voriconazole
Voriconazole (Vfend) is an azole antifungal. It's used in adults and children ages 2 years and older to treat serious fungal infections, including invasive aspergillosis (IA) and esophageal candidiasis (EC). If you have a serious infection that needs voriconazole (Vfend), your healthcare team will typically give you this medication as an intravenous infusion in a hospital setting first. Once your condition improves, they might switch you to voriconazole (Vfend) tablet or oral suspension that's taken by mouth every 12 hours. Some common side effects of voriconazole (Vfend) include vision changes, nausea, and rash.
What is Voriconazole (Vfend)?
What is Voriconazole (Vfend) used for?
- Invasive aspergillosis (IA)
- Candidemia (candidiasis infection of the bloodstream)
- Candidiasis infections that have spread to deep tissue areas, including stomach and wounds
- Esophageal candidiasis (EC)
- Scedosporiosis and fusariosis fungal infections in people who can't take, or didn't respond well, to other treatment
How Voriconazole (Vfend) works
Voriconazole (Vfend) is an azole antifungal medication that works by stopping the fungus from being able to make a protective covering. This causes the fungus to not grow or survive.
Drug facts
Side effects of Voriconazole (Vfend)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Adults:
- Vision changes (19%)
- Fever (6%)
- Nausea (5%)
- Rash (5%)
Children:
- Vision changes (26%)
- Fever (25%)
- Vomiting (20%)
- Nose bleeds (16%)
- Nausea (13%)
- Rash (13%)
- Stomach pain (12%)
- Low blood potassium levels (11%)
- Diarrhea (11%)
- High blood pressure (11%)
- Cough (10%)
- Low platelet count (10%)
- Headache (10%)
Less Common Side Effects
Adults
- Vomiting
- Chills
- Headache
- High liver enzymes
- Fast heart rate
- Hallucinations (seeing or hearing things that aren't real)
Children
- Low blood pressure
- High blood sugar
- Swelling in the arms and legs
- Fast heart rate
- Dizziness
- Hallucinations (seeing or hearing things that aren't real)
- Shortness of breath
- Low blood calcium levels
- Low magnesium levels
- Constipation
- High liver enzymes
Voriconazole (Vfend) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver damage: nausea, vomiting, feeling tired, stomach pain, yellowing of your skin or whites of your eye (jaundice), dark-colored urine, pale-colored stool
- Abnormal heart rhythm (QT prolongation): chest pounding, short of breath, chest pain, feeling faint or lightheaded
- Serious allergic and skin reactions: hives, rash, blisters, swelling of the lips or tongue, difficulty breathing, skin reddening, skin scaling, skin itching
The following Voriconazole (Vfend) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Black, tarry stools
blistering, peeling, loosening of the skin
chills
difficulty seeing at night
increased sensitivity of the eyes to sunlight
itching, rash
joint or muscle pain
painful or difficult urination
red irritated eyes
red skin lesions, often with a purple center
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
trouble breathing
unusual bleeding or bruising
unusual tiredness or weakness
vision changes
Less common
Bloating or swelling of the face, arms, hands, lower legs, or feet
blurred vision
chills
clay-colored stools
confusion
dark urine
decreased urine
dizziness
faintness or lightheadedness when getting up suddenly from a lying or sitting position
feeling of warmth
increased thirst
irregular or pounding heartbeat
loss of appetite
muscle pain or cramps
muscle spasms or twitching
nervousness
numbness or tingling in the hands, feet, or lips
pounding in the ears
rapid weight gain
rash with flat lesions or small raised lesions on the skin
redness of the face, neck, arms, and occasionally, the upper chest
seizures
stomach pain
slow or fast heartbeat
sweating
trembling
unpleasant breath odor
vomiting of blood
yellow eyes or skin
Rare
Agitation
blistering, peeling, or loosening of the skin
hostility or anger
increased sensitivity of the skin to sunlight
irritability
redness or other discoloration of the skin
seeing things that are not there
severe sunburn
Incidence not known
Backache
blindness
blue-yellow color blindness
bone pain
darkening of the skin
decreased vision
facial hair growth in females
fainting
fractures
full or round face, neck, or trunk
increased urination
irritability
loss of sexual desire or ability
menstrual irregularities
mental depression
muscle wasting
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Headache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Voriconazole (Vfend)
Pros
- Liquid suspension available for people who can't swallow tablets
- Liquid suspension can be stored at room temperature
- Possible option in children as young as 2 years old
Cons
- Interacts with many medications, including omeprazole (Prilosec)
- Can cause serious skin reactions, vision problems, and sensitivity to light
- Tablets contain lactose, not a good choice for people who need to avoid lactose
Pharmacist tips for Voriconazole (Vfend)
- Food affects how well voriconazole (Vfend) is absorbed into your body. Be sure to take voriconazole (Vfend) at least 1 hour before or 1 hour after a meal.
