Itraconazole

Details About Generic Salt ::  Itraconazole 

Main Medicine Class:: Anti Infectives   Sub Medicine Class ::  Anti Fungals

13I. ANTI-FUNGALS in 13. ANTI-INFECTIVES
ITRACONAZOLE
TRIAZOLE | ANTI-FUNGAL
PK: A: Well absorbed D: 10 L/kg (vd) M: Hepatic E: Urine, feces

Indications & Dose: ASPERGILLOSIS PO Adult Invasive (salvage therapy): 200-400mg/day 6-12 wk Child Systemic:1 month-18 yr: 5mg/kg BID, max 200mg/day | BLASTOMYCOSIS PO Adult 200mg TID 3 days, then 200mg BID 6-12 months | BRAIN ABSCESS Combination therapy PO Adult 200mg BID 6 month with amphotericin | COCCIDIOIDES FOCAL PNEUMONIA PO Adult 200mg TID 3 days, then 200mg BIDHIV positive | COCCIDIOIDES MENINGITIS PO Adult 400-800mg/day | COCCIDIOIDES PNEUMONIA Mild-to-moderate PO Adult 200mg BID | COCCIDIOIDOMYCOSIS PO Adult 200mg BID | ESOPHAGEAL CANDIDIASIS PO Adult Solution: 100-200mg/day 3 wk, continue dosing for 2 wk after resolution of symptoms. Solution should be vigorously swished in the mouth (10 mL at a time) for several seconds & then swallowed | FUNGAL INFECT IN FEBRILE NEUTROPENIC PATIENTS Empirical therapy IV Adult Initially 200mg BID for 4 doses, then 200mg OD 2 wk. Switch to oral therapy | HISTOPLASMOSIS Mild-to-moderate PO Adult 200mg TID 3 days, then 200mg OD/BID for 6-12 wk Child 1 month-18 yr: 5mg/kg OD/BID, max 200mg | LIFE-THREATENING INFECT PO Adult Loading dose: 200mg TID 3 days | LYMPHOCUTANEOUS SPOROTRICHOSIS PO Adult 100-200mg/day 3-6 month | ONYCHOMYCOSIS PO Adult 200mg/day 12 consecutive wks Child 12–18 yr: 200mg/day 3 month | PO Adult Pulse-dosing: 200mg BID 1 wk, repeat 1 wk course after 3 wk after drug-free intervals Child 1–12 yr: 5mg/kg/day 1 wk, max 200mg, repeat 2 wk course after 3 wk after drug-free intervals, 12–18 yr: 200mg BID 1 wk, repeat 2 wk course after 3 wk after drug-free intervalsinvolving only fingers | OROPHARYNGEAL CANDIDIASIS PO Adult Solution: 200mg/day 1-2 wk Child Capsule: 1 month-12 yr: 3-5mg/kg/day 15 days, 12-18 yr: 100mg/day 15 days | OSTEOARTICULAR/PULMONARY SPOROTRICHOSIS PO Adult 200mg BID 1-2 yr (may use amphotericin B initially for stabilization) | PITYRIASIS VERSICOLOR PO Adult 200mg OD 7 days Child 1 month-12 yr: 3-5mg/kg/day, max 200mg OD 7 days, 12-18 yr: 200mg OD 7 days | PROTOTHECAL INFECT PO Adult 200mg/day 2 month | PULMONARY HISTOPLASMOSIS Chronic PO Adult 200mg TID 3 days, then 200mg OD/BID >1 yr | TINEA CORPORIS/TINEA CRURIS PO Adult 100mg OD 15 days or 200mg OD 7 days Child 1 month-12 yr: 3-5mg/kg/day, max 100mg/day 15 days, 12-18 yr: 100mg/day 30 days or 200mg BID 1 wk | TINEA PEDIS/TINEA MANUUM PO Adult 100mg OD 1 month or 200mg BID 7 days Child 1 month-12 yr: 3-5mg/kg/day or max 100mg OD 30 days, 12-18 yr: 100mg OD 30 days or 200mg BID 1 wk | VULVOVAGINAL CANDIDIASIS PO Adult 200mg BID 1 day

Contra: Hypersensitivity, history of HF/ventricular dysfunction, onychomycosis treatment, concurrent use of cisapride, dofetilide, ergot derivatives, statins, midazolam

Precautions: Renal impairment, cystic fibrosis, concurrent use of CCBs

ADR: Serious: Edema, HTN, chest pain, hypokalemia, Others: Rhinitis, sinusitis, pruritus, cough, dyspnea, constipation, vomiting, abdominal pain, pneumonia, sputum increased, diaphoresis, fever, headache, fatigue, dizziness

DDI: Serious Pimozide leads to life-threatening cardiac dysrhythmias, Terfenadine/Astemizole leads to serious cardiovascular adverse effects including ventricular tachycardia, torsades de pointes, Corticosteroids/Cisapride/HIV protease inhibitors levels increased, Phosphodiesterase type-5 inhibitors/CCBs levels increased & increase risk of adverse effects, Benzodiazepines levels increased & prolongs its sedative and hypnotic effects

Diet: With food (Capsule), without food (Solution)

Monitor: LFTs, renal function

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