Drug & supplement interaction

Vitamin E + Voriconazole

Voriconazole brand name: Vfend.

Moderate Interaction
The bottom line Moderate

Vitamin E has a moderate interaction with Voriconazole. Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Vitamin E and Voriconazole

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Voriconazole

Voriconazole falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Vitamin E interacts with.

Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the idea behind this one. Voriconazole is partly cleared by a liver enzyme called CYP3A4, and high-dose vitamin E may gently nudge that enzyme to work a little faster. If that happens, your body could clear voriconazole a bit quicker, which in theory could lower its blood levels. For an antifungal, weaker levels can mean the medicine doesn't fight a serious infection as well as it should, and that really matters when you're treating something like aspergillosis or a bloodstream yeast infection.

I want to be honest though: this is theoretical, based on how vitamin E behaves in the lab, not on real patient cases. Normal food amounts of vitamin E almost certainly won't matter. If you're taking concentrated high-dose vitamin E supplements, just mention it to your pharmacist or doctor so they can keep an eye on things.

References
  1. Landes N, Pfluger P, Kluth D, et al. Vitamin E activates gene expression via the pregnane X receptor. Biochem Pharmacol 2003;65:269-73. . PubMed
  2. Brigelius-Flohe R. Vitamin E and drug metabolism. Biochem Biophys Res Commun 2003;305:737-40. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Vitamin E Also Interacts With Other Medications

Vitamin E has 762 moderate, 1 minor known drug interactions in our database — the Voriconazole one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Vitamin E

Covers the 2,830 medications we’ve checked against Vitamin E. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Voriconazole

This page covers Vitamin E only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Voriconazole page lists 205 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 159 moderate · 40 minor.

From our pharmacist’s overview on the Voriconazole page

“Voriconazole (Vfend) is a heavy-hitter antifungal, usually prescribed for dangerous infections like invasive aspergillosis, and its list of 205 interacting supplements includes six rated major, enough that anyone on this drug should read those entries before touching a supplement bottle. Most interactions run through the liver enzymes…”

Reviewed by 2 · Jul 18, 2026

Open the Voriconazole interaction page

One more smart check

Taking Vitamin E as Part of a Dietary Supplement Product? Check It for Interactions

We hold 22,182 real supplement products containing Vitamin E, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Vitamin E. Your product may carry other ingredients that interact with Voriconazole too, on top of Vitamin E — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Vitamin E and Voriconazole Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Vitamin E
Top 10

#9 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Voriconazole
Steady interest

#1,794 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Vitamin E

What is Vitamin E?

Vitamin E
  • General antioxidant support
  • Skin and hair care
  • Heart health
  • Eye health (age-related conditions)
  • Immune support

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitamin E has not been clearly proven to prevent heart disease or cancer and may carry risks. Talk to your pharmacist or doctor before taking high doses.

Read the full Vitamin E monograph & all interactions
Medication

About Voriconazole

What Is Voriconazole Used For?

Brand name: Vfend

Voriconazole treats several serious fungal infections. Across all available forms — tablets, oral suspension, and intravenous (IV) injection — it is used for invasive aspergillosis (a dangerous mold infection), candidemia (Candida fungus in the bloodstream) in patients who are not neutropenic (not severely low on white blood cells), other deep-tissue Candida infections, and serious infections caused by Scedosporium apiospermum or Fusarium species in patients who cannot tolerate or have not responded to other antifungal treatments.

Esophageal candidiasis (a Candida infection of the esophagus, the swallowing tube) is also an approved use for most formulations. Note on the oral tablet form (generic voriconazole tablets): that specific tablet formulation is approved for patients aged 12 to 14 years weighing at least 50 kg, and all patients 15 years and older — not for younger or smaller children. The oral suspension and the IV injection are approved for patients 2 years and older for most of these conditions.

See full Voriconazole drug information
Keep checking

Other Drugs & Vitamin E

Browse every other medication we’ve checked against Vitamin E — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
762Moderate
1Minor
2,066No known interaction
Moderate

762 interactions

Showing 60 of 762 moderate interactions — see all 762 on the Vitamin E page.

Minor

1 interaction

No interaction 2,066 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Vitamin E and Voriconazole Together: Common Questions

Can you take Vitamin E with Voriconazole?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Vitamin E and Voriconazole interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.