Itraconazole Teva (Itraconazole)

Itraconazole is an azole antifungal used to manage a range of systemic and mucosal fungal diseases.

• Blastomycosis: eradicates the organism and resolves pulmonary and disseminated disease.
• Histoplasmosis: clears infection in acute and chronic forms, including disseminated disease.
• Aspergillosis: controls invasive disease and reduces fungal burden.
• Candidiasis (oropharyngeal and esophageal): eliminates Candida overgrowth and relieves symptoms.
• Dermatophyte infections: treats skin and nail infections caused by dermatophytes.
• Sporotrichosis: resolves cutaneous and subcutaneous infection caused by Sporothrix species.

• Itraconazole inhibits the fungal enzyme lanosterol 14α‑demethylase, a cytochrome P450 isoform essential for converting lanosterol to ergosterol. By blocking ergosterol synthesis, the drug disrupts fungal cell‑membrane integrity, leading to increased permeability and ultimately cell death. This mechanism is selective for fungi, providing antifungal activity across a broad spectrum of yeasts and molds.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: transient cranial discomfort.
• Abdominal pain: cramping or discomfort in the abdomen.
• Rash: mild skin irritation or erythema.
• Taste alteration: temporary changes in flavor perception.
• Diarrhea: loose stools that may be self‑limiting.

Serious or Rare Side Effects

• Hepatotoxicity: elevated liver enzymes or liver injury.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Cardiac failure: worsening of pre‑existing heart failure.
• Visual disturbances: blurred vision or photophobia.
• Interstitial lung disease: rare pulmonary inflammation.
• Severe hypokalemia: marked drop in blood potassium levels.

Before initiating therapy, clinicians should assess liver function, cardiac status, and potential drug interactions.

• Liver monitoring: obtain baseline hepatic enzymes and repeat periodically.
• Cardiac risk: avoid in patients with uncontrolled heart failure.
• Drug‑interaction review: evaluate concomitant CYP3A4 substrates or inhibitors.
• Pregnancy caution: use only if benefits outweigh potential risks; safety data are limited.
• Pediatric use: dosage and safety must be determined by a qualified prescriber.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Itraconazole has a high potential for pharmacokinetic interactions due to CYP3A4 inhibition.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): may cause toxic itraconazole levels.
• Rifampin or other potent CYP3A4 inducers: can markedly reduce efficacy.
• Certain statins (simvastatin, lovastatin): increased risk of myopathy.
• Antacids containing aluminum or magnesium: reduce absorption of itraconazole.
• HIV protease inhibitors (e.g., indinavir): may lead to excessive drug exposure.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., erythromycin, clarithromycin): may require dose adjustment.
• Warfarin: enhanced anticoagulant effect, monitor INR.
• Oral contraceptives: reduced effectiveness, advise alternative contraception.
• Digoxin: possible increase in serum levels.
• Fluconazole: additive antifungal effect, monitor for toxicity.