By Gary M. White, MD
This is only a parietal summary. For this and any other medication, the complete package insert should be consulted.
- Infection by Blastomycosis, Histoplasmosis, and Aspergillosis.
- Onychomycosis of fingernails and/or toenails by dermatophytes.
History of heart failure or evidence of left ventricular cardiac dysfunction. Itraconazole can rarely cause congestive heart failure.
There are significant drug interactions that can lead to QT prolongation and ventricular tachyarrhythmias including torsades de pointes, a potentially fatal arrhythmia.
Dosing for Onychomycosis
- Intermittent therapy for itraconazole is as follows. The drug is taken 200 mg twice a day for 7 consecutive days per month. Thus, the patient takes it for 7 days, then off for 3 weeks, on for 7 days etc. For fingernails, 2 cycles are given (2 months or 56 pills). For toenails, 3 cycles are given (3 months or 84 pills).
- Swallow whole after a big meal.
- For children unable to swallow capsules, place the capsule within a fatty food, e.g. peanut butter. Orange juice decreases the half life and absorption of the drug.
- For children, 3-5 mg/kg/day as continuous therapy has been used.
- Pulse therapy in children, 5 mg/kg/day for 7 days.
Dosing for tinea corporis
Nausea and Vomiting
Itraconazole very rarely can cause congestive heart failure [Indian J Pharmacol. 2013 Sep-Oct; 45(5): 524–525.]
Rare cases of serious hepatotoxicity, including liver failure and death have been observed. Patients should be screened for any history of liver disease and LFTs measured.
Transient or permanent hearing loss has been reported in patients receiving treatment with itraconazole.
RARE SIDE EFFECTS
Visual Hallucinations: VH occurred repeatedly in one patient after just 200 mg of itraconazole (Clin Infect Dis 1995;21;456).
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