CV: edema, HF, hypertension.
Derm: photosensitivity, pruritus, rash, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS.
EENT: hearing loss, tinnitus.
Endo: adrenal insufficiency.
F and E: hypokalemia.
GI: nausea, abdominal pain, anorexia, diarrhea, flatulence, HEPATOTOXICITY, vomiting.
GU: albuminuria, ↓ libido, erectile dysfunction.
MS: RHABDOMYOLYSIS.
Neuro: dizziness, drowsiness, fatigue, headache, malaise, neuropathy.
Misc: fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS).
65–mg tablets are NOT interchangeable with other products.
Aspergillosis
- PO (Adults): 200 mg once or twice daily for
3 mo OR 130 mg once or twice daily for 3 mo.
Blastomycosis, Histoplasmosis
- PO (Adults): 200 mg once daily; may be ↑ by 100 mg/day up to 200 mg twice daily; continue therapy for 3 mo; OR 130 mg once daily; may be ↑ by 65 mg/day up to 130 mg twice daily; continue therapy for 3 mo.
Onychomycosis
- PO (Adults): Toenail fungus — 200 mg once daily for 12 consecutive wk. Fingernail fungus — 200 mg twice daily for 1 wk, then 3 wk without therapy, then 200 mg twice daily an additional wk–6 mo.
Candidiasis
- PO (Adults): Oropharyngeal candidiasis — 200 mg (20 mL) daily for 1–2 wk. Oropharyngeal candidiasis unresponsive to fluconazole — 100 mg (10 mL) twice daily for at least 2–4 wk. Esophageal candidiasis — 100 mg (10 mL) once daily for at least 3 wk.
Therapeutic Classification: antifungals (systemic)
Pharmacologic Classification: azoles
Absorption: Absorption is enhanced by food.
Distribution: Tissue concentrations are higher than plasma concentrations. Does not enter CSF; enters breast milk.
Protein Binding: Itraconazole — 99.8%; hydroxyitraconazole — 99.5%.
Metabolism/Excretion: Mostly metabolized by the liver by the CYP3A4 isoenzyme and excreted in feces. Hydroxyitraconazole, the major metabolite, has antifungal activity.
Half-life: 21 hr.
