Table 4.

Summary of voriconazole-mediated drug–drug interactions

Type of interaction, drug	Recommendation
Decreases voriconazole levels
Carbamazepine	Contraindicated
Long-acting barbiturates	Contraindicated
Rifampin	Contraindicated
Ritonavir	Avoid unless benefit outweighs risk
Levels increased by voriconazole
Astemizole	Contraindicated
Cisapride	Contraindicated
Cyclosporine	Reduce cyclosporine dosage by half and monitor cyclosporine levels
Ergot alkaloids	Contraindicated
Omeprazole	Reduce dosage by half
Quinidine	Contraindicated
Sirolimus	Contraindicated Reduce sirolimus dose by 90% and monitor sirolimus levels
Tacrolimus	Reduce tacrolimus dosage by two-thirds and monitor tacrolimus levels
Terfenadine	Contraindicated
Warfarin	Monitor prothrombin time and international normalized ratio
Decreases voriconazole levels and increases other drug levels
Rifabutin	Contraindicated
Phenytoin	Double voriconazole dosage and monitor for increased phenytoin levels
Efavirenz	Double voriconazole dosage and reduce efavirenz dose by half
Levels likely increased by voriconazole: sulfonylureas, statins, vinca alkaloids, calcium channel blockers, benzodiazepines	Monitor effect of drug and consider decreasing dosage when voriconazole is started

Modified from reference ²⁷.