Capsules: 100 mg
Oral liquid: 10 mg/ml
Intravenous infusion: 10 mg/ml
(The oral solution should always be used in preference to capsules due to the poor bioavailability of the capsules)
Therapeutic drug level monitoring should be performed to ensure adequate drug levels are achieved
Oropharyngeal candidiasis: 200–400 mg orally daily for 7–14 days
Fluconazole resistant oral or oesophageal candidiasis:
100–200mg orally twice a day for up to 14 days
Other systemic fungal infections (aspergillosis, histoplasmosis, cryptococcosis, coccidioidomycosis): Up to 400 mg orally daily
Oropharyngeal candidiasis: fluconazole resistance 200–400 mg orally daily for 5–14 days
Other systemic fungal infections – second line options (aspergillosis, histoplasmosis, cryptococcosis, coccidioidomycosis): Up to 400 mg orally daily
Histoplasmosis - disseminated: Itraconazole 200 mg three times a day for 3 days then 200 mg twice a day for at least 12 months
Acute infection: Itraconazole 200 mg orally once or twice a day for 6–12 weeks, may be more prolonged if CD4 count <300.
Gastrointestinal disturbances (dyspepsia, nausea, abdominal pain, constipation); headache; increases in LFTs; rash; dizziness.
CSM advice (heart failure)
Caution in older patients, those receiving high doses or long courses or those taking negative inotropic drugs e.g. calcium channel blockers
Antacids, H2 antagonists, proton pump inhibitors and didanosine tablets reduce absorption (acid environment required).
Plasma concentration reduced by rifampicin and phenytoin; warfarin effect enhanced; terfenadine and astemizole contraindicated – risk of arrhythmias; delayed metabolism of vincristine; increased risk of myopathy with simvastatin – avoid concomitant use; increased plasma levels of sildenafil
Itraconazole levels are reduced by both efavirenz and nevirapine and the dose of itraconazole may need to be increased if given with an NNRTI
Dose as in normal renal function
The IV formulation contains hydroxypropyl-b-cyclodextrin, which is contraindicated in patients with a creatinine clearance of less than 30
Itraconazole is predominantly metabolized in the liver. The terminal half-life of itraconazole in cirrhotic patients may be prolonged and dosage adjustment should be considered.
Human Data Suggest Low Risk