- Take voriconazole (Vfend) exactly as prescribed. Make sure to finish your treatment course, even if you're feeling better. Stopping the medication earlier than prescribed can make your infection come back and become more difficult to treat.
- Voriconazole (Vfend) can cause skin sensitivity to the sun. To protect your skin, make sure to wear a high-SPF sunscreen when going outside, wear long-sleeve clothing, and avoid being exposed to light or sun for a long time as much as possible. Contact a dermatologist if you notice any changes in your skin.
- Voriconazole (Vfend) can cause vision changes, including blurry vision, changes to color vision, and sensitivity to light. This medication can also cause dizziness. Don't drive or operating machinery until you know how this medication affects you.
- Let your prescriber know if you're lactose intolerant or have a dairy allergy because voriconazole (Vfend) contains lactose.
- If you're able to become pregnant, you're recommended to use effective birth control during voriconazole (Vfend) treatment due to the risk of harm to babies. Talk to your healthcare professional about your options.
- Voriconazole (Vfend) can interact with several medications, including warfarin (Coumadin), omeprazole (Prilosec), and statins. This isn't a complete list of everything that interacts with voriconazole (Vfend). Make sure to tell your pharmacist about all of the medications you take before and during treatment with voriconazole (Vfend).
- Contact your prescriber if you develop other symptoms of an illness or if your symptoms become worse. This could be a sign that you're infected with a virus or bacteria instead of a fungus. If so, you'll need to a different medication than voriconazole (Vfend) because it's only used to treat certain fungal infections.
More tips for voriconazole (Vfend) 40 mg/mL oral suspension
- Shake the voriconazole (Vfend) suspension bottle well for 10 seconds before measuring out and taking your dose. Only use the measuring device provided at the pharmacy. Don't use household spoons to measure your dose since this could cause you to take the wrong amount.
- Never mix the voriconazole (Vfend) suspension with any other beverages, syrups, flavorings, or other medications. Take it exactly as it's supplied to you from the pharmacy. If the taste is bothersome, try drinking a citrus drink right after you take your dose to get rid of the bad taste.
- Store voriconazole (Vfend) suspension at room temperature. The mixture is good for 2 weeks from the time the pharmacist mixes it for you. If you need to take voriconazole (Vfend) suspension for longer than 2 weeks, your pharmacist will dispense a new bottle of medication every 2 weeks. Make sure to discard the old bottle, even if there's still some medication left.
Common questions about Voriconazole (Vfend)
Your healthcare team will gauge how long you need to take voriconazole (Vfend) based on different factors, including what type of infection you have, how well voriconazole (Vfend) is working for you, and whether you're experiencing any serious side effects. For example, general guidelines from the Infectious Disease Society of America recommend that treatment for invasive aspergillosis (IA) last at least 6 to 12 weeks, and treatment for candidemia continue for at least 2 weeks after the fungus is cleared from the bloodstream. For most infections, your healthcare team will have you start treatment in a hospital setting with IV voriconazole (Vfend). Once your symptoms start to get better and you're able to take medications by mouth, they'll switch you over to oral voriconazole (Vfend).
