Guidelines by the Clinical Pharmacogenetics Implementation Consortium (CPIC) regarding the use of pharmacogenetic tests of CYP2C19 for voriconazole prescribing decisions have been accepted for publication in Clinical Pharmacology and Therapeutics. The accepted article can currently be viewed on the PharmGKB or CPIC websites.
Voriconazole is a triazole antifungal agent active against a variety of fungi and molds, such as Candida, Aspergillus, Fusarium and Cryptococcous. However, it is particularly recommended for pulmonary invasive aspergillosis, an infection that primarily occurs in immunocompromised patients. CYP2C19 is the primary enzyme responsible for the metabolism of voriconazole, and variations within the CYP2C19 gene have been shown to affect exposure to voriconazole. CYP2C19 ultrarapid or rapid metabolizers may have decreased voriconazole exposure, affecting the ability to achieve therapeutic concentrations, while poor metabolizers may have increased exposure, affecting the risk for adverse effects.
For therapeutic recommendations and further details, please refer to the CPIC Guideline for CYP2C19 and Voriconazole Therapy on the PharmGKB or CPIC websites.