Voriconazole toxicology

Treatment with voriconazole can be associated with a number of adverse effects that in some cases may require treatment discontinuation or switching to another agent. The most common toxicities observed during voriconazole therapy include visual disturbances, neurological side effects, asymptomatic liver injury, and drug interaction s. Occasionally, more severe neurological adverse include hallucinations or encephalitis, especially in patients with high exposures (voriconazole troughs > 5.5 mg/L) have been reported. Severe toxicities, including neuropathy, severe phototoxicity / squamous cell carcinoma, and fluoride toxicity /periostitis, should be anticipated in a subset of patients receiving long-term voricoconazole therapy, especially at high doses.