How long it takes for voriconazole (Vfend) to work depends on different factors, such as the type of infection you're taking it to treat and how serious it is. In general, studies show people start to get better within 2 weeks of starting the medication. It's important that you keep taking voriconazole (Vfend) for the amount of time your healthcare team recommended, even if you start to feel better. Stopping treatment too early can cause your infection to come back or become harder to treat.
It might take about 4 days for most of voriconazole (Vfend) to leave your body after you've been receiving either oral or IV treatment for a while. This timeframe is estimated based on the half-life of voriconazole (Vfend). But the timeframe can differ from person to person based on other factors, such as whether you have liver problems. Talk with your healthcare team if you have specific concerns about how long this medication might stay in your body.
You should avoid drinking alcohol until you've finished your course of voriconazole (Vfend). Drinking alcohol can weaken your immune system and make it harder for you to recover from an infection. Additionally, drinking alcohol while taking voriconazole (Vfend) raises your risk for stomach-related side effects (e.g., nausea, vomiting, diarrhea) as well as the risk for liver problems. If it's difficult for you to stop drinking, ask your healthcare team for resources or support to help you quit.
No, voriconazole (Vfend) and fluconazole (Diflucan) aren't the same. Voriconazole (Vfend) is a newer azole antifungals compared to fluconazole (Diflucan) and is able to treat more types of fungal infections, including some that might be resistant to fluconazole (Diflucan). But voriconazole (Vfend) tends to have more side effects and drug interactions than fluconazole (Diflucan). Guidelines recommend voriconazole (Vfend) as a first-choice option for invasive aspergillosis (IV). But guidelines generally recommend fluconazole (Diflucan) over voriconazole (Vfend) for candidiasis infections. Ask your healthcare professional if you have more questions on the differences between both medications.
The manufacturers of voriconazole (Vfend) don't say whether the tablets can be crushed. Results from a small study suggest that crushing voriconazole (Vfend) might not change how well the tablets work, but more research is needed in this area. If you're having trouble swallowing the tablets whole, it's best to ask your healthcare team whether they can switch you to the oral suspension instead.
The manufacturers of voriconazole (Vfend) tablets don't give guidance on whether the medication can be cut in half. But because voriconazole (Vfend) tablets don't have a score line (a line down the middle of the tablet), general guidelines say to avoid cutting this type of tablet in half because it's difficult to do so accurately. An alternative option is to ask your healthcare team about the voriconazole (Vfend) oral suspension instead.
No, voriconazole (Vfend) should be avoided during pregnancy due to the potential for severe development problems in babies. It's recommended for females who are able to get pregnant to use birth control while taking voriconazole (Vfend). In addition, there aren't any studies to know if voriconazole (Vfend) is safe to take while breastfeeding, so using a different medication is typically recommended. If you're pregnant, thinking of becoming pregnant, or are breastfeeding, let your prescriber know right away. They'll look into switching you to a safer option.
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Risks and warnings for Voriconazole (Vfend)
Voriconazole (Vfend) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver damage
- Risk factors: Liver problems | Alcohol use | Current liver problems | Certain blood cancers | Children | Taking other medications that cause liver problems
Although rare, people who took voriconazole (Vfend) have developed liver problems. Because of this risk, your prescriber might order blood tests before you start and during treatment to check your liver function tests to make sure your liver is healthy. Also, it's recommended to limit or avoid alcohol because it can also cause liver damage. Get medical attention right away if you notice yellowing of your skin or the whites of your eyes; stool changes; dark or brown urine; swelling of your stomach; stomach pain; or confusion. Your prescriber might ask you to stop taking voriconazole (Vfend) in order to prevent further liver damage.
