Subtherapeutic voriconazole concentrations associated with concomitant dexamethasone: case report and review of the literature

K. L. Wallace, R. L. Filipek, R. M. La Hoz, J. C. Williamson

Research output: Contribution to journalArticle

4 Scopus citations


What is known and objective: Voriconazole has significant drug interactions due to metabolism by CYP enzymes. Subtherapeutic voriconazole concentrations associated with concomitant dexamethasone are not well described. Case description: An 84-year-old male was started on voriconazole for a fungal brain abscess. He was readmitted due to clinical failure thought to be the result of subtherapeutic voriconazole concentrations. Dexamethasone was identified as a potential cause due to its induction of CYP enzymes. This interaction was substantiated by sequential troughs that demonstrated a rise in voriconazole concentrations as dexamethasone was tapered off. What is new and conclusion: Therapeutic drug monitoring for patients on voriconazole and dexamethasone is essential to prevent suboptimal clinical outcomes.

Original languageEnglish (US)
Pages (from-to)441-443
Number of pages3
JournalJournal of Clinical Pharmacy and Therapeutics
Issue number4
StatePublished - Aug 1 2016



  • dexamethasone
  • drug–drug interaction
  • fungal brain abscess
  • therapeutic drug monitoring
  • voriconazole

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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