Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy

Clin Pharmacol Ther. 2017 Jul;102(1):45-51. doi: 10.1002/cpt.583. Epub 2017 Apr 18.


Voriconazole, a triazole antifungal agent, demonstrates wide interpatient variability in serum concentrations, due in part to variant CYP2C19 alleles. Individuals who are CYP2C19 ultrarapid metabolizers have decreased trough voriconazole concentrations, delaying achievement of target blood concentrations; whereas poor metabolizers have increased trough concentrations and are at increased risk of adverse drug events. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for the use of voriconazole for treatment based on CYP2C19 genotype (updates at and

Publication types

  • Practice Guideline
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / pharmacokinetics
  • Antifungal Agents / therapeutic use
  • Cytochrome P-450 CYP2C19 / genetics*
  • Dose-Response Relationship, Drug
  • Drug-Related Side Effects and Adverse Reactions* / metabolism
  • Drug-Related Side Effects and Adverse Reactions* / prevention & control
  • Genotyping Techniques / methods*
  • Humans
  • Metabolic Clearance Rate / physiology*
  • Patient Selection
  • Pharmacogenomic Variants / genetics
  • Risk Assessment / methods
  • Voriconazole* / pharmacokinetics
  • Voriconazole* / therapeutic use


  • Antifungal Agents
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19
  • Voriconazole