Life-threatening abnormal heart rhythm
- Risk factors: Low blood potassium or magnesium levels | Older age | Kidney problems | History of heart problems, slow heart rate, or other abnormal heart rhythms (arrhythmias) | Personal or family history of long QT syndrome | Taking other medications that cause QT prolongation
Voriconazole (Vfend) can affect your heart rhythm, which can be serious and life-threatening. One example includes lengthening the time period from when the heart pumps and then relaxes. This is known as QT prolongation. Your risk is higher if you have certain factors, including abnormal electrolyte levels, heart rhythm problems, or are taking other medications that cause heart rhythm problems, such as amiodarone (Pacerone) and ciprofloxacin (Cipro), among others. To lower your risk, your prescriber might periodically monitor your heart and perform electrocardiograms (ECGs) to make sure your heart rhythm is normal. If you feel your chest pounding, have trouble breathing, have chest pain, or feel faint or lightheaded while taking voriconazole (Vfend), call 911 right away.
Vision changes
- Risk factors: Taking voriconazole (Vfend) longer than 28 days
Voriconazole (Vfend) can cause blurred vision, changes in eyesight, and sensitivity to light. Your risk is higher if you take voriconazole (Vfend) for longer than 28 days. Schedule an eye exam with your optometrist if you are going to be taking voriconazole (Vfend) for more than 28 days or if you notice any major changes to your vision while using this medication. Avoid driving at night and wear sunglasses if bright lights bother you while taking this medication. If this side effect is bothersome that you can't continue your usual daily activities, contact your prescriber.
Allergic reaction (during IV infusions)
Severe allergic reactions to voriconazole (Vfend) are possible, including life-threatening reactions like facial swelling, hives, and anaphylaxis (e.g., closing of the throat). If you notice difficulty breathing; a choking sensation; dizziness; fast heartbeat; nausea; or swelling around your eyes, lips, or tongue after taking voriconazole (Vfend), get medical attention right away.
Severe skin reaction
Very rarely, voriconazole (Vfend) can cause Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or drug reaction with eosinophilia and systemic symptoms (DRESS). If you notice changes in your skin, such as rash, blisters, or skin reddening or peeling, and have a fever and swollen lymph nodes, seek medical help right away.
Sun and light sensitivity
Voriconazole (Vfend) makes your skin more sensitive to the sun and ultraviolet (UV) light. This means you can get sunburns more easily than usual. This can happen even during the winter and on overcast days. To lower your risk, make sure to wear a high-SPF sunscreen when going outside and wear long-sleeved clothing to protect your skin. Also avoid being exposed to light or sun for a long time.
Harm during pregnancy
Voriconazole (Vfend) should be avoided during pregnancy due to the potential for severe development problems in babies. If you're able to get pregnant, it's recommended to use birth control while taking voriconazole (Vfend). Let your prescriber know right away if you're pregnant or thinking of becoming pregnant.
Low adrenal hormone levels
Some people taking azole antifungals like voriconazole (Vfend) have reported low adrenal hormone levels. Symptoms include tiredness, dizziness, and nausea. Tell your prescriber if you have these symptoms.
Inflammation of the pancreas
- Risk factors: Recent chemotherapy | Recent stem cell transplant
Pancreatitis (inflammation of the pancreas) has been reported by people who took voriconazole (Vfend). If you experience stomach pain, nausea, vomiting, tingling in your arms, legs, hands, or feet, or yellowing of the whites of your eyes or skin, tell your prescriber so you can be checked for these problems.
Bone and teeth problems
- Risk factors: Long-term use of voriconazole (Vfend)
Long-term use of voriconazole (Vfend) can sometimes cause bone problems or discolored teeth. While both of these reactions can be mild and temporary, if left untreated, they can become very painful or damaging. Let your prescriber know right away if you experience any bone pain or discoloration in your teeth. You'll likely need to stop taking voriconazole (Vfend).
