Voriconazole therapeutic drug monitoring: focus on safety

IMPORTANCE OF THE FIELD: Voriconazole has been widely used for the treatment of invasive fungal diseases, particularly invasive aspergillosis. Drug-drug interactions are, however, the main drawback associated with voriconazole use, since this drug suffers from extensive hepatic metabolism. AREAS COVERED IN THIS REVIEW: This article reviews the current literature on voriconazole therapeutic drug monitoring, with a special focus on drug safety. WHAT THE READER WILL GAIN: An update on voriconazole metabolism, drug interactions, toxicity and the relation of these with voriconazole drug concentrations. TAKE HOME MESSAGE: Therapy with voriconazole may be better guided by measuring voriconazole concentrations in the plasma.