Itraconazole - Revision history

Aidan at 13:03, 22 October 2024

2024-10-22T13:03:01Z

← Older revision		Revision as of 13:03, 22 October 2024
Line 11:		Line 11:
	* Excreted in urine and feces		* Excreted in urine and feces

			=== Breakpoints ===
			{\| class="wikitable"
			! rowspan="2" \|Species
			! rowspan="2" \|ECOFF (mg/L)
			! colspan="4" \|Breakpoints (μg/mL)
			! colspan="4" \|Breakpoints (mm)
			\|-
			! S
			! I
			!SDD
			!R
			!S
			!I
			! SDD
			! R
			\|-
			\| [[Candida albicans]]
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|-
			\|[[Candida glabrata]]
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|-
			\|[[Candida krusei]]
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|-
			\|[[Candida parapsilosis]]
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|-
			\|[[Candida tropicalis]]
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|-
			\|[[Cryptococcus neoformans]]
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|-
			\|[[Cryptococcus gattii]]
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|-
			\|[[Aspergillus flavus]]
			\|1
			\|≤1
			\| colspan="2" rowspan="5" \|
			\|>1
			\|
			\|
			\|
			\|
			\|-
			\|[[Aspergillus fumigatus]]
			\| 1
			\|≤1
			\|>1
			\|
			\|
			\|
			\|
			\|-
			\|[[Aspergillus nidulans]]
			\|1
			\|≤1
			\|>1
			\|
			\|
			\|
			\|
			\|-
			\|[[Aspergillus niger]]
			\|4
			\|—
			\|—
			\|
			\|
			\|
			\|
			\|-
			\|[[Aspergillus terreus]]
			\|0.5
			\|≤1
			\|>1
			\|
			\|
			\|
			\|
			\|}
	== Dosing ==		== Dosing ==

Aidan: /* Pharmacokinetics */

2024-09-23T14:08:11Z

Pharmacokinetics

← Older revision		Revision as of 14:08, 23 September 2024
Line 8:		Line 8:
	* Wide intersubject variability in levels		* Wide intersubject variability in levels
	* Serum half-life is long		* Serum half-life is long
	* Metabolized by [[Metabolized by::CYP3A4]] and inhibits [[Inhibits:CYP3A4]]		* Metabolized by [[Metabolized by::CYP3A4]] and inhibits [[Inhibits::CYP3A4]]
	* Excreted in urine and feces		* Excreted in urine and feces

Aidan at 14:06, 23 September 2024

2024-09-23T14:06:43Z

← Older revision		Revision as of 14:06, 23 September 2024
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	* Azole antifungal		* Azole antifungal
	* Indications include {{#ask: [[Is treated by::itraconazole]]}}		* Indications include {{#ask: [[Is treated by::itraconazole]]}}

			=== Pharmacokinetics ===

			* Blood concentrations are about 30% higher with oral solution compared to oral capsules
			* Wide intersubject variability in levels
			* Serum half-life is long
			* Metabolized by [[Metabolized by::CYP3A4]] and inhibits [[Inhibits:CYP3A4]]
			* Excreted in urine and feces

	== Dosing ==		== Dosing ==

			* Preference for oral solution rather than capsules in severe infections (see PK section above)
			* Can consider initial loading doses with IV or p.o
	* Typical dose: 200 mg p.o. twice daily		* Typical dose: 200 mg p.o. twice daily
	* May be used once daily for the treatment of some [[Candida\|candidal]] or [[dermatophytes\|dermatophytic]] infections		* May be used once daily for the treatment of some [[Candida\|candidal]] or [[dermatophytes\|dermatophytic]] infections
Line 11:		Line 21:

	=== Therapeutic Drug Monitoring ===		=== Therapeutic Drug Monitoring ===
			* Recommended in more serious or severe infections
	* Should be measured 5 to 7 days after starting or changing the dose, or when interacting medications are changed		* Should be measured 5 to 7 days after starting or changing the dose, or when interacting medications are changed
			** Can likely be collected at any time after steady-state is reached, due to long halflife
	* Target in prophylaxis is a trough ot 0.5 mg/L
	* Target in ~~treatment~~ is a trough >0.5 mg/L		* Target in prophylaxis is a trough level of 0.5 µg/mL
			* Target in treatment is a trough level greater than 0.5 µg/mL, or greater than 0.5 to 1 µg/mL for [[blastomycosis]]
			* Toxicity likely increased at trough levels greated than 10 µg/mL

	=== Adverse Drug Reactions ===		=== Adverse Drug Reactions ===
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	* [[Adverse drug reaction::Hepatotoxicity]]		* [[Adverse drug reaction::Hepatotoxicity]]
	* [[Adverse drug reaction::QTc prolongation]]		* [[Adverse drug reaction::QTc prolongation]]

			== Further Reading ==

			* Therapeutic drug monitoring (TDM) of antifungal agents: guidelines from the British Society for Medical Mycology. ''J Antimicrob Chemother.'' 2014;69(5):1162-1176. doi: [https://doi.org/10.1093/jac/dkt508 10.1093/jac/dkt508]

	[[Category:Triazoles]]		[[Category:Triazoles]]

