Antimicrobials
Itraconazole

Itraconazole

N/A
See Additional Information
$$ - $$$

Spectrum of Activity

Dosing

General Information

  • Periodic liver function tests, CBC with diff, chemistries, renal function
  • Signs/symptoms of liver toxicity and/ or congestive heart failure
  • See Itraconazole Blackbox warning

Itraconazole trough levels

Efficacy

  • Levels not routinely performed, but some evidence suggests troughs > 0.25 mg/L decrease likelihood of prophylaxis failure and levels > 0.5 mg/L are associated with treatment success

Toxicity

  • Troughs > 1 mg/L are associated with increased rates of toxicity, especially hepatic toxicity
  • Heart failure
  • QTc prolongation and Torsades for more information
  • Hepatitis/hepatic dysfunction
  • Blurred/double vision
  • Ringing in the ears
  • GI
  • Muscle/joint pain or weakness
  • Psychiatric concerns (e.g. nervousness, depression)
  • Allergic reactions

Please refer to Lexicomp for more information

  • Addition of other QTc prolonging medications can potentiate the effect and some are contraindicated see Itraconazole Blackbox warning
  • Significant CYP drug-drug interactions

10 mg/mL solution (formulary item)

  • 65 mg capsule
  • 100 mg capsule (formulary item)
  • Solution and capsules are not equivalent. Oral solution preferred due to increased absorption
  • Hydroxypropyl-β-cyclodextrin in the oral solutions increases the bioavailability compared to the capsules
    • Oral solution should be taken under fasting conditions
  • 100 mg capsules should be taken with food and acidic pH for optimal absorption (65 mg capsules have different recommendations - refer to Lexicomp for more information if considering use)