Voriconazole is a prescription antifungal used for serious fungal infections. Doctors reach for it most often for invasive aspergillosis and certain Candida infections when milder drugs won’t work. It comes as tablets and an IV form, and it’s powerful — but that power also means more side effects and drug interactions than many other antifungals.
Treatment often starts with a higher loading dose (given twice in the first day) then moves to a regular maintenance dose twice a day. Exact amounts depend on your weight, kidney and liver function, and whether you take other medicines. For oral use, people are usually prescribed a 200 mg twice-daily dose, but doctors adjust this a lot. If you have liver problems, your provider will lower the dose. If you’re getting the IV version, your kidney function matters because the IV vehicle can build up in severe kidney disease.
Some side effects are common and usually manageable: visual changes (blurred vision, seeing flashes or color changes) are reported early in treatment and often go away. Nausea, headache, and skin rash are fairly common too. More serious issues include raised liver enzymes — so doctors check liver tests before starting and during treatment. Voriconazole can also cause dizziness, mood or sleep changes, and rarely bone pain from long-term use (periostitis).
Voriconazole interacts with many drugs. It blocks CYP2C19, CYP2C9 and CYP3A4 — that affects blood thinners, some statins, benzodiazepines, and transplant drugs like tacrolimus or cyclosporine. Your doctor will often change doses or pick a different medicine because interactions can be dangerous.
Because people process voriconazole very differently (genetic differences in CYP2C19 affect how fast it’s broken down), doctors may use therapeutic drug monitoring for tough infections. Target blood levels help balance effectiveness and toxicity—especially if you have side effects, kidney or liver problems, or take interacting drugs.
A few practical tips: take oral voriconazole on an empty stomach for more consistent absorption and avoid grapefruit or grapefruit juice. Don’t drive or operate heavy machinery until you know how it affects your vision or thinking. If you’re pregnant or planning pregnancy, discuss alternatives — voriconazole is usually avoided in pregnancy.
If treatment lasts long-term, your provider will monitor liver tests, drug levels, and look out for skin sensitivity to sunlight. If an infection doesn’t respond or resistance is suspected, other options include amphotericin B or newer azoles like isavuconazole or posaconazole.
Questions about your dose, side effects, or other medicines? Talk with your prescriber or pharmacist — they can explain why voriconazole was chosen and how to stay safe while on it.
Struggling with persistent fungal infections or Fluconazole just isn’t cutting it? This article walks you through seven practical alternatives, breaking down why each one may work better in certain cases. Expect clear pros and cons, side-by-side details, and tips that matter when picking the right antifungal option. If you’re after plain talk and real advice instead of pharma jargon, you’re in the right place. Get informed, skip the fluff, and make smarter decisions about your treatment options.
