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Voriconazole was discontinued, and the patient was switched to posaconazole, leading to a decline in cholestatic markers. This report underscores the importance of therapeutic drug monitoring and highlights posaconazole as a safer alternative in patients experiencing voriconazole-induced hepatotoxicity.<\/jats:p>","DOI":"10.1136\/bcr-2024-264664","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T09:55:25Z","timestamp":1745661325000},"page":"e264664","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Voriconazole-induced cholestatic hepatotoxicity in fungal pneumonia"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4158-1974","authenticated-orcid":false,"given":"Mahima","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Pharmacology, All India Institute of Medical Sciences Rishikesh Department of Pharmacology, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjunath","family":"Bidarolli","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Amrita Vishwa Vidyapeetham - Faridabad Campus, Faridabad, HR, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NPK","family":"Teja","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, All India Institute of Medical Sciences Rishikesh Department of Pharmacology, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bicky","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh, UK, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"key":"2025082712205174000_18.4.e264664.1","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/S0140-6736(21)00219-1","article-title":"Posaconazole versus voriconazole for primary treatment of invasive aspergillosis: a phase 3, randomised, controlled, non-inferiority trial","volume":"397","author":"Maertens","year":"2021","journal-title":"Lancet"},{"key":"2025082712205174000_18.4.e264664.2","doi-asserted-by":"crossref","first-page":"317","DOI":"10.2147\/IDR.S154457","article-title":"Posaconazole achieves prompt recovery of voriconazole-induced liver injury in a case of invasive aspergillosis","volume":"11","author":"Mart\u00ednez-Casanova","year":"2018","journal-title":"Infect Drug Resist"},{"key":"2025082712205174000_18.4.e264664.3","doi-asserted-by":"publisher","DOI":"10.1086\/504328"},{"key":"2025082712205174000_18.4.e264664.4","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.11.158"},{"key":"2025082712205174000_18.4.e264664.5","doi-asserted-by":"crossref","unstructured":"Silvester E , Plover C , Gwee A . 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