Risk of kidney problems
People who take voriconazole (Vfend) have reported kidney problems. But it's unclear whether this was caused by voriconazole (Vfend) or by other medications. Your healthcare team might order lab work to check on your kidney health from time to time.
Voriconazole (Vfend) dosage
Bottle of oral suspension| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 75ml of 40mg/ml | 1 bottle | $236.55 | $236.55 |
Interactions between Voriconazole (Vfend) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Alprazolam
- Astemizole
- Bepridil
- Carbamazepine
- Cisapride
- Colchicine
- Conivaptan
- Dihydroergotamine
- Dronedarone
- Efavirenz
- Eletriptan
- Eliglustat
- Eplerenone
- Ergoloid Mesylates
- Ergonovine
- Ergotamine
- Flibanserin
- Fluconazole
- Isavuconazonium Sulfate
- Ivabradine
- Lomitapide
- Lovastatin
- Lurasidone
- Maraviroc
- Mephobarbital
- Mesoridazine
- Methylergonovine
- Methysergide
- Naloxegol
- Nelfinavir
- Nimodipine
- Phenobarbital
- Pimozide
- Piperaquine
- Posaconazole
- Primidone
- Quinidine
- Rifabutin
- Rifampin
- Ritonavir
- Saquinavir
- Simvastatin
- Sirolimus
- Sparfloxacin
- St John's Wort
- Terfenadine
- Thioridazine
- Tolvaptan
- Ubrogepant
- Venetoclax
- Voclosporin
- Ziprasidone
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acalabrutinib
- Acenocoumarol
- Ado-Trastuzumab Emtansine
- Alfentanil
- Amiodarone
- Amisulpride
- Amitriptyline
- Amoxapine
- Anagrelide
- Apalutamide
- Apomorphine
- Aprepitant
- Aripiprazole
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Artemether
- Asenapine
- Avanafil
- Avapritinib
- Axitinib
- Azithromycin
- Bedaquiline
- Benzhydrocodone
- Boceprevir
- Bosutinib
- Brentuximab Vedotin
- Bretylium
- Brexpiprazole
- Brigatinib
- Bromocriptine
- Buprenorphine
- Buserelin
- Cabazitaxel
- Cabozantinib
- Calcifediol
- Cariprazine
- Carvedilol
- Ceritinib
- Chloramphenicol
- Chloroquine
- Chlorpromazine
- Cilostazol
- Ciprofloxacin
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Cobicistat
- Cobimetinib
- Codeine
- Copanlisib
- Crizotinib
- Cyclobenzaprine
- Cyclosporine
- Dabrafenib
- Daclatasvir
- Dasabuvir
- Dasatinib
- Deflazacort
- Degarelix
- Delamanid
- Delavirdine
- Desipramine
- Deslorelin
- Deutetrabenazine
- Dexamethasone
- Dicumarol
- Dihydrocodeine
- Disopyramide
- Docetaxel
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Droperidol
- Duvelisib
- Elagolix
- Elexacaftor
- Elvitegravir
- Encorafenib
- Entacapone
- Entrectinib
- Enzalutamide
- Erlotinib
- Erythromycin
- Escitalopram
- Eslicarbazepine Acetate
- Eszopiclone
- Everolimus
- Fedratinib
- Fentanyl
- Fingolimod
- Flecainide
- Fluoxetine
- Fluticasone
- Formoterol
- Fosaprepitant
- Foscarnet
- Fosphenytoin
- Fostemsavir
- Gatifloxacin
- Gemifloxacin
- Glasdegib
- Glimepiride
- Gonadorelin
- Goserelin
- Granisetron
- Halofantrine
- Haloperidol
- Histrelin
- Hydrocodone
- Hydroxychloroquine
- Hydroxyzine
- Ibrutinib
- Ibutilide
- Idelalisib
- Ifosfamide
- Iloperidone
- Imipramine
- Inotuzumab Ozogamicin
- Irinotecan
