Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

Careful monitoring of patients using voriconazole concomitantly with the following drugs is recommended becausevoriconazole is an inhibitor of cytochrome P450 isoenzymes, including 3A4 and 2C19 and is expected to increase bloodlevels of these drugs:• Alfuzosin • Erlotinib • Nilotinib• Alosetron • Erythromycin • Omeprazole• Amprenavir/Fosamprenavir • Esomeprazole • Oxycodone• Atazanavir • Estrogens • Paracalcitol• Benzodiazepines • Etravirine • Phenytoin/• Cinacalcet • Everolimus Fosphenytoin• Clarithromycin • Fentanyl & derivatives • Romidepsin• Clopidogrel • HMG-CoA • Saquinavir• Cyclosporin reductase inhibitors • Sirolimus• Dasatanib • Maraviroc • Sulfonylureas• Delavirdine • Meloxicam • Sunitinib & metab• Dihydropyridine Ca ++ channel blockers • Methadone • Tacrolimus• Eletriptan • Nelfinavir • Temsirolimus• Eplerenone • Nevirapine • Vinca alkaloidsOther drugs that should be used cautiously with voriconazole due to the risk of additive QT prolongation are:• Amiodarone• Methadone• Bretylium• Nilotinib• Clarithromycin• Pazopanib• Dofetilide• Ranolazine• Erythromycin• Sotalol• Ibutilide• TelavancinMiscellaneous drug interactions with voriconazole include:• Amprenavir/Fosamprenavir – blood levels of either drug may be increased• Chloramphenicol – increases voriconazole blood levels• Darunavir – decreases overall exposure to voriconazole• Non-nucleoside reverse transcriptase inhibitors – may increase voriconazole blood levels• Phenytoin/Fosphenytoin – decrease voriconazole blood levels• Saquinavir – increased blood levels of either drug• Tretinoin – risk of hypercalcemia is increased• Tipranivir – blood levels of either drug may increase or decreaseZIDOVUDINEFor up-to-date information on the use of antiretrovirals, consult an HIV expert or www.aidsinfo.nih.gov/ZYVOX ® -- see linezolid