Itraconazole Capsule 100mg

Generic Name:

Itraconazole

Brand Names:

Sporanox, Itranox, Canditral, Onmel etc.

Drug Class:

Triazole antifungal

Indications / Uses:

Itraconazole capsules are used to treat a wide range of fungal infections, including:

• Onychomycosis (fungal infection of nails)

• Blastomycosis

• Histoplasmosis

• Sporotrichosis

• Aspergillosis (non-life-threatening)

• Tinea corporis, cruris, pedis (ringworm, jock itch, athlete’s foot – when topical treatment fails)

Mechanism of Action:

Itraconazole inhibits fungal cytochrome P450 enzyme (14α-demethylase), disrupting ergosterol synthesis, which is essential for fungal cell membrane integrity. This leads to fungal cell death.

Dosage Forms:

• Capsules: 100 mg

• Oral Solution: 10 mg/mL (note: has different absorption pattern from capsules)

Dosage Examples:

Important: Must be taken after a full meal for best absorption (capsules only).

• Onychomycosis (toenail):
  200 mg once daily for 12 weeks

• Fingernail infection (pulse therapy):
  200 mg twice daily for 1 week, repeated after 3 weeks (2 pulses)

• Histoplasmosis or blastomycosis:
  200–400 mg per day depending on severity

Side Effects:

Common:

• Nausea

• Abdominal pain

• Diarrhea or constipation

• Headache

• Rash

Serious:

• Hepatotoxicity (monitor liver function)

• Congestive heart failure (CHF) exacerbation

• Peripheral neuropathy (rare)

• Visual disturbances

Warnings & Precautions:

• Black Box Warning:

  • Not for use in patients with heart failure (can cause negative inotropic effects).

  • Serious drug interactions with certain medications that prolong the QT interval (risk of torsades de pointes).

• Hepatotoxicity risk – Monitor LFTs before and during therapy.

• Caution in renal or hepatic impairment.

Drug Interactions:

Itraconazole is a strong inhibitor of CYP3A4:

• Increases levels of:

  • Statins (simvastatin, lovastatin) – risk of rhabdomyolysis

  • Benzodiazepines (e.g., midazolam, triazolam)

  • Digoxin, warfarin, certain antiarrhythmics

• Antacids, PPIs, H2 blockers reduce absorption (needs acidic environment for capsule form).

Pregnancy & Lactation:

• Pregnancy Category C (D in some cases): Avoid unless benefits outweigh risks.

• Contraindicated in onychomycosis during pregnancy.

• Avoid during breastfeeding unless advised by a doctor.

Patient Counseling Points:

• Take capsules with food (unlike the oral solution).

• Do not take antacids within 2 hours of the dose.

• Complete full course even if symptoms improve.

• Report signs of liver problems (dark urine, yellowing of skin, fatigue).

• Do not self-medicate with over-the-counter drugs that interact (e.g., PPIs, antihistamines).