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Itraconazole

[itraconazole photo]

KEY POINTS

  • Itraconazole (Sporanox) is an Azole derivative antifungal drug that works by interfering with ergosterol synthesis, which is the principal sterol in the fungal cell membrane
  • Is a common drug to consider when managing a fungal infection caused by an endemic fungi such as Histoplasma capsulatum, Coccidiodes immitis, and Blastomycosis dermatitidis
    • Also has activity versus many Aspergillus species and Candida species
    • Can be used for onychomycosis, chromomycosis, dermatomycoses, paracoccidiodomycosis and sporotrichosis
  • Available oral or injectable
    • Some oral formulations are better absorbed when administered under acidic conditions
    • Capsule and oral solution are not bioequivalent and hence are not directly interchangeable
  • Levels are sometimes monitored
  • Beware drug-drug interactions via CYP enzymes
    • May be so significant that it contraindicates use with other drugs
  • Beware hepatotoxicity and increases in AST/ALT
  • Black box warning regarding use in patients with evidence of ventricular dysfunction (e.g., existing congestive heart failure or history of congestive heart failure)
    • Can cause negative inotropic effects
  • Neuropathy, CNS depression, diarrhea, nausea or hearing loss are potential side effects
  • Pregnancy category: C

RESOURCES

  • Itraconazole Capsules Package Insert
  • Itraconazole Oral Solution Package Insert
  • Itraconazole Injection Package Insert
  • IDSA Candidemia Guideline (2016)
    • Other IDSA Guidelines For Fungi
  • Guidelines For Opportunistic Infections From AIDSinfo
  • 2015 CDC Sexually Transmitted Diseases Guideline (2015)
  • Pharmacology Of Systemic Antifungal Agents (2006)
  • Current Concepts In Antifungal Pharmacology (2011)

Free Antibiotic Cheat Sheet

Study Guide

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