Itraconazole is an antifungal azole. It is a synthetic triazole analogue with a wide spectrum of antifungal activity. It was first synthesized in 1980, and approved in Europe in 1987.
It was approved by the FDA in 1992 for systemic mycoses, and then for onychomycoses in 1995, and for use by pulse therapy in 1997. In 2000, itraconazole was also approved to treat blastomycosis, histoplasmosis, and aspergellosis in patients intolerant of amphotericin B.
Itraconazole is used effectively in the treatment of onychomycosis and candidal infection.
It is lipophylic and quickly achieves high skin and mucous membrane concentrations, and may still be found in the stratum corneum 4 weeks after discontinuation of therapy.
- Oral: Capsules: Itraconazole 100mg Sporanox*
- Solution: Itraconazole 100mg/10 mL Sporanox*
- Candidiasis, oropharyngeal
- Onychomycosis #
- Paronychia #
- Leishmaniasis, cutaneous #
- Candidiasis, vulvo-vaginal #
- Candidiasis mucocutaneous #
- Tinea corporis #
- Tinea cruris#
- Tinea pedis#
- Tinea manum #
- Hirsutism #
# - not approved in Canada
- Itraconazole 100mg oral solution po daily x 3weeks
- Itraconazole 200 mg twice a day po x1week, followed by 200 mg twice a day for the first week of each month. For toenail involvement, continue treatment x12 consecutive weeks
Safety and efficacy have not been established.
Hepatic function tests should be monitored periodically during treatment. Serum potassium may be monitored as hypokalemia has lead to ventricular fibrillation in patients on itraconazole.
Drug Safety Information
!! Warnings & Contraindications !!
- Concurrent use with cisapride, azemizole and terfenadine is contraindicated.
- Iatroconazole capsules not to be prescribed for onychomycosis in patients with history of congestive heart failure.
- Hypokalemia has lead to ventricular fibrillation in patients on itraconazole
FDA Pregnancy Category C
- Cutaneous effects may include hypersensitivity reactions including exfoliative dermatitis and Stevens-Johnson syndrome
- Gastrointestinal effects may include nausea, abdominal pain, diarrhea, constipation, loss of appetite and rarely, hepatotoxicity.
- Other effects may include headache, dizziness and drowsiness.
Animal studies have shown itraconazole to be teratogenic and embryotoxic in dose-related studies. Iatroconazole is distributed in the breast milk.
Major Drug Interactions
Concurrent use of itraconazole anticholinergics, omeprazole, and antacids may reduce the absorption of itraconazole; with digoxin levels may be increased and should be monitored; lovstatin and simvastatin concentrations may be increased, and have been associated with rhabdomyolysis; Didanosene may decrease the absorption of itroconazole; antidiabetic agents can lead to hypoglycemia; cyclosporine and phenytoin plasma concentrations may be increased; triazolam and midazolam serum concentrations may be increased; isoniazid, rifampin metabolism may be affected; anticoagulant effects may be increased.
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Havu V, Brandt H, Haikkila H et al: Continuous and intermittent itraconazole dosing schedules for the treatment of onychomycosis: a pharmacokinetic comparison. Br. Jour. Derm. 1999: 140: 96-101
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