Voriconazole

A triazole antifungal, FDA-approved for invasive aspergillosis, candidemia and other deep Candida infections, esophageal candidiasis, and Scedosporium or Fusarium infections.

psilodex.org/m/voriconazole · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: Dose-dependent; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Voriconazole”, v2026.10.05. psilodex.org/m/voriconazole

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

FDA-approved for

Invasive aspergillosis
Candidemia and deep tissue Candida infections
Esophageal candidiasis
Scedosporium and Fusarium infections (when other therapy fails or is not tolerated)

Sources [1]

Other safety

The label warns of liver toxicity, visual disturbances (including optic neuritis with long use), severe skin reactions, photosensitivity with skin cancer reports, and adrenal dysfunction.

About the medication itself, separate from any interaction with psilocybin.

Sources [1]

01 Interaction with psilocybin

Not studied with psilocybin; it blocks an enzyme that clears psilocybin, so higher levels are possible. Also, it can affect heart rhythm and cause hallucinations.

Detail There are no psilocybin data. Voriconazole is a strong CYP3A4 inhibitor (it blocks a liver enzyme). CYP3A4 metabolized psilocin (psilocybin's active form) in lab studies (Thomann 2024). So voriconazole may raise psilocin levels, though psilocin is eliminated mainly by glucuronidation and conversion to 4-HIAA. Its label reports visual disturbances and hallucinations (visual and auditory) as adverse reactions, which may be hard to tell apart from psilocybin effects. It prolongs the QT interval (a heart-rhythm measure), and psilocybin transiently raises heart rate and blood pressure. Sources [1][2]

Human data with psilocybin: No psilocybin data; based on how it works and its label
Half-life: Dose-dependent (nonlinear kinetics) (FDA label, checked 2026-10-04) The label states the terminal half-life is dose dependent and not useful for predicting elimination.

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

2 listed · counted on reports

Liver injury: The label or source warns of liver injury, from raised liver enzymes to liver failure. Liver disease also affects how the body clears psilocin. Sources [1]
QT-prolonging: Lengthens the QT interval on an ECG, a measure of the heart’s electrical recovery between beats. A long QT raises the risk of a dangerous heart rhythm, more so with other QT-prolonging drugs or low potassium or magnesium. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not named

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

None linked

No condition named in state rules is linked to this medication.

05 Sources

VFEND (voriconazole) tablets, oral suspension and injection (Pfizer) · FDA label (DailyMed) — revised 2026-03 | QT-prolonging: 5.2 Arrhythmias and QT Prolongation "Some azoles, including VFEND, have been associated with prolongation of the QT interval on the electrocardiogram." | Liver injury: 5.1 Hepatic Toxicity "In clinical trials, there have been uncommon cases of serious hepatic reactions during treatment with VFEND (including clinical hepatitis, cholestasis and fulminant hepatic failure, including fatalities)." | "Voriconazole is a strong inhibitor of CYP3A4, and also inhibits CYP2C19 and CYP2C9." "Pooled reports include such terms as: hallucination; hallucination, auditory; hallucination, visual. Several patients had both visual and auditory hallucinations." | 12.3 "As a result of non-linear pharmacokinetics, the terminal half-life of voriconazole is dose dependent and therefore not useful in predicting the accumulation or elimination of voriconazole."
Thomann J, Kolaczynska KE, Stoeckmann OV, et al. In vitro and in vivo metabolism of psilocybin’s active metabolite psilocin. Front Pharmacol 2024;15:1391689. — Abstract: "recombinant CYP2D6 and CYP3A4 enzymes metabolized nearly 100% and 40% of psilocin, respectively." "MAO-A transformed psilocin into minimal amounts of 4-HIAA and 4-HTP." "In conclusion, MAO-A, CYP2D6, and CYP3A4 are involved in psilocin's metabolism." Introduction: "Around 33% of a psilocybin dose is renally excreted as 4-HIAA."

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

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