Antimicrobials
Itraconazole

Itraconazole

N/A
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See Additional Information

Spectrum of Activity

Dosing

General Information

Aspergillosis.

Endemic fungi: Histoplasmosis, Blastomycosis, and Coccidioidomycosis.

Onychomycosis.

Serum level monitoring (trough) is recommended for patients on long term treatment.

Liver and renal function, as well as potassium should be monitored at baseline and periodically.

Signs and symptoms of CHF, peripheral edema, or peripheral neuropathy.

GI upset, including nausea and diarrhea occur in > 10% of patients.  

Hypotension, hyperkalemia, and peripheral edema, as well as hepatotoxicity can occur.

Heart failure has also been reported. [US Boxed Warning]: Use is contraindicated for treatment of onychomycosis in patients with ventricular dysfunction such as heart failure (HF) or a history of HF

Multiple drug interactions, assess prior to initiation of itraconazole.

Major CYP3A4 substrate and strong CYP3A4 inhibitor; p-glycoprotein inhibitor

Oral formulations are NOT interchangeable. Oral solution is preferred based on improved absorption.

Bioavailability: 

  • Solution 75% WITHOUT food
  • Capsule or tablet 55% with food/acidic beverage (AVOID acid suppressants such as proton pump inhibitors)

Cost evaluation recommended prior to discharge. Solution is preferred but may be more expensive.

Antimicrobial class: Triazole antifungal

Pregnancy category: C, AVOID use in pregnancy due to concerns that azole antifungals can cause fetal malformation and miscarriage.

Urine penetration: Poor

Lung penetration: Therapeutic

CSF penetration: Poor