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Genotype-Guided Antifungal Selection

3001508

CYP2C19 3001508

3001524

Cytochrome P450 Genotyping Panel 3001524

3004255

Cytochrome P450 Genotyping Panel, with GeneDose Access 3004255

About This Topic

Voriconazole is used for fungal infection treatment and prophylaxis. Achieving target serum concentrations of voriconazole is critical for effective prophylaxis and treatment of invasive fungal infections (IFIs). IFIs and IFI‐related mortality are strongly associated with subtherapeutic trough concentrations of voriconazole.

Rapid and ultrarapid CYP2C19 metabolizers (a phenotype harbored by 30-35% of White and Black patients) may metabolize voriconazole too quickly resulting in subtherapeutic plasma concentrations increasing the risk of breakthrough fungal infections.

Recommendation

Guide antifungal drug selection by CYP2C19 (3001508) genotype to reduce the risk of treatment failure.

Other genotyping panels with these gene targets included are Cytochrome P450 Genotyping Panel (3001524) and Cytochrome P450 Genotyping Panel, with GeneDose Live Access (3004255).

ARUP Consult

ARUP Test Fact Sheet

CPIC Guideline for Voriconazole and CYP2C19

Clinical Pharmacogenetics Implementation Consortium. CPIC guideline for voriconazole and CYP2C19. Last modified Dec 2016; accessed Dec 2020.

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Genotype-Guided Antifungal Selection

CPIC Guideline for Voriconazole and CYP2C19