(voriconazole)

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Contraindications

4 CONTRAINDICATIONS

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VFEND is contraindicated in patients with known hypersensitivity to voriconazole or its excipients [see Warnings and Precautions (5.5) and Adverse Reactions (6.1, 6.2)]. There is no information regarding cross-sensitivity between VFEND and other azole antifungal agents. Refer to the prescribing information for other azole antifungal agents.
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Concomittant use of VFEND with the interacting drugs described and listed below in this section are a guide and not considered a comprehensive list of all possible drugs that may be contraindicated with VFEND.
1.
Concomitant use of VFEND is contraindicated with drugs that are highly dependent on CYP3A4 for metabolism, and for which elevated plasma concentrations are associated with serious and/or life-threatening reactions [see Drug Interactions (7)]:
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Eplerenone
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Ergot alkaloids (e.g., ergotamine, dihydroergotamine)
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Finerenone
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Ivabradine
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Lurasidone
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Naloxegol
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Pimozide
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Quinidine
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Rifabutin [see Clinical Pharmacology (12.3)]
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Sirolimus [see Clinical Pharmacology (12.3)]
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Tolvaptan
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Venetoclax: Coadministration at initiation and during the ramp-up phase is contraindicated in patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) due to the potential for increased risk of tumor lysis syndrome [see Drug Interactions (7)].
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Voclosporin
2.
Concomitant use of VFEND is contraindicated with drugs and herbal products that induce CYP2C19, CYP2C9, and/or CYP3A4 and for which significantly reduced voriconazole plasma concentrations may be associated with loss of efficacy [see Drug Interactions (7)]:
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Carbamazepine
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Efavirenz
Concomitant use with efavirenz dosages of 400 mg every 24 hours or higher is contraindicated [see Clinical Pharmacology (12.3)].
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Long-acting barbiturates
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Rifabutin
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Rifampin
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Ritonavir
Concomitant use with high-dose ritonavir (400 mg every 12 hours) is contraindicated. Concomitant use with low-dose ritonavir (100 mg every 12 hours) should be avoided, unless an assessment of the benefit/risk to the patient justifies the use of VFEND [see Clinical Pharmacology (12.3)].
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St. John’s Wort [see Clinical Pharmacology (12.3)]
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