Dosing
CrCl > 80: 200-400 mg iv/po q 24 h.
CrCl 80-50: 200-400 mg iv/po q 24 h.
CrCl 50-10:
CrCl < 10:
Hemodialysis:
Peritoneal dialysis:
Important side effects
Hypokalemia, congestive heart failure (iv), hepatotoxicity, n/v, diarrhea, neutropenia, rash, Stevens-Johnson syndrome.
Important drug interactions
Acid dependent absorption, drug levels will go to stink if you block stomach acid. acenocoumarol, alfentanil, alfuzosin, aluminum carbonate, basic, aluminum hydroxide, aluminum phosphate, amlodipine, amprenavir, anisindione, aprepitant, astemizole, atorvastatin, benzodiazepines, bexarotene, budesonide, buspirone, busulfan, calcium, carbamazepine, cerivastatin, cimetidine, cinacalcet, cisapride, clarithromycin, conjugated estrogens, corticosteroids, cyclosporine, darifenacin, dicumarol, didanosine, digoxin, dihydroxyaluminum aminoacetate, dihydroxyaluminum sodium carbonate, disopyramide, docetaxel, dofetilide, eletriptan, ergot derivatives, erlotinib, erythromycin, esterified estrogens, estradiol, estriol, estrone, estropipate, eszopiclone, famotidine, felodipine, fentanyl, fosphenytoin, gefitinib, halofantrine, imatinib, indinavir, isoniazid, isradipine, lansoprazole, levomethadyl, lovastatin, magaldrate, magnesium carbonate, magnesium hydroxide, magnesium oxide, magnesium trisilicate, nevirapine, nicardipine, nifedipine, nimodipine, nizatidine, omeprazole, pantoprazole, phenindione, phenobarbital, phenprocoumon, phenytoin, pimozide, quetiapine, quinidine, rabeprazole, ranitidine, ranitidine, repaglinide, rifabutin, rifampin, rifapentine, ritonavir, rosuvastatin, roxatidine, saquinavir, sildenafil, simvastatin, sirolimus, sodium bicarbonate, tacrolimus, tadalafil, terfenadine, tolterodine, trazodone, trimetrexate, vardenafil, verapamil, vinca alkaloids, warfarin.
These drugs interact with damn near everything else so check with your pharmacist or this reference at CID.
May mess with the efficacy of rituximab (PubMed).
Rants and Screeds
Pearls
Coca-cola® is acidic and will increase serum levels of itraconazole. So coke does indeed add life.
Treatment of choice
Use for
Aspergillus (marginal at best, use voriconazole), Blastomyces dermatiditus, Candida albicans keratitis/oropharyngeal/esophageal/vaginal, chromoblastomycosis, cladophialophora bantiana, disseminated, Coccidioides immitis, Cryptococcus neoformans, dermatomycosis, fungal infections - prophylaxis, histoplasmosis, Leishmania, mycetoma, mycosis fungoides, Onychomycosis, Paracoccidiodes, Penicillium marneffei infection, phaeohyphomycosis, Pseudallescheria boydii, sporotrichosis, tinea unguium, yellow nail syndrome.
Don't use for
Class
Imidazole.
Curious Cases
Relevant links to my Medscape blog
Last update 11/27/19