconazole injection.

  • Difficulty breathing
  • Fever or sweating
  • Redness of your face and neck or rash
  • Fast heartbeat or chest tightness
  • Feeling faint
  • Nausea

Severe Skin Reactions. Voriconazole can cause severe skin reactions, called Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop voriconazole and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Difficulty swallowing or breathing

Eye Problems. Voriconazole can cause eye problems and vision changes. Keep all appointments to have your eyes checked. Tell your healthcare provider right away if you have any of the following changes in your vision.

  • Blurry vision
  • Changes in how you see colors
  • Sensitivity to light

Sensitivity to Sunlight. Your skin may be very sensitive to light from the sun and devices that give off similar light, such as sunlamps and tanning beds, while you are using voriconazole. This is called photosensitivity. Avoid direct sunlight, use sunscreen, and wear a hat and clothes that cover your skin if you must be in the sun. Exposing your skin to this kind of light, even for a short time, can cause your skin to be severely sunburned, blistered, or swollen. Tell your healthcare provider right away if any of these happen.

Kidney Damage. Kidney damage can happen when using voriconazole. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Adrenal Gland Problems. Voriconazole may rarely cause problems with your body’s adrenal glands. It may cause reduced adrenal function, known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Using voriconazole with corticosteroid medicines may also increase the risk for Cushing’s syndrome. Tell your healthcare provider if you have any of the following symptoms of adrenal insufficiency or Cushing’s syndrome.

  • Nausea, vomiting, or stomach pain
  • Weight gain or loss
  • Weakness, tiredness, or lack of energy
  • Dizziness or lightheadedness
  • A rounded, rosy color of the face
  • A fat buildup in the upper back or base of the neck
  • Thinning skin that bruises easily
  • Excessive sweating
  • High blood sugar
  • Darkening of the skin in certain areas, such as the stomach, thighs, or arms

Weak Bones. Using voriconazole may cause bone pain or your bones to become weaker. Tell your healthcare provider if you break a bone or have bone pain. 

Warnings & Precautions

Who should not use voriconazole?

Allergies to Ingredients. People who are allergic to any of the following should not use voriconazole.

  • Vfend
  • Voriconazole
  • Any of the ingredients in the specific product dispensed, which may include lactose or sucrose

Your pharmacist can tell you all of the ingredients in the specific voriconazole products they stock.

Drug Interactions. Voriconazole should not be used while you are using certain other medicines. Before using voriconazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about voriconazole before using it?

Do not use voriconazole unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share voriconazole with other people, even if they have the same condition as you. It may harm them.

Keep voriconazole out of the reach of children.

There are several forms of voriconazole available. Ask your healthcare provider if you are not sure how to use the itraconazole form you are prescribed. 

If you are prescribed voriconazole liquid, read and follow the “Instructions for Use.” Shake it well (for ten seconds) before each dose. Use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device. Do not mix the oral liquid with any other medicine, flavored liquid, or syrup. 

Voriconazole can affect your alertness or coordination. It can also cause blurry vision and make your eyes sensitive to light. Do not drive at night while you are using voriconazole. Also avoid driving or doing other activities that require alertness or coordination until you know how voriconazole affects you.

Keep all appointments, including appointments for bloodwork, before you start and while you are using voriconazole.

What should I tell my healthcare provider before using voriconazole?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if voriconazole is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have or have had any of the following.

  • Liver or kidney problems
  • Heart problems, including heart rate or rhythm problems or cardiomyopathy 
  • Low electrolyte levels, such as potassium, magnesium, and calcium
  • Adrenal gland problems
  • Recent chemotherapy 
  • Stem cell transplant

Trouble Digesting Dairy Products. Voriconazole tablets have lactose in them. Tell your healthcare provider if you have trouble digesting dairy products, including if you have certain conditions such as hereditary galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption. 

Pregnancy. Voriconazole may cause harm to an unborn baby. You should use effective birth control while using voriconazole. Tell your healthcare provider if you are or plan to become pregnant. 

Breastfeeding. It is not known if voriconazole passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use voriconazole while breastfeeding.

Interactions

Does voriconazole interact with foods or drinks?

Take voriconazole tablets or oral liquid at least one hour before or one hour after a meal.

It is unknown if drinking alcohol will affect voriconazole, but heavy drinking can slow your immune response and make it harder for your body to fight infection. The risk of blurred vision may also be increased if you drink alcohol while taking voriconazole.

Does voriconazole interact with other medicines (drug interactions)?

Voriconazole interacts with many other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using voriconazole.

  • A corticosteroid, such as dexamethasone, methylprednisolone, or prednisone, which is a medicine for certain inflammatory conditions
  • Medicines that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as pimozide or quinidine
  • Sirolimus (Rapamune), which is commonly used after an organ transplant
  • Ivabradine (Corlanor), which is a medicine used for heart failure
  • Rifampin, which is a medicine commonly used to treat an infection called tuberculosis
  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
  • Ritonavir (Norvir) or efavirenz, which is a medicine commonly used to treat HIV
  • Rifabutin (Mycobutin), which is a medicine used to prevent mycobacterium avium complex infection
  • An ergot, such as ergotamine (Ergomar) or dihydroergotamine (Migranal or Trudhesa), which is a medicine used to treat migraine
  • St. John’s wort, which is a supplement that may be used to treat depression
  • Naloxegol (Movantik), which is used to treat constipation from pain medicines
  • Tolvaptan (Samsca, Jynarque), which is to treat low sodium levels in your blood
  • Lurasidone (Latuda), which is a medicine for certain mental health conditions
  • Venetoclax (Venclexta), which is a medicine for certain types of blood cancer
  • Methotrexate (Trexall and others), which is a medicine commonly used for rheumatoid arthritis or certain types of cancer

Many other medicines may alter the blood levels of voriconazole, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with voriconazole. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much voriconazole?

If you or someone else has used too much voriconazole, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of voriconazole?

It is important to complete your prescribed course of voriconazole, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to voriconazole or other similar medicines.

Oral Tablet or Liquid. If you miss a dose of voriconazole tablets or oral liquid, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

Injection Liquid. Voriconazole injections are usually given by a healthcare provider in a hospital. Your healthcare provider will make sure you are receiving voriconazole as scheduled. If you miss an appointment to get your voriconazole dose, call to make another appointment as soon as possible.