Phenytoin and Voriconazole: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Phenytoin and Voriconazole unless specifically directed by your doctor.
How Phenytoin interacts with Voriconazole
Phenytoin induces CYP2C19 and CYP3A4 metabolism of voriconazole (reducing antifungal levels), while voriconazole inhibits phenytoin metabolism (raising phenytoin levels).
What you should do
Increase voriconazole maintenance dose to 5 mg/kg every 12 hours and monitor phenytoin levels; consider alternative antifungal.
Key facts
Severity
Major — avoid combination
Mechanism
Phenytoin induces CYP2C19 and CYP3A4 metabolism of voriconazole (reducing antifungal levels), while voriconazole inhibit...
Action
Increase voriconazole maintenance dose to 5 mg/kg every 12 hours and monitor phenytoin levels; consider alternative anti...
Frequently asked questions
Can I take Phenytoin and Voriconazole together?
No — this combination should generally be avoided. Increase voriconazole maintenance dose to 5 mg/kg every 12 hours and monitor phenytoin levels; consider alternative antifungal.
What is the severity of this interaction?
The interaction between Phenytoin and Voriconazole is classified as Major — avoid combination. Phenytoin induces CYP2C19 and CYP3A4 metabolism of voriconazole (reducing antifungal levels), while voriconazole inhibits phenytoin metabolism (raising phenytoin levels).
What should I do if I'm prescribed both?
Increase voriconazole maintenance dose to 5 mg/kg every 12 hours and monitor phenytoin levels; consider alternative antifungal. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.