itraconazole at a glance
Medicine class
Systemic triazole antifungal
Available routes
Oral solution and intravenous infusion
Oral solution
Take without food. For mouth or oesophageal candidosis, swish around the mouth before swallowing and do not rinse afterwards.
Interactions
A full check of medicines, supplements and herbal remedies is essential because itraconazole has many important interactions.
What is itraconazole used for?
Selected products are licensed for:
Oral or oesophageal candidosis in people with HIV or another cause of impaired immunity.
Prevention of susceptible deep fungal infections when standard therapy is inappropriate in selected patients with haematological malignancy or bone-marrow transplantation who are expected to become neutropenic. Evidence for preventing aspergillosis is insufficient.
Intravenous treatment of histoplasmosis.
Intravenous treatment of systemic aspergillosis, candidosis or cryptococcosis, including cryptococcal meningitis, when first-line systemic antifungal treatment is inappropriate or ineffective, within the product licence’s specified contexts.
How does itraconazole work?
Itraconazole blocks fungal 14-alpha-demethylase, reducing ergosterol production. This disrupts normal fungal cell-membrane formation and inhibits fungal growth.
itraconazole preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 10 mg/mL
Oral solution
Route: Oral
Strengths: 10 mg/mL
How to take itraconazole
Follow product-specific directions because itraconazole formulations are not automatically interchangeable.
Take the oral solution without food and avoid eating immediately afterwards.
For oral or oesophageal candidosis, move the liquid around the mouth, swallow it and do not rinse afterwards.
Measure oral solution with the supplied measuring device, not a household spoon.
Healthcare professionals prepare and administer the infusion using the supplied sodium chloride bag, dedicated line and filter. Other medicines or fluids must not share that line.
itraconazole side effects
Common or expected effects
- Headache or dizziness
- Unpleasant or altered taste
- Abdominal pain, nausea, vomiting, diarrhoea or indigestion
- Rash or fever
- Cough or breathlessness
- Swelling or infusion-site inflammation with intravenous treatment
