Drug Index

Itraconazole

 
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Mechanism :

Itraconazole inhibits the cytochrome P-450-dependent synthesis of ergosterol, which is a vital component of fungal cell membranes.


Indication :

• Systemic Fungal infections (off-label)

• Candidiasis (off-label)

• Histoplasmosis (off-label)

• Cystic Fibrosis


Contraindications :

Coadministration of terfenadine, astemizole or cisapride with itraconazole is contraindicated.

Concomitant administration with oral triazolam or with oral midazolam is contraindicated.

Should not be administered to pregnant patients or to women contemplating pregnancy.

Contraindicated in patients who have shown hypersensitivity to the drug or its excipients.


Dosing :

Oral <12 years: 3-5 mg/kg/day in two divided doses and 12-18 years: 200 mg once or twice daily. Max: 600 mg/day. Duration for 15 days in tinea corporis, tinea cruris and oropharyngeal candidiasis and 30 days for tinea pedis and tines manuum. Duration is one year for histoplasmosis.


Adverse Effect :

Commonly seen adverse reactions are dizziness, abdominal pain, raised hepatic enzymes, nausea, constipation, headache, dyspepsia, menstrual disorders. Allergic reactions including rash, urticaria, pruritus and angioedema have been seen.


Interaction :

Terfenadine: Has led to elevated plasma concentrations of terfenadine, resulting in rare instances of life-threatening cardiac dysrhythmias.
Astemizole: Inhibits the metabolism of astemizole, resulting in elevated plasma concentrations of astemizole which may prolong QT intervals.
Midazolam or Triazolam: Resulted in elevated plasma concentrations of the two drugs. This may potentiate and prolong hypnotic and sedative effects.
Cyclosporine, Tacrolimus or Digoxin: Increased plasma concentrations.
Phenytoin, Rifampin, or H2antagonists: Reduced plasma concentrations of itraconazole were reported.
Anticoagulant: Enhances the anticoagulant effect of coumarin-like drugs. Therefore, prothrombin time should be carefully monitored.
Oral Hypoglycemic Agents: Severe hypoglycemia has been reported in patients concomitantly receiving azole antifungal agents and oral hypoglycemic agents.


08/06/2019 12:17:57 Itraconazole
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