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Sporanox

Sporanox (generic name: itraconazole) is an oral antifungal medication used to treat a variety of fungal infections, including blastomycosis, histoplasmosis, and onychomycosis (fungal infections of the nails). It belongs to the azole antifungal class and works by stopping the growth of fungi. Sporanox is also sometimes used off-label to treat other fungal infections, particularly in immunocompromised patients.

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Frequently Asked Questions

How long does it take for Sporanox to clear a fungal nail infection?
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It can take several months for the full effects to become visible, as new, healthy nails must grow in to replace the infected ones. The medication itself is typically taken for 12 weeks for toenail infections.

Can I drink alcohol while taking Sporanox?
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It is best to avoid alcohol while taking Sporanox, as both Sporanox and alcohol can increase the risk of liver damage.

What should I do if I miss a dose of Sporanox?
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If you miss a dose, take it as soon as you remember. If it is close to the next dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses.

Does Sporanox interact with other medications?
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Yes, Sporanox has significant interactions with many medications, including certain statins, calcium channel blockers, and anticoagulants. Always inform your doctor about all medications you are taking.

Can Sporanox treat skin fungal infections?
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Sporanox can be used to treat certain types of skin fungal infections, especially if topical treatments are ineffective or if the infection is severe. Always consult your doctor for the best treatment plan.

Comprehensive Drug Guide

How Does Sporanox Work?

Sporanox works by inhibiting cytochrome P450 14α-demethylase, an enzyme involved in the synthesis of ergosterol, a key component of the fungal cell membrane. Without ergosterol, the fungal cell membrane becomes weakened, preventing the growth and survival of the fungus. This action helps the body clear the infection.

Common Dosages

  • Capsules: 100 mg
  • Oral solution: 10 mg/mL

The typical dosage depends on the condition being treated:

  • Onychomycosis: 200 mg once daily for 12 weeks (toenails) or 200 mg twice daily for one week per month for two months (fingernails).
  • Systemic fungal infections: Dosing can vary depending on the type and severity of the infection.

Typical Dosing

  • For onychomycosis: The standard dose is 200 mg once daily for 12 continuous weeks or pulse dosing for shorter cycles.
  • For systemic infections: Dosing may vary and often involves higher doses over extended periods. Consult your healthcare provider for specifics on dosing based on the type of infection.

Typical Dosing

FDA Approved Indications

  • Onychomycosis (fungal infections of the fingernails and toenails)
  • Blastomycosis
  • Histoplasmosis
  • Aspergillosis

Who Shouldn't Take Sporanox?

  • Congestive heart failure (CHF): Sporanox may exacerbate CHF symptoms.
  • Hypersensitivity to itraconazole or any components of the formulation.
  • Concurrent use with certain medications that can cause serious drug interactions (e.g., statins, certain heart medications).

Advice From The Pharmacist

  • Sporanox capsules should be taken with food to improve absorption, while the oral solution is best taken on an empty stomach.
  • It is important to follow the prescribed course, even if symptoms improve before completion.
  • Avoid using antacids, proton pump inhibitors, or H2-blockers close to the time of taking Sporanox, as they may reduce the absorption of the drug.
  • Sporanox may interact with several medications, so be sure to inform your healthcare provider about all medications you are currently taking.

Side Effects of Sporanox

Common Side Effects

  • Nausea
  • Diarrhea
  • Abdominal pain
  • Headache

Uncommon/Severe Side Effects

  • Liver toxicity: Yellowing of the skin or eyes, dark urine, or unusual fatigue.
  • Congestive heart failure: Shortness of breath, rapid weight gain, or swelling.
  • Allergic reactions: Hives, swelling, or difficulty breathing.

Risks and Warnings of Sporanox

  • Heart Failure Risk: Sporanox can increase the risk of heart failure, particularly in patients with a history of CHF or other heart problems. Close monitoring is recommended for these patients.
  • Liver Toxicity: Sporanox may cause liver damage, particularly in patients with pre-existing liver disease. Regular liver function tests are often recommended during treatment.
  • Drug Interactions: Sporanox interacts with a wide range of medications, including those metabolized by the liver. Always inform your healthcare provider of all current medications.

Interactions with Sporanox

Common Drug Interactions

  • Antacids: May reduce Sporanox absorption. Take antacids at least two hours before or after Sporanox.
  • Statins: Combining statins like simvastatin with Sporanox can increase the risk of severe muscle damage (rhabdomyolysis).
  • Calcium channel blockers: These medications, when taken with Sporanox, can increase the risk of heart-related side effects.

Alternatives to Sporanox

  • Lamisil (terbinafine): An antifungal often used for onychomycosis and similar fungal infections.
  • Fluconazole: Another azole antifungal used for a variety of systemic fungal infections.
  • Ketoconazole: Another azole antifungal used for treating fungal infections, though it is generally less favored due to its risk of liver toxicity.