Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Clarithromycin (Biaxin), erythromycin, indinavir (Crixivan) or ritonavir
(Norvir) increase blood levels of itraconazole by reducing its elimination from
the liver, resulting in increased side effects of itraconazole.
Carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin (Rifadin),
rifabutin (Mycobutin) and isoniazid reduce the blood concentration of oral
itraconazole, probably by increasing the elimination of itraconazole by the
liver. This may reduce the effectiveness of itraconazole.
Itraconazole tablets require acid from the stomach to dissolve. Therefore,
itraconazole should be administered at least two hours before taking antacids or
other acid reducing medications such as cimetidine (Tagamet), ranitidine
(Zantac) or omeprazole (Prilosec).
PREGNANCY: Ketoconazole has not been adequately studied in
pregnant
women.
NURSING MOTHERS: Itraconazole is excreted in human milk. Therefore, it
probably should not be administered to nursing women or, alternatively,
breastfeeding should be discontinued.
SIDE EFFECTS: The most common side effects of itraconazole include
nausea,
vomiting, diarrhea, rash, edema, fatigue, dizziness. High blood pressure
(hypertension) and increased blood triglycerides may also occur. Less common but
more serious side effects include hepatitis and congestive heart failure. It is
important to report any signs or symptoms that may suggest liver dysfunction so
that the appropriate laboratory testing can be done. These signs include unusual
fatigue, poor appetite, nausea and/or vomiting, yellowing of the eyes
(jaundice), dark urine or pale stool. Itraconazole should not be used for
treatment of onychomycosis in patients with a history of heart failure. It
should be discontinued if signs and symptoms of heart failure occur. Symptoms of
heart failure include fatigue, edema (fluid retention), shortness of breath,
nausea, abdominal pain and inability to sleep unless sitting upright. Use of
calcium channel blockers may increase the risk of heart failure associated with
itraconazole (see drug interactions).
The term "ringworm" or "ringworms" refers to fungal infections that are on the surface of the skin. A physical examination of the affected skin, evaluation of skin scrapings under the microscope, and culture tests can help doctors make the appropriate distinctions. A proper diagnosis is essential to successful treatment. Among the different types of ringworm are the following: tinea barbae, tinea capitis, tinea corporis, tinea cruris, tinea faciei, tinea manus, tinea pedis, and tinea unguium.
Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking, peeling, and bleeding feet. Treatment involves keeping the feet dry and clean, wearing shoes that can breathe, and using medicated powders to keep your feet dry.
Jock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Tinea versicolor is a fungus infection that mainly affects the skin of young people. Recognized by light or reddish brown spots, and areas lighter than the surrounding skin. Tinea versicolor is caused by yeast actually found in our skin. Factors like heat, humidity, and sweat help it proliferate in people, resulting in a rash that is not contagious to others.
Fungal nails (onychomycosis) may be caused by many species of fungi but the most common is Trichophyton rubrum. Distal subungal onychomycosis starts as a discolored area at the nail's corner and slowly spread toward the cuticle. In proximal subungal onychomycosis, the infection starts at the cuticle and spreads toward the nail tip. Yeast onychomycosis is caused by Candida and may be the most common cause of fungal fingernail.
Histoplasmosis is a disease caused by the Histoplasma capsulatum fungus. Symptoms and signs of this infection are fever, dry cough, chills, malaise, sweats, and abdominal pain. Transmission of the infection occurs when people inhale the spores. Most infections resolve on their own, and resistant infections are treated with itraconazole, ketoconazole, or amphotericin B.
Valley fever (coccidioidomycosis) is a disease caused by the inhalation of the Coccidioides immitis or C. posadasii fungus. Symptoms are flu-like and resolve over two to six weeks. Infection typically requires no treatment, though there are many antifungal drugs to treat valley fever.
Sporotrichosis is a skin infection caused by a fungus called Sporothrix schenckii. The fungus, which may be present in sphagnum moss, thorny plants, or baled hay, enters the skin through punctures and small cuts. Symptoms include painless bumps on the skin near the site of infection. The nodules may open and look like boils. The infection is treated with potassium iodide or itraconazole (Sporanox).
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