Infectious Disease Book

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ItraconazoleAka: Sporanox

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  1. Indications
    1. Onychomycosis
  2. Metabolism
    1. Hepatic cytochrome P450
  3. Drug Interactions: Serious (Contraindicated)
    1. Serious arrhythmia with
      1. Astemizole
      2. Cisapride
      3. Quinidine
      4. Pimozide (Orap)
    2. Rhabdomyolysis Risk
      1. HMG-CoA Reductase Inhibitors (e.g. Simvastatin)
    3. Significant Sedation with Benzodiazepines
      1. Midazolam (Versed)
      2. Triazolam (Halcion)
      3. Avoid other Benzodiazepines also
      4. Avoid barbiturates (e.g. Phenobarbital)
  4. Drug Interactions: Other
    1. Medications raising gastric pH and lowering absorption
      1. H2 Blockers (e.g. Ranitidine)
      2. Proton Pump Inhibitors (e.g. Omeprazole)
    2. Oral Hypoglycemics (e.g. Sulfonylureas)
      1. Risk of Hypoglycemia
    3. Increased bleeding risk with Warfarin
  5. Dosing: Onychomycosis
    1. Continuous Therapy Dosing (Adult)
      1. Fingernail: 200 mg PO qd for 6 weeks
      2. Toenail: 200 mg PO qd for 3 months
    2. Pulse Therapy (Adult dosing)
      1. 200 mg PO bid for 1 week per month
      2. Course
        1. Fingernail: 2-3 months
        2. Toenail: 3-4 months
  6. Cost
    1. Twelve week supply: $900
  7. Directions
    1. Take with food (lower pH increases absorption)
  8. Monitoring: Onychomycosis
    1. Pulse therapy: no monitoring
    2. Continuous therapy at baseline and every 4 to 6 weeks
      1. Aspartate Aminotransferase (AST)
      2. Alanine Aminotransferase (ALT)
  9. References
    1. Boogaerts (2001) Drugs 61(Suppl I):39
    2. De Beule (2001) Drugs 61(Suppl I):27
    3. De Doncker (1997) J Am Acad Dermatol 37:969
    4. Friedlander (1999) Pediatr Infect Dis J 18(2):205
    5. Gupta (1998) Int J Dermatol 37:303
    6. Gupta (1999) J Am Acad Dermatol 41:237
    7. Gupta (2001) Eur J Dermatol 11(1):6

Itraconazole (C0064113)

Definition (MSH)One of the triazole ANTIFUNGAL AGENTS that inhibits cytochrome P-450-dependent enzymes resulting in impairment of ERGOSTEROL synthesis. It has been used against histoplasmosis, blastomycosis, cryptococcal meningitis & aspergillosis.
Definition (CSP)orally active antimycotic; structurally related to ketoconazole.
Definition (NCI)A drug used to prevent or treat fungal infections. It belongs to the family of drugs called antifungal agents.
Definition (PDQ)A synthetic triazole agent with antimycotic properties. Formulated for both topical and systemic use, itraconazole preferentially inhibits fugal cytochrome P450 enzymes, resulting in a decrease in fungal ergosterol synthesis. Because of its low toxicity profile, this agent can be used for long-term maintenance treatment of chronic fungal infections. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39106&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39106&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1138" NCI Thesaurus)
Definition (NCI)A synthetic triazole agent with antimycotic properties. Formulated for both topical and systemic use, itraconazole preferentially inhibits fugal cytochrome P450 enzymes, resulting in a decrease in fungal ergosterol synthesis. Because of its low toxicity profile, this agent can be used for long-term maintenance treatment of chronic fungal infections. (NCI04)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishICZ, Itraconazole, ITRACONAZOLE PREPARATION
Spanishitraconazol
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Sporanox (C0699614)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishSporanox
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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