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Itraconazole
Itraconazole is an antifungal medication used to treat a variety of fungal infections. It is effective against a range of fungi, including Aspergillus, Candida, and Blastomyces species. Itraconazole is often prescribed for conditions such as onychomycosis (fungal nail infection), systemic fungal infections, and fungal infections in immunocompromised patients.
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Frequently Asked Questions
How long does it take for itraconazole to start working?
Patients may start to notice improvement in symptoms within a few days to weeks, but full resolution of fungal infections may take several weeks or months.
Can I take itraconazole with other medications?
Always consult your healthcare provider before combining itraconazole with other medications, especially those that affect liver enzymes.
What should I do if I miss a dose of itraconazole?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Is it safe to use itraconazole during pregnancy?
Itraconazole is generally not recommended during pregnancy unless clearly needed, and the risks and benefits should be discussed with a healthcare provider.
Can itraconazole cause weight gain?
Weight gain is not a common side effect of itraconazole. Any significant changes in weight should be discussed with a healthcare provider.
Comprehensive Drug Guide
How Does Itraconazole Work?
Itraconazole works by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes. By disrupting ergosterol production, itraconazole compromises the integrity of the fungal cell membrane, leading to cell death and the resolution of the infection.
Common Dosages
- Capsules: Common dosages include 100 mg.
- Oral solution: Typically contains 10 mg/mL.
Typical Dosing
- For onychomycosis: The usual dose is 200 mg taken once daily for 12 weeks for toenail infections or 6 weeks for fingernail infections.
- For systemic fungal infections: The dosage may vary depending on the specific infection, typically ranging from 100 mg to 200 mg once daily.
Typical Dosing
FDA Approved Indications
- Treatment of fungal infections, including:
- Aspergillosis
- Blastomycosis
- Histoplasmosis
- Onychomycosis
Who Shouldn't Take Itraconazole?
- Known hypersensitivity to itraconazole or any components of the formulation
- History of heart failure or current congestive heart failure
- Concurrent use of certain medications that may interact adversely, such as strong CYP3A4 inhibitors
Advice From The Pharmacist
- Patients should be advised to take itraconazole capsules with food to enhance absorption, while the oral solution should be taken on an empty stomach.
- Encourage patients to complete the full course of therapy, even if symptoms improve before the medication is finished.
- Advise patients to report any signs of liver dysfunction (e.g., jaundice, dark urine) or heart failure symptoms (e.g., swelling, rapid weight gain).
Side Effects of Itraconazole
Common Side Effects
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Headache
Uncommon/Severe Side Effects
- Liver toxicity
- Heart failure exacerbation
- Severe allergic reactions (anaphylaxis)
Risks and Warnings of Itraconazole
- Cardiovascular Risk: Use caution in patients with a history of heart disease or heart failure.
- Liver Function: Monitor liver function tests regularly, especially in patients with pre-existing liver conditions or those on long-term therapy.
Interactions with Itraconazole
Common Drug Interactions
- CYP3A4 Inhibitors: Concomitant use with strong inhibitors of this enzyme (e.g., ketoconazole, erythromycin) may increase itraconazole levels and risk of toxicity.
- CYP3A4 Inducers: Medications that induce this enzyme (e.g., rifampin) can decrease itraconazole effectiveness.
Alternatives to Itraconazole
- Other Azole Antifungals: Such as fluconazole or voriconazole for specific fungal infections.
- Terbinafine: For certain dermatophyte infections or onychomycosis.
