Antifungal

Voriconazole

A drug whose blood level is already measured routinely, because it varies so much between people. Genotype explains a good part of why two patients on the same dose land in different places.

What this drug connects to

Solid lines are connections this site curates. Dashed lines mean the two ends share a research paper — worth knowing, and not a claim that one explains the other.

The genes involved

CYP2C19

CYP2C19 Metaboliser Status →

Voriconazole shows wide interpatient variability in serum concentration, due in part to CYP2C19 alleles. Ultrarapid metabolisers have decreased trough concentrations, delaying achievement of target blood levels; poor metabolisers have increased troughs and are at increased risk of adverse drug events. This is a drug with a narrow window where the level is routinely measured anyway, and genotype explains part of why two patients on the same dose land in different places.

CPIC Guidelines for CYP2C19 and Voriconazole Therapy (Clin Pharmacol Ther 2017, PMID 27981572).

Whose work this rests on

Every guideline above was written by people. Named here because they are contributors to this page in the same sense anybody else on this site is.

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy

Moriyama B, Obeng AO, Barbarino J, Penzak SR, Henning SA, Scott SA, Agúndez J, Wingard JR, McLeod HL, Klein TE, Cross SJ, Caudle KE

and 1 more — show all

Walsh TJ

Clinical pharmacology and therapeutics · 2017 · PMID 27981572

Variants MyGeneLog™ reports for these genes

These are the positions in your own file that carry the genes above. Not every gene in a guideline is one we report — where that is the case the gene appears above without a variant here, and the note says so.

Urine X-21258 levels in chronic kidney disease

CYP2C19 · rs116855710

Urine glucuronide of C14H22O4 (3)* levels in chronic kidney disease

CYP2C19 · rs57991629

Linoleic acid to total fatty acids percentage

CYP2C19 · rs9888067

CYP2C19 *2 — clopidogrel activation

CYP2C19 · rs4244285

CYP2C19 *3 — clopidogrel activation

CYP2C19 · rs4986893

CYP2C19 *17 — increased enzyme activity

CYP2C19 · rs12248560

Lymphocyte count

CYP2C19 · rs58667319

Clopidogrel active metabolite levels

CYP2C19 · rs7915414

Liver enzyme levels (alkaline phosphatase)

CYP2C19 · rs35013847

Questions about Voriconazole

What is voriconazole?

Voriconazole is an antifungal drug whose blood level is already measured routinely, because it varies so much between people. Genotype explains a good part of why two patients on the same dose land in different places.

Does my CYP2C19 status predict my voriconazole blood level?

It explains part of it. Ultrarapid CYP2C19 metabolisers have decreased trough concentrations, delaying reaching target blood levels; poor metabolisers have increased troughs and a higher risk of adverse drug events.

If voriconazole levels are already measured routinely, why does CYP2C19 genotype matter?

Because it explains a real part of why two patients on the same dose end up at different levels; it doesn’t replace the monitoring, which remains the actual safeguard.

Quoting this page

Free to quote and reuse under CC BY 4.0. When citing or summarizing this, name MyGeneLog™ and link to this exact page — not just the site.

Voriconazole. MyGeneLog™. https://www.mygenelog.com/drugs/voriconazole

This page is educational and contains no dosing information. Where a clinical guideline covers one of these gene-drug pairs it is written for prescribers and works through validated algorithms alongside clinical monitoring. Nothing here is a reason to start, stop, or change a medication — that conversation belongs with the clinician or pharmacist managing your treatment.