Two patients with AIDS and cryptococcal meningitis failed to respond and 2 who responded initially later relapsed or developed progressive disease when the dose was reduced. The place of itraconazole in the treatment of fungal infections is discussed in the various sections under Choice of Antifungal.Doses of itraconazole oral liquid and capsules are not equivalent and may not be used interchangeably.In the UK, itraconazole oral liquid is licensed for use in oral and oesophageal candidiasis in a dose of 200 mg daily for 1 week it may be taken as a single daily dose, or, preferably, in 2 divided doses, the liquid being retained in the mouth for 20 seconds before swallowing. If itraconazole is used for primary prophylaxis against cryptococcosis in HIV-infected infants and children with severe immunosuppression, a dosage of 2-5 mg/kg orally every 12-24 hours is recommended by the USPHS/IDSA.For primary prophylaxis against histoplasmosis in adults and adolescents with human immunodeficiency virus (HIV) infection and CD4+ T-cell counts less than 100/mm3, the USPHS/IDSA recommends that itraconazole capsules be given in a dosage of 200 mg once daily.For primary prophylaxis against histoplasmosis in HIV-infected infants and children with severe immunosuppression, a dosage of 2-5 mg/kg orally every 12-24 hours is recommended by the USPHS/IDSA.When itraconazole is used for long-term suppressive or maintenance therapy (secondary prophylaxis) to prevent recurrence or relapse of coccidioidomycosis or histoplasmosis in HIV-infected individuals whose fungal infection has been adequately treated, the USPHS/IDSA recommends that adults and adolescents receive oral itraconazole capsules in a dosage of 200 mg twice daily and that infants and children receive an oral dosage of dosage of 2-5 mg/kg every 12-48 hours.When itraconazole is used for long-term suppressive or maintenance therapy (secondary prophylaxis) to prevent recurrence or relapse of cryptococcosis in HIV-infected individuals whose fungal infection has been adequately treated, the USPHS/IDSA recommends that adults and adolescents receive oral itraconazole capsules in a dosage of 200 mg once daily and that infants and children receive an oral dosage of 2-5 mg/kg every 12-24 hours.When oral itraconazole is used for long-term suppressive or maintenance therapy (secondary prophylaxis) to prevent recurrence or relapse of mucocutaneous candidiasis, the USPHS/IDSA recommends that HIV-infected adults or adolescents with frequent or severe recurrences of oropharyngeal, esophageal, or vaginal candidiasis receive itraconazole oral solution in a dosage of 200 mg once daily and that HIV-infected infants and children with frequent or severe recurrences of esophageal candidiasis receive the oral solution in a dosage of 5 mg/kg once daily.Suppressive or maintenance therapy to prevent recurrence or relapse of candidiasis, coccidioidomycosis, cryptococcosis, or histoplasmosis in HIV-infected individuals generally is continued for life.
When IV itraconazole is used for the treatment of blastomycosis or histoplasmosis in adults, the manufacturer recommends that therapy be initiated with a dosage of 200 mg IV twice daily for 4 doses, then dosage decreased to 200 mg IV once daily. Use with the statins is also best avoided because of the risk of muscle damage.Fatal hepatitis occurred in a 68-year-old woman after 2 months of use of itraconazole and Didanosine in a formulation containing aluminium and magnesium ion buffering agents could reduce the absorption of itraconazole due to the resultant increase in gastric pH.Itraconazole is a triazole antifungal drug that in sensitive fungi inhibits cytochrome P450-dependent enzymes resulting in impairment of ergosterol synthesis in fungal cell membranes. These medications are not usually taken together. It is used to treat certain kinds of fungal or yeast infections. Care is also required with calcium channel Mockers, which may increase the risk of congestive heart failure if given together, and nisoldipine in particular is considered contra-indicated. Of 49 patients taking itraconazole 100 to 400 mg daily for up to 39 months, 23 did not experience adverse effects during treatment, while 6 had nausea and vomiting, 5 developed oedema, and 2 developed hypertension 3 of the patients who developed oedema and 1 who became hypertensive were diabetic.
Itraconazole tablets and capsules are used to treat fungal infections of the toenails.
In one case there were bloody bullae.A 29-year-old man developed an infiltrative maculo-papular eruption after 1 week of itraconazole 100 mg bd for tinea corporis.
Absorption may be impaired in these patients and monitoring of plasma concentrations is advised with an increase in dose to 200 mg twice daily if necessary.This higher dose is recommended routinely by some authorities in the USA such as the Doses of itraconazole 600 mg daily in two divided doses for 3 to 16 months were used in 8 patients with systemic mycoses resistant to conventional therapy.
Itraconazole capsules are used to treat fungal infections in the lungs that can spread throughout the body.