Adult Dosing
Fungal infections
- 200 mg CAPS PO daily-bid for > 3 months; [Max: 400 mg/day]
- Life threatening infections: Start 200 mg CAPS PO tid x 3 days; [Max: 600 mg/day]
Onchomycosis
- Toenails with/without fingernail involvement: 200 mg CAPS PO daily x 12 wks; confirm diagnosis prior to treatment
- Fingernail involvement:
- 200 mg CAPS PO bid x 7 days; course repeated after 21 day intervals. Total 2 courses
- Confirm diagnosis prior to treatment
Orophryngeal candidiasis (oral solution)
- Swish and swallow 20 mL PO daily x 1-2 wks
- Swish and swallow 10 mL PO bid x 2-4 wks if unresponsive to fluconazole
Esophageal candidiasis (oral solution)
- 10 mL PO daily ; [Max: 20 mL/day] x 3 weeks & continuing for 2 weeks past symptom resolution
Histoplasmosis/cryptococcosis prevention in HIV infection (Not FDA approved)
Suppression of coccidioidomycosis/histoplasmosis in HIV infection (Not FDA approved)
Suppression of cryptococcosis in HIV infection (Not FDA approved)
Note: Give capsules with food and solution without food. Oral solution and capsules are not interchangeable
Pediatric Dosing
Fungal infections (Not FDA approved)
- 3-16 yrs: 100 mg PO daily; alt: 5 mg/kg/day PO div qd-bid. [Max: 200 mg/day]
Onchomycosis
- 1-12 yrs:
- Finger nail involvement: 5 mg/kg PO daily x 7 days; course repeated after 21 days. Total 2 courses
- Toenail involvement: 5 mg/kg PO daily x 7 days; 2 courses repeated q21 days. Total 3 courses
- 12-18 yrs:
- Finger nail involvement: 200 mg PO daily X 3 months. Alt: 200 mg PO bid x 7 days; course repeated after 21 days. Total 2 courses
- Toenail involvement: 200 mg PO daily X 3 months. Alt: 200 mg PO bid x 7 days; course repeated q21 days. Total 3 courses
Histoplasmosis/cryptococcosis prevention in HIV infection (Not FDA approved)
Suppression of coccidioidomycosis/histoplasmosis in HIV infection (Not FDA approved)
- 2-5 mg/kg PO every 12-48 hrs
Suppression of cryptococcosis in HIV infection (Not FDA approved)
Note: Give capsules with food and solution without food. Oral solution and capsules are not interchangeable
[Outline]
- Avoid interchanging Oral Solution and Capsules for initiating therapy in patients
- Only oral solution is effective for oral and/or esophageal candidiasis
- Rare occasions of serious hepatotoxicity, including liver failure and death have occurred in association with therapy
- Avoid administration of capsules/tablets for the treatment of onychomycosis in patients having evidence of ventricular dysfunction such as CHF or a history of CHF. On development of signs or symptoms of CHF discontinue therapy with capsules/tablets
- Discontinue therapy on developing clinical signs or symptoms consistent with liver disease and perform liver function test. Monitor liver function in patients with pre-existing hepatic function abnormalities or those having liver toxicity with other medications
- Discourage continued itraconazole use or reinstitution of treatment with itraconazole unless there is a serious or life-threatening manifestations where the expected benefit exceeds the risk
- Life-threatening cardiac dysrhythmias and/or sudden death have occurred in patients using cisapride, pimozide, levacetylmethadol (levomethadyl), or quinidine concurrently with itraconazole and/or other CYP3A4 inhibitors. Concurrent administration of these drugs with itraconazole is contraindicated
- Avoid using therapy in patients having evidence of ventricular dysfunction unless the benefit clearly outweighs the risk. Carefully review risks and benefits of therapy with this drug in patients having risk factors for CHF. Inform patients possessing risk factors about the signs and symptoms of CHF. Monitor patients for signs and symptoms of CHF during treatment
- On development of signs or symptoms of CHF during administration of oral solution carefully monitor patients and consider other alternative which may include withdrawal of oral solution
- Exercise caution while co-administering itraconazole and calcium channel blockers as risk of CHF may increase
- Concomitant administration of itraconazole and nisoldipine is contraindicated
- Occasions of CHF, peripheral edema, and pulmonary edema have been reported on post-marketing surveillance in patients treated for onychomycosis and/or systemic fungal infections
- Consider switching to alternative therapy if patients with cystic fibrosis does not respond to oral solution
- Therapy with oral solution is not recommended for initiation of treatment in patients at immediate risk of systemic candidiasis
- Discontinue therapy on development of neuropathy
- Transient or permanent hearing loss has been reported in patients receiving treatment with itraconazole
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- History of cardiovascular disease
- Edema
- Pulmonary impairment
- Cystic fibrosis (oral solution)
- Immunocompromised patients
- Severe neutropenia (oral solution)
- Co-administration with Calcium channel blockers
Pregnancy Category:C
Breastfeeding: Itraconazole is excreted in breast milk; use not recommended. HIV infected women should not breastfeed to avoid potential transmission of HIV to uninfected infants.
Pricing data from www.DrugStore.com in U.S.A.
- Itraconazole 100 MG CAPS [Disp Pack] (PATRIOT PHARMACEUTICALS LLC)
28 mg = $239.97
84 mg = $669.98 - Sporanox 10 MG/ML SOLN [Bottle] (JANSSEN PRODUCTS)
150 ml = $217.99
450 ml = $632 - Sporanox 100 MG CAPS [Bottle] (JANSSEN)
30 mg = $439.99
90 mg = $1230.01 - Itraconazole 100 MG CAPS [Bottle] (PATRIOT PHARMACEUTICALS LLC)
30 mg = $251.98
90 mg = $691.99
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
