Itraconazole (serum)

General Information

Itraconazole , invented in 1984, is a triazole antifungal agent that is prescribed to patients with fungal infections. The drug may be given orally or intravenously. Itraconazole can be used to treat Aspergillus, which fluconazole is not. It is also licenced for use in blastomycosis, histoplasmosis and onychomycosis. Itraconazole is over 99% protein bound and has virtually no penetration into cerebrospinal fluid. Therefore, it should never be used to treat meningitis or other central nervous system infections.

It is also prescribed for systemic infections such as aspergillosis, candidiasis and cryptococcosis where other antifungal drugs are inappropriate or ineffective. Itraconazole is currently being explored as an anti-cancer agent for patients with basal cell carcinoma, non-small cell lung cancer, and prostate cancer.

Caution needed when used in patients with renal or liver disease. Regular LFT's required when on treatment for >1 month or if existing liver pathology is present. Absorption of this drug is reduced in patients with AIDS and neutropenia, therefore in these cases the serum levels must be monitored and dosage increased. Risk of heart faliure when high dose prolonged treatment given.

Side effects include nausea, abdominal pain, dyspepsia, constipation, vomiting, headache, dizziness, raised liver enzymes, menstrual disorders, hepatitis and cholestatic jaundice, heart faliure, peripheral neuropathy, oedema and hypokalaemia. Safety and efficacy not established in children and the elderly.