MajormTOR kinase inhibitor – immunosuppressant and antineoplastic×Triazole derivatives, systemic antifungals
Updated · Methodology
Mechanism
Voriconazole strongly inhibits CYP3A4, the enzyme that clears everolimus. The pair has not been studied directly, but ketoconazole, an inhibitor of the same strength, raises everolimus AUC 15-fold.
Symptoms
Immunosuppression, nephrotoxicity.
Management
Both labels advise against the pair (AEMPS, FDA): there are no data to set an everolimus dose. For antifungal treatment, choose a drug that does not inhibit CYP3A4 this strongly. If voriconazole cannot be avoided, measure everolimus trough levels and adjust the dose to them.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Vfend (voriconazole) prescribing information – CYP3A4 inhibitor, statin/immunosuppressant interactions (2020)– FDA Vfend label, Drug Interactions §7 – tacrolimus, cyclosporine, sirolimus, statins; DailyMed setid ce3ef5cf-3087-4d92-9d94-9eb8287228db
- FDA: Afinitor (everolimus) prescribing information – strong CYP3A4 inhibitor restriction (2020)– FDA Afinitor label, Drug Interactions §7.1; DailyMed setid 2150f73a-179b-4afc-b8ce-67c85cc72f04
- EMA: Votubia (everolimus) EPAR – EMA (2024)– EMA EPAR Certican
- AEMPS: Ficha técnica: Everolimus (nº registro 84203), sección 4.5 (2024)– AEMPS, CIMA, nº registro 84203, sección 4.5
- AEMPS: Ficha técnica: Voriconazol (nº registro 80105), sección 4.5 (2026)– AEMPS, CIMA, nº registro 80105, sección 4.5
- FDA: Everolimus Tablets – Prescribing Information (2026)– FDA, DailyMed SPL, Hikma Pharmaceuticals, разделы 2.11 и 7.1, пересмотр этикетки 08/2026
- FDA: Zortress (everolimus) tablets – Prescribing Information (2026)– FDA, DailyMed SPL, Novartis Pharmaceuticals, разделы 5.14 и 7.1, пересмотр этикетки 02/2026
- FDA: Voriconazole Tablets – Prescribing Information (2026)– FDA, DailyMed SPL, Safecor Health, раздел 7, пересмотр этикетки 05/2026