Voriconazole interaction with class: Analgesics

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Voriconazole

Interaction with Meloxicam

Monitor therapy
QT risk: Voriconazole Meloxicam

Effect: Voriconazole may increase the plasma concentrations of meloxicam.

Clinical management: Caution should be exercised upon coadministration of these drugs. Carefully monitor for increased meloxicam toxicity and adjust dose if necessary.

Probable mechanism: Inhibition of the cytochrome P450 2C9-mediated biotransformation by voriconazole.

Summary: Coadministration of voriconazole (400 mg BID on day 1, 200 mg BID on day 2) and meloxicam (15 mg single oral dose) increased meloxicam AUC (0-72 hours) and half-life by 47% and 51% (17.4 to 26.7 hours), respectively, in 12 healthy subjects. Cmax and Tmax of meloxicam were not affected by voriconazole. Although pharmacokinetics of meloxicam were significantly altered, there was no difference in thromboxane B2 inhibition at any measurement point between voriconazole and control.

QT effect

Voriconazole: Conditional QT risk

Substantial evidence reports that this drug causes QT prolongation and has a risk of TdP, but only under certain known conditions (e.g. excessive dose, drug interaction, etc.).

References

Meloxicam: QT risk not available