Aidan at 16:52, 2 January 2024

2024-01-02T16:52:06Z

← Older revision		Revision as of 16:52, 2 January 2024
Line 6:		Line 6:

	* Typical dose: 200 mg p.o. twice daily		* Typical dose: 200 mg p.o. twice daily
	* May be used once daily for the treatment of some [[dermatophytes]]		* May be used once daily for the treatment of some [[Candida\|candidal]] or [[dermatophytes\|dermatophytic]] infections

	== Safety ==		== Safety ==

Aidan at 16:51, 2 January 2024

2024-01-02T16:51:20Z

← Older revision		Revision as of 16:51, 2 January 2024
Line 1:		Line 1:
			== Background ==
	* Azole antifungal		* Azole antifungal
	* Indications include {{#ask: [[Is treated by::itraconazole]]}}		* Indications include {{#ask: [[Is treated by::itraconazole]]}}

			== Dosing ==
⚫	== Therapeutic Drug Monitoring ==

			* Typical dose: 200 mg p.o. twice daily
			* May be used once daily for the treatment of some [[dermatophytes]]

			== Safety ==

		⚫	=== Therapeutic Drug Monitoring ===
	* Should be measured 5 to 7 days after starting or changing the dose, or when interacting medications are changed		* Should be measured 5 to 7 days after starting or changing the dose, or when interacting medications are changed
	* Target in prophylaxis is a trough ot 0.5 mg/L		* Target in prophylaxis is a trough ot 0.5 mg/L
	* Target in treatment is a trough >0.5 mg/L		* Target in treatment is a trough >0.5 mg/L

	== Adverse Drug Reactions ==		=== Adverse Drug Reactions ===
	* [[Adverse drug reaction::Headache]]		* [[Adverse drug reaction::Headache]]
	* [[Adverse drug reaction::Relative adrenal insufficiency]]		* [[Adverse drug reaction::Relative adrenal insufficiency]]

Aidan at 11:02, 26 August 2020

2020-08-26T11:02:13Z

← Older revision		Revision as of 11:02, 26 August 2020
Line 13:		Line 13:
	* [[Adverse drug reaction::QTc prolongation]]		* [[Adverse drug reaction::QTc prolongation]]

	[[Category:~~Antifungals~~]]		[[Category:Triazoles]]

Aidan: /* Adverse Effects */

2020-02-18T03:14:49Z

Adverse Effects

← Older revision		Revision as of 03:14, 18 February 2020
Line 7:		Line 7:
	* Target in treatment is a trough >0.5 mg/L		* Target in treatment is a trough >0.5 mg/L

	== Adverse ~~Effects~~ ==		== Adverse Drug Reactions ==
	* [[~~Has adverse~~ drug reaction::Headache]]		* [[Adverse drug reaction::Headache]]
	* [[~~Has adverse~~ drug reaction::Relative adrenal insufficiency]]		* [[Adverse drug reaction::Relative adrenal insufficiency]]
	* [[~~Has adverse~~ drug reaction::Hepatotoxicity]]		* [[Adverse drug reaction::Hepatotoxicity]]
	* [[~~Has adverse~~ drug reaction::QTc prolongation]]		* [[Adverse drug reaction::QTc prolongation]]

	[[Category:Antifungals]]		[[Category:Antifungals]]

Aidan at 03:05, 18 February 2020

2020-02-18T03:05:39Z

← Older revision		Revision as of 03:05, 18 February 2020
Line 8:		Line 8:

	== Adverse Effects ==		== Adverse Effects ==
	* [[Has adverse drug reaction::~~Headaches~~]]		* [[Has adverse drug reaction::Headache]]
	* [[Has adverse drug reaction::Relative adrenal insufficiency]]		* [[Has adverse drug reaction::Relative adrenal insufficiency]]
	* [[Has adverse drug reaction::Hepatotoxicity]]		* [[Has adverse drug reaction::Hepatotoxicity]]

Aidan: /* Adverse Effects */

2020-02-18T03:05:24Z

Adverse Effects

← Older revision		Revision as of 03:05, 18 February 2020
Line 8:		Line 8:

	== Adverse Effects ==		== Adverse Effects ==
	* Headaches		* [[Has adverse drug reaction::Headaches]]
	* Relative adrenal insufficiency		* [[Has adverse drug reaction::Relative adrenal insufficiency]]
	* Hepatotoxicity		* [[Has adverse drug reaction::Hepatotoxicity]]
	* QTc prolongation		* [[Has adverse drug reaction::QTc prolongation]]

	[[Category:Antifungals]]		[[Category:Antifungals]]

Aidan: added adverse effects

2019-11-21T15:04:36Z

added adverse effects

← Older revision		Revision as of 15:04, 21 November 2019
Line 6:		Line 6:
	* Target in prophylaxis is a trough ot 0.5 mg/L		* Target in prophylaxis is a trough ot 0.5 mg/L
	* Target in treatment is a trough >0.5 mg/L		* Target in treatment is a trough >0.5 mg/L

			== Adverse Effects ==
			* Headaches
			* Relative adrenal insufficiency
			* Hepatotoxicity
			* QTc prolongation

	[[Category:Antifungals]]		[[Category:Antifungals]]