Voriconazole by LC-MS/MS
Clinical details: 
Voriconazole is used for the prophylaxis and treatment of invasive fungal infections (IFIs). The development of IFIs in patients being treated for haematological malignancies is associated with increased morbidity and mortality. As diagnosis of IFIs may be difficult, targeted prophylactic therapy is important in high-risk patients. Voriconazole is used in patients who have become resistant to itraconazole, and offers a broader spectrum of antifungal activity. Voriconazole is metabolised by CYP 2C19, which exhibits genetic polymorphism. Homozygous extensive metabolisers may have half the plasma concentration compared to homologous poor metabolisers. As a result in individuals prescribed the same dose of voriconazole, plasma voriconazole concentrations may vary up to 100-fold. Thus monitoring plasma concentration may help in dose optimisation and in monitoring adherence to medication. A pre-dose target plasma voriconazole concentration of 2-4 mg/L has been suggested for effective prophylaxis in patients being treated for haematological malignancies.
Sample type and Volume required: 
2mL EDTA whole blood or 1 mL plasma or serum (pre-dose or ‘trough’ sample).
Turnaround time: 
5 working days
Storage and transport: 
Please refrigerate (if possible) if not sending immediately. Send by first class post.
Toxicology Department at King's Hospital
020 3299 5881
King's College Hospital
Bessemer Wing - 3rd Floor
Denmark Hill
London SE5 9RS
For clinical advice or interpretation of results, please contact the laboratory in the first instance.

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Last updated: 07/08/2015