Abrocitinib and Voriconazole: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Voriconazole
Abrocitinib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
These two medicines can push each other's levels up in your body. Voriconazole (an antifungal) slows down the enzymes that break down abrocitinib (your eczema medicine). That can let more abrocitinib build up. At the same time, abrocitinib can slow the breakdown of voriconazole, so its levels can rise too. When either drug builds up, side effects become more likely (things like nausea, headache, or blood count changes).
The good news: this is a well-understood, manageable situation. Your care team can lower your abrocitinib dose, adjust your voriconazole dose, and keep a closer eye on how you feel. Please don't change anything on your own. Just talk with your pharmacist or doctor.
Direction: bidirectional increase in exposure. Voriconazole inhibits CYP2C9 and CYP2C19, reducing abrocitinib metabolism and raising abrocitinib AUC. Abrocitinib is a CYP2C19 inhibitor and can reduce voriconazole clearance, raising voriconazole exposure. Neither drug is a prodrug here, so higher exposure means greater effect and adverse-effect risk.
- Severity: major; evidence: theoretical; onset: unspecified.
- Management: reduce abrocitinib dose per labeling, adjust voriconazole dose, and monitor for dose-related toxicity (GI effects, cytopenias, thromboembolic risk, voriconazole visual/hepatic/QT effects).
- Individualize dosing; consider voriconazole level monitoring where available.
What happens
Increased abrocitinib exposure, an increased risk of abrocitinib-related adverse effects, an increased voriconazole exposure and an increased risk of voriconazole-related adverse effects
Interaction Deep Dive
When voriconazole is given together with abrocitinib (a substrate of CYP2C9 and CYP2C19 as well as a CYP2C19 inhibitor), the exposure to abrocitinib and/or voriconazole may rise, potentially heightening the likelihood of adverse effects. The dose of abrocitinib should be lowered, voriconazole dosing should be adjusted, and patients should be monitored for adverse reactions1.
Why it happens (mechanism)
Inhibition of CYP2C9-mediated metabolism of abrocitinib; inhibition of CYP2C19-mediated metabolism of abrocitinib; inhibition of CYP2C19-mediated metabolism of voriconazole
How to manage this interaction
Keep taking both medicines exactly as prescribed unless your care team tells you otherwise. This interaction is manageable with a few standard steps:
- Your team may reduce your abrocitinib dose while you are also on voriconazole.
- Your voriconazole dose may be adjusted and individualized by your care team.
- They may monitor you more closely for side effects such as nausea, headache, changes in vision, or blood count changes.
What to do: tell your pharmacist and prescriber that you take both drugs, and report any new or worsening side effects promptly. Don't stop or change doses on your own.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A drug interaction study administered oral voriconazole (400 mg every 12 hours for 1 day, followed by 200 mg every 12 hours for 2.5 days) together with oral fluconazole (a CYP2C19 inhibitor) (400 mg on day 1, then 200 mg every 24 hours for 4 days) to 6 healthy male subjects, producing an average increase in voriconazole Cmax and AUC(tau) of 57% (90% CI: 20%, 107%) and 79% (90% CI: 40%, 128%), respectively. In a subsequent clinical study of 8 healthy male subjects, lowering the dose and/or frequency of voriconazole and fluconazole did not remove or lessen this effect 1.
Common questions
Can I take Abrocitinib and Voriconazole together?
Voriconazole and abrocitinib can raise each other's blood levels and side-effect risk, so your care team will likely lower the abrocitinib dose, adjust voriconazole, and watch you more closely. Keep taking both as prescribed and report any new side effects. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abrocitinib and Voriconazole interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abrocitinib and Voriconazole interaction managed?
Keep taking both medicines exactly as prescribed unless your care team tells you otherwise. This interaction is manageable with a few standard steps: Your team may reduce your abrocitinib dose while you are also on voriconazole. Your voriconazole dose may be adjusted and individualized by your care team. They may monitor you more closely for side effects such as nausea, headache, changes in vision… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abrocitinib or Voriconazole need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: VFEND(R) oral tablets, oral suspension, intravenous injection, voriconazole oral tablets, oral suspension, intravenous injection. Roerig (per FDA), New York, NY, 2025. DailyMed
Keep reading about Voriconazole
Keep reading about Abrocitinib
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