What it's for (Indications)
- Itraconazole is used for the treatment of various fungal infections, including systemic fungal infections such as Blastomycosis, Histoplasmosis, and Aspergillosis, as well as superficial fungal infections like Pityriasis versicolor (skin yeast infection), Dermaphytosis (skin fungal infection), and Onychomycosis.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | Itraconazole capsules must be swallowed whole and taken with a full meal to ensure maximal absorption. Itraconazole capsules and oral solution are different preparations and should not be used interchangeably. - **Treatment of Blastomycosis and Histoplasmosis**: The recommended dose is 200 mg once daily (2 capsules). If there is no obvious improvement or evidence of progressive fungal disease, the dose should be increased in 100-mg increments to a maximum of 400 mg daily. Doses above 200 mg/day should be given in two divided doses. - **Treatment of Aspergillosis**: A daily dose of 200 to 400 mg is recommended. - **Treatment in Life-Threatening Situations**: A loading dose of 200 mg (2 capsules) three times daily (600 mg/day) is recommended for the first day, based on pharmacokinetic data. |
Safety & Warnings
Common Side Effects
- Common side effects include nausea, abdominal pain, dyspepsia (indigestion), and headache.
- Importantly, itraconazole has been associated with rare but serious cases of hepatotoxicity, including liver failure and death.
- If clinical signs or symptoms consistent with liver disease develop, treatment should be discontinued, and liver function testing performed.
Serious Warnings
- Black Box Warning: Congestive Heart Failure, Cardiac Effects and Drug Interactions: Itraconazole capsules should not be administered for the treatment of onychomycosis in patients with evidence of ventricular dysfunction such as congestive heart failure (CHF) or a history of CHF. If signs or symptoms of congestive heart failure occur during administration of itraconazole capsules, discontinue administration.
- Patients with a history of liver disease or liver toxicity from other drug therapies must be closely monitored due to the risk of serious hepatotoxicity, including liver failure and death.
- The drug should not be administered for onychomycosis in patients with evidence or a history of ventricular dysfunction, such as congestive heart failure (CHF).
- If signs or symptoms of CHF occur during treatment, administration should be discontinued.
- For pregnant individuals, no definite data regarding pregnancy is available, and consultation with a doctor is advised before use.
- Itraconazole is contraindicated or not recommended for females who are breastfeeding.
- Patients should avoid driving when taking this medicine as it may affect their ability to drive.
- Additionally, alcohol consumption should be avoided while on itraconazole.
How it Works (Mechanism of Action)
Itraconazole acts by inhibiting the cytochrome P450-dependent synthesis of ergosterol, which is an essential component of fungal cell membranes. This disruption leads to altered cell membrane permeability and ultimately inhibits fungal growth.