- Irinotecan Liposome
- Istradefylline
- Ivacaftor
- Ivosidenib
- Ixabepilone
- Ketoconazole
- Lansoprazole
- Lapatinib
- Larotrectinib
- Lefamulin
- Lemborexant
- Lenvatinib
- Letermovir
- Levofloxacin
- Levomilnacipran
- Lofexidine
- Lopinavir
- Lorlatinib
- Lumacaftor
- Lumateperone
- Lumefantrine
- Lurbinectedin
- Macimorelin
- Macitentan
- Manidipine
- Mefloquine
- Meperidine
- Methadone
- Metronidazole
- Midostaurin
- Mifepristone
- Mirtazapine
- Moxifloxacin
- Nafarelin
- Neratinib
- Nevirapine
- Nifedipine
- Nilotinib
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olaparib
- Ombitasvir
- Omeprazole
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxycodone
- Ozanimod
- Palbociclib
- Paliperidone
- Panobinostat
- Paritaprevir
- Pasireotide
- Pazopanib
- Pemigatinib
- Pentazocine
- Pexidartinib
- Phenprocoumon
- Phenytoin
- Pimavanserin
- Pitolisant
- Ponatinib
- Ponesimod
- Pralsetinib
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinine
- Ranolazine
- Reboxetine
- Regorafenib
- Retapamulin
- Ribociclib
- Rimegepant
- Romidepsin
- Ruxolitinib
- Salmeterol
- Selpercatinib
- Selumetinib
- Sertraline
- Sevoflurane
- Sildenafil
- Simeprevir
- Siponimod
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Solifenacin
- Sonidegib
- Sorafenib
- Sotalol
- Sufentanil
- Sulpiride
- Sunitinib
- Suvorexant
- Tacrolimus
- Tamsulosin
- Tazemetostat
- Telaprevir
- Telavancin
- Telithromycin
- Temsirolimus
- Tetrabenazine
- Tezacaftor
- Thiotepa
- Ticagrelor
- Toremifene
- Trabectedin
- Tramadol
- Trazodone
- Triazolam
- Triclabendazole
- Trifluoperazine
- Trimipramine
- Triptorelin
- Valbenazine
- Vandetanib
- Vardenafil
- Vemurafenib
- Vilanterol
- Vilazodone
- Vinblastine
- Vincristine
- Vincristine Sulfate Liposome
- Vinflunine
- Vinorelbine
- Vorapaxar
- Voxelotor
- Warfarin
- Zanubrutinib
- Zolpidem
- Zuclopenthixol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amprenavir
- Atorvastatin
- Cerivastatin
- Desogestrel
- Dienogest
- Drospirenone
- Esomeprazole
- Estradiol
- Ethinyl Estradiol
- Ethynodiol
- Etravirine
- Fosamprenavir
- Gestodene
- Glipizide
- Glyburide
- Levonorgestrel
- Meloxicam
- Mestranol
- Midazolam
- Nomegestrol
- Norethindrone
- Norgestimate
- Norgestrel
- Tolbutamide
- Tretinoin
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Voriconazole (Vfend) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Voriconazole (Vfend) will not be safe for you to take.
- Taking pimozide, quinidine, ivabradine (Corlanor), sirolimus (Rapamune), rifampin (Rifadin), carbamazepine (Tegretol), long-acting barbiturates, St. John's Wort, rifabutin (Mycobutin), ergot alkaloids, naloxegol (Movantik), tolvaptan (Samsca, Jynarque), or lurasidone (Latuda)
- Taking efavirenz 400 mg or higher every 24 hours
- Taking ritonavir (Norvir) 400 mg every 12 hours
- Taking venetoclax (Venclexta) with voriconazole (Vfend) at starting and ramp-up phases in people with CLL or SLL due to the risk of tumor lysis syndrome
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