Table 1.

Variability in voriconazole plasma levels^a and dosing schedules.

Day	Voriconazole level (mg/L)	Voriconazole dose and comment
+21		Dose induction at 300 mg bd IV (4.3 mg/kg) Antifungal therapy commenced with presumptive diagnosis of Scedosporium spp. (four days after first VATS procedure)
+25	12.8	Patient reported visual hallucinations; dose altered to 300 mg bd PO on day +27
+35	6.3	Dose reduced to 250 mg bd PO on day +42
+59	<0.1
+79	<0.1	Assays confirmed with repeat testing at two different laboratories
+86	0.5	Dose increased to 300 mg bd PO on day +87
+93	1.2
+97	0.1
+100	0.47	Dose increased to 400 mg bd PO on day +114 (5.8 mg/kg)
+120	2.3
+148	1.4
+160	3.15
+181	0.9
+218	0.7	Dose increased to 500 mg bd PO on day +239 (8.1 mg/kg)
+246	3.5
+285	2.4
+293		Temporary cessation of voriconazole and terbinafine due to significant deterioration in liver function tests; restarted on day +304
+317	2.4
+340	0.5
+411	1.5	Cessation of antifungals due to nausea and vomiting, worsening liver function abnormalities and peripheral sensory neuropathy

^aA selection of plasma voriconazole levels are shown in relation to adjustments in dosing schedule.