Voriconazole is the first-line agent for invasive aspergillosis. Which adverse effects are commonly associated with this drug?

• A. Nephrotoxicity and insomnia.
• B. Hepatotoxicity and visual disturbances.
• C. Visual disturbances and rash.
• D. Hepatotoxicity and visual disturbances.

Answer: (D)

The main concept here is the typical adverse effect profile of voriconazole. The two most commonly seen toxicities are liver injury (hepatotoxicity) and visual disturbances. Visual effects, such as blurred vision, photophobia, and changes in color vision, are relatively common and usually appear early in therapy; they’re generally transient and reversible with dose adjustment or discontinuation if needed. Hepatotoxicity is also a recognized risk, so liver function tests should be monitored during treatment, and significant elevations may necessitate dose changes or stopping the drug. While other adverse effects like rash or QT prolongation can occur, hepatotoxicity paired with visual disturbances best represents the most frequently observed concerns with voriconazole.