Itraconazole
 Itraconazole

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Itraconazole

Generic name: Itraconazole
Brand names: sporanox

Why is Itraconazole prescribed?

Sporanox capsules are used to treat three types of serious fungal infection: blastomycosis, histoplasmosis, and aspergillosis. Blastomycosis can affect the lungs, bones, and skin. Histoplasmosis can affect the lungs, heart, and blood. Aspergillosis can affect the lungs, kidneys, and other organs. The drug is also prescribed for onychomycosis, which infects the toenails and fingernails. Additionally, Sporanox is used against fungal infections in people with weak immune systems, such as AIDS patients.

Sporanox oral solution is used to treat candidiasis (fungal infection) of the mouth, throat, and gullet (esophagus), and for other fungal infections in people with weakened immunity and fever.

Most important fact about Itraconazole

Be sure to take Sporanox for as long as your doctor prescribes. It will take 3 months or more to cure some infections completely. If you stop taking Sporanox too soon, the infection may return.

How should you take Itraconazole?

Take Sporanox exactly as prescribed. To make sure the capsules are properly absorbed, you should take them after a full meal; the oral solution should be taken without food. A cola drink can help some people absorb the capsules better. Continue taking Sporanox until all the medication is gone. Do not take antacids within 1 hour before or 2 hours after taking Sporanox.

Swish the oral solution, 10 milliliters at a time, in your mouth for a few seconds before swallowing it.

Mouth and throat candidiasis should clear up in several days.

The oral solution and capsules cannot be used interchangeably.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Never try to "catch up" by doubling the dose.

--Storage instructions...

Store at room temperature. Protect the capsules from light and moisture. Do not freeze the oral solution.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Sporanox.

  • More common side effects may include:
    Anxiety, bursitis, diarrhea, fatigue, fever, gas, headache, high blood pressure, indigestion, injury, muscle pain, nasal and sinus inflammation, nausea, pain, rash, respiratory infection, swelling due to water retention, urinary infection, vomiting
  • Additional side effects that may be seen with the oral solution are:
    Back pain, blood in the urine, breathing difficulty, chest pain, cough, dehydration, difficulty swallowing, hemorrhoids, hot flushes, impaired speech, inflamed mouth, insomnia, pneumonia, shivering, sweating, vision problems, weight loss

People being treated for onychomycosis may experience stomach and intestinal disorders or rash, or, less commonly, headache, light-headedness upon standing up, low blood pressure, muscle pain, a sick feeling, or vertigo.

Why should Itraconazole not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Sporanox or similar antifungal drugs such as Nizoral, you should not take Itraconazole. Make sure that your doctor is aware of any drug reactions that you have experienced.

Sporanox can have a negative effect on the heart. It should not be used for fungal nail infections in people with cardiac problems such as congestive heart failure.

Serious heart problems, such as irregular heartbeats and even death, have occurred in people who have taken Sporanox at the same time as cisapride, levacetylmethadol, pimozide, or cholesterol-lowering drugs known as statins, such as Mevacor and Zocor. Never take these drugs with Sporanox, and avoid Halcion, Quinidex, Versed, and Tikosyn as well.

During pregnancy, Sporanox should not be used for treatment of fungal nail infections.

If you have cystic fibrosis or a low white blood cell count, taking Sporanox is not advised.

Special warnings about Itraconazole

In rare cases, Sporanox has been known to cause liver failure and even death, sometimes within the first week of treatment. Sporanox treatment is strongly discouraged if you have liver disease or have experienced liver toxicity from other drugs. If you take Sporanox continuously for more than a month, your doctor should monitor your liver function periodically. If you develop such symptoms of liver disease as unusual fatigue, loss of appetite, nausea, vomiting, jaundice, dark urine, or pale stool, stop taking Sporanox and contact your doctor immediately.

People with cardiac problems such as congestive heart failure should avoid Sporanox unless the benefit clearly outweighs the danger. In fact, anyone who is even at risk of heart failure should use Sporanox with caution. Risk factors include heart and lung disorders and kidney failure. If you experience swelling--especially in the feet and ankles--or difficulty breathing while taking Sporanox, stop taking Itraconazole and contact your doctor immediately.

