itraconazole (cont.)
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).
Reference: FDA Prescribing Information
Last Editorial Review: 3/3/2009
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