Voriconazole-Associated QTc Prolongation

Introduction to QTc Prolongation Risk

• The Infectious Diseases Society of America guidelines list azole antifungals, including voriconazole, as agents that can cause QT interval prolongation, torsades de pointes, and other cardiac arrhythmias 1

Monitoring and Pre-Treatment Requirements

• The Infectious Diseases Society of America guidelines recommend obtaining baseline ECG to assess QTc interval, correcting electrolyte abnormalities, and reviewing concomitant medications for QT-prolonging agents before initiating voriconazole, and monitoring electrolytes regularly, performing serial ECG monitoring, and considering therapeutic drug monitoring during voriconazole therapy 1

Drug Interactions and Risk Amplification

• The Infectious Diseases Society of America guidelines emphasize that voriconazole should be used cautiously with other QT-prolonging agents, as the combined effect creates additive risk for arrhythmias 1