If you develop any nerve disorders while taking Sporanox, see your doctor. Treatment will probably need to be discontinued.

Possible food and drug interactions when taking Itraconazole

If Sporanox is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Sporanox with any of the following:

Acid-blocking drugs such as Tagamet, Pepcid, and Zantac
Alprazolam (Xanax)
Atorvastatin (Lipitor)
Blood-thinning drugs such as Coumadin
Buspirone (BuSpar)
Busulfan (Myleran)
Caffeine-containing agents such as Cafergot
Calcium channel blockers such as Cardene, Norvasc, and Procardia
Carbamazepine (Tegretol)
Cilostazol (Pletal)
Clarithromycin (Biaxin)
Cyclosporine (Sandimmune, Neoral)
Diazepam (Valium)
Disopyramide (Norpace)
Dofetilide (Tikosyn)
Digoxin (Lanoxin)
Docetaxel (Taxotere)
Eletriptan (Relpax)
Erythromycin (E-Mycin, Ery-Tab, and others)
Indinavir (Crixivan)
Isoniazid
Levacetylmethadol
Lovastatin (Mevacor)
Methylprednisolone (Medrol)
Midazolam (Versed)
Nevirapine (Viramune)
Oral diabetes medications such as DiaBeta, Diabinese, Glucotrol, Micronase, Orinase, and Tolinase
Phenobarbital
Phenytoin (Dilantin)
Pimozide (Orap)
Quinidine (Quinidex)
Rifabutin (Mycobutin)
Rifampin (Rifadin, Rimactane)
Ritonavir (Norvir)
Saquinavir (Invirase)
Simvastatin (Zocor)
Sirolimus (Rapamune)
Tacrolimus (Prograf)
Triazolam (Halcion)
Trimetrexate (Neutrexin)
Vinblastine (Velban)

Special information if you are pregnant or breastfeeding

The effects of Sporanox during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. You should not take Sporanox to treat onychomycosis if you are or may become pregnant. In any event, Sporanox should not be used during pregnancy if the problem is a nail infection. In other cases, check with your doctor before you take Sporanox.

Sporanox appears in breast milk and could affect a nursing infant. If Itraconazole is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Sporanox is finished.

Recommended dosage

ADULTS

Blastomycosis and Histoplasmosis

The usual dose is two 100-milligram capsules, taken after a full meal once a day. If you feel no improvement, or if there is evidence that the fungal disease has spread, your doctor will increase the dose 100 milligrams at a time to a maximum of 400 milligrams a day. Daily dosages above 200 milligrams a day should be divided into 2 smaller doses.

Aspergillosis

The usual dose is 200 to 400 milligrams a day. Treatment usually continues for a minimum of 3 months, until tests indicate that the fungal infection has subsided.

Onychomycosis

The usual dose for a toenail infection, whether or not fingernails are also involved, is 200 milligrams once a day for 12 weeks.

If only fingernails are infected, treatment is given in two 7-day-long sessions during which you take 200 milligrams of Sporanox twice a day, with a 3-week rest period between sessions.

Candidiasis, mouth and throat

The usual dose is 20 milliliters of oral solution a day for 1 to 2 weeks. If the infection does not go away, your dose will be changed to 10 milliliters twice a day.

Candidiasis, esophagus

The usual dose is 10 milliliters of oral solution a day for at least 3 weeks. You should continue the treatment for 2 weeks after your symptoms clear up. If necessary, the doctor may increase the dose to 20 milliliters a day.

Fungal infections in people with weakened immunity and fever

Recommended treatment starts with 200-milligram injections twice a day for 2 days followed by 200 milligrams injected once a day for up to 14 days. This may be followed by 20 milliliters of oral solution twice a day for up to a total of 28 days of treatment

CHILDREN

The safety and effectiveness of Sporanox in children have not been established.

Overdosage

Any drug taken in excess can have dangerous consequences. If you suspect an overdose, seek emergency medical treatment immediately.





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