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- What is itraconazole, and how does it work (mechanism of action)?
- What brand names are available for itraconazole?
- Is itraconazole available as a generic drug?
- Do I need a prescription for itraconazole?
- What are the side effects of itraconazole?
- What is the dosage for itraconazole?
- Which drugs or supplements interact with itraconazole?
- Is itraconazole safe to take if I'm pregnant or breastfeeding?
- What else should I know about itraconazole?
What is itraconazole, and how does it work (mechanism of action)?
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.
What are the side effects of itraconazole?
The most common side effects of itraconazole are:
Other important side effects include:
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).
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What is the dosage for itraconazole?
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.
Which drugs or supplements interact with itraconazole?
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) 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. Itraconazole increases blood levels of tacrolimus, sirolimus, and cyclosporine. It may also increase blood levels of fentanyl or prolong elimination of fentanyl, potentially leading to fatal respiratory depression. 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).
Is itraconazole safe to take if I'm pregnant or breastfeeding?
Itraconazole has not been adequately studied in pregnant women. Cases of congenital abnormalities have been reported. Itraconazole should not be used to treat nail fungal infections (onychomycosis) in pregnant patients. Women of child bearing age undergoing treatment for fungal infections of the nails must use adequate contraception measures while receiving itraconazole and for two months after treatment.
What else should I know about itraconazole?
What preparations of itraconazole are available?
Capsules: 100 mg; Oral Solution: 10 mg/ml; Injection: 10 mg/ml
How should I keep itraconazole stored?
Capsules should be stored at room temperature, 15 C - 25 C (59 F - 77 F) and protected from light and moisture. Oral and injectable solutions should be stored below 25 C (77 F) but not frozen.
Reference: FDA Prescribing Information
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Itraconazole (Sporanox) is a medication used to treat fungal infections such as fungal nails, aspergillosis, blastomycosis, histoplasmosis, and candidiasis, as well as HIV and non-HIV infected individuals. Side effects, warnings and precautions, drug interactions, and pregnancy safety information should be reviewed prior to taking this medication.
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Athlete's FootAthlete'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.
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Lotrisone (clotrimazole and betamethasone) is a drug prescribed for the treatment of jock itch, athlete's foot, and tinea corporis (fungal infections elsewhere on the body). Side effects include:
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Drug interactions, dosage, and pregnancy and breastfeeding information should be reviewed prior to using this medication.
Drug InteractionsDrug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.
Drugs: What You Should Know About Your DrugsImportant information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.
Diflucan (fluconazole) is a drug prescribed to treat fungal infections caused by Candida, for example, vaginal, oral, esophageal, urinary tract, pneumonia, and peritonitis. Side effects include
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- abdominal pain.
Drug interactions, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication.
Fungal Nail Infection PictureNails that are infected with a fungus may become discolored (yellowish-brown or opaque), thick and brittle, and may separate from the rest of the nail. See a picture of Fungal Nail Infection and learn more about the health topic.
Fungal NailsFungal 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 FactsHistoplasmosis is a disease caused by a fungus called Histoplasma capsulatum. The symptoms are similar to those of pneumonia and include chest pain, fever, and sweats. Antifungal medications are used in treatment.
Jock ItchJock 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.
ketoconazoleKetoconazole (Nizoral, Extina, Xolegel, Kuric) is an anti-fungal medication prescribed to treat fungal infections such as thrush, ringworm, jock itch, athlete's foot, dandruff, tinea versicolor, blastomycosis, histoplasmosis, and coccidiomycosis. Side effects and drug interactions should be reviewed prior to taking this medication.
RingwormThe 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.
SporotrichosisSporotrichosis 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).
ThrushThrush is an infection of the mouth caused by the Candida fungus. Symptoms of Thrush include pain or difficulty swallowing, a feeling that food gets stuck in the throat, and fever.
Tinea VersicolorTinea 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.
Valley FeverValley 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.