Viewer Question

Can you please provide more information re: the side effects of Sporanox ? Which liver enzymes are elevated? What is the impact of these enzymes being elevated? How can this drug cause hepatitis?
Signed, TH

Doctor's Answer

The enzymes in blood that are used to monitor for liver injury are alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase. Itraconazole (Sporanax) causes mild and temporary elevations of these liver enzymes in 1-3% of patients. These small, temporary elevations of liver enzymes are of little concern., Very rarely, itraconazole may cause reversible hepatitis (reversible when the itraconazole is stopped early enough) or irreversible, complete liver failure. Therefore, itraconazole should be discontinued if liver enzymes are substantially or persistently elevated or if there are signs of liver failure. The reason for the liver injury by itraconazole is not well understood. Because of the risk of liver failure, liver enzymes should be measured at the start of therapy with itraconazole, then monthly for 3-4 months, andthen periodically thereafter when itraconazole is used for longer than one month.

Thank you for your question.

Omudhome Ogbru, Pharm.D.
Editor: Jay Marks, MD