Itraconazole Teva (Itraconazole)

Itraconazole is used to treat fungal infections that affect the skin, lungs and other organs.

• Dermatophyte infections: eradicates superficial fungal skin infections such as tinea corporis and tinea pedis.
• Histoplasmosis: clears systemic infection caused by Histoplasma capsulatum.
• Blastomycosis: treats disseminated disease caused by Blastomyces dermatitidis.
• Coccidioidomycosis: resolves infection from Coccidioides species.
• Aspergillosis: manages invasive disease caused by Aspergillus species.
• Cryptococcal infections: combats systemic infection by Cryptococcus neoformans.

• Itraconazole inhibits the fungal enzyme lanosterol 14α‑demethylase, a key step in ergosterol synthesis. By blocking this pathway, the drug disrupts cell membrane formation, leading to increased membrane permeability and inhibition of fungal growth. The selective inhibition of fungal cells while sparing human cholesterol synthesis underlies its antifungal activity.

Itraconazole may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Vomiting: occasional emesis.
• Abdominal pain: discomfort in the upper abdomen.
• Headache: transient cranial pain.
• Rash: skin redness or itching.
• Taste disturbances: altered or reduced taste perception.

Serious or Rare Side Effects

• Hepatotoxicity: elevated liver enzymes or hepatitis.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Cardiac failure: worsening of pre‑existing heart conditions.
• QT interval prolongation: risk of arrhythmias.
• Severe liver injury: hepatic failure requiring medical intervention.

Before initiating therapy, clinicians should assess patient risk factors and monitor for complications.

• Liver function monitoring: obtain baseline and periodic liver enzyme tests.
• Avoid hepatotoxic drugs: do not co‑administer with other agents known to affect liver health.
• Caution in heart failure: assess cardiac status before use.
• Dose adjustment in hepatic impairment: reduce dose as recommended for reduced liver function.
• Grapefruit juice avoidance: advise patients not to consume grapefruit products.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Itraconazole interacts with several medicines; some combinations should be avoided while others require close observation.

Major Interactions (Avoid)

• Rifampin: induces metabolism, markedly reducing itraconazole levels.
• Ketoconazole: competitive inhibition leading to increased toxicity.
• St. John’s wort: strong enzyme inducer decreasing efficacy.
• Erythromycin: may increase itraconazole concentrations, raising toxicity risk.
• HIV protease inhibitors (e.g., ritonavir): can cause unpredictable plasma levels.

Moderate Interactions (Monitor Closely)

• Warfarin: potentiates anticoagulant effect, monitor INR.
• Phenytoin: may lower itraconazole exposure, adjust dose if needed.
• Carbamazepine: enzyme induction may reduce efficacy.
• Digoxin: increased serum levels possible, watch for toxicity.
• NSAIDs: may increase risk of gastrointestinal irritation.