Medications and Drugs

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Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: itraconazole

BRAND NAME: Sporanox

DRUG CLASS AND MECHANISM: Itraconazole is an anti-fungal drug in the same class of drugs as fluconazole (Diflucan), ketoconazole (Nizoral), and miconazole (Micatin, Monistat). It prevents growth of several types of fungi by preventing the fungi from producing the membranes that surround the fungal cells. The FDA approved itraconazole in September 1992.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Capsule: 100 mg; Oral Solution: 10 mg/ml

STORAGE: Capsules should be stored at room temperature, 15-25 C (59-77 F) and protected from light and moisture. Solution should be stored below 25 C (77 C) but not frozen.

PRESCRIBED FOR: Itraconazole is used for the treatment of fungal infections in both HIV- and non-HIV-infected individuals. It is active against fungal infections such as aspergillosis, blastomycosis, histoplasmosis, and candidiasis, as well as fungal infection localized to the toenails and fingernails (onychomycosis). It also is used for treating patients with fever and low white blood cell counts who are likely to develop a fungal infection.

DOSING: The usual recommended dose is 200-400 mg daily as a single dose or two divided doses. Capsules should be taken with a full meal because food improves absorption. The capsule and liquid are not interchangeable, and only the liquid form is used for treating oral candidiasis.

DRUG INTERACTIONS: Itraconazole reduces the liver metabolism (breakdown) of some drugs, resulting in increased blood levels and side effects from the affected drugs. Life threatening adverse effects occurred when itraconazole was combined with cisapride (no longer available in the U.S.), pimozide (Orap), quinidine (Quinaglute, Quinidex), dofetilide (Tikosyn), or levomethadyl (Orlaam). Therefore, itraconazole should not be combined with these drugs. Other drugs whose blood levels are increased by itraconazole include warfarin (Coumadin), tolbutamide, glyburide (Micronase, Diabeta, Glynase), glipizide (Glucotrol), protease inhibitors [for example, indinavir (Crixivan), ritonavir (Norvir), saquinavir (Invirase, Fortovase)], midazolam (Versed), triazolam (Halcion), "statins" (for example, simvastatin or Zocor) and several others.

Itraconazole increases blood levels of certain calcium channel blockers, for example, nisoldipine (Sular) and verapamil (Calan). Such combinations increase the occurrence of congestive heart failure due to itraconazole.