[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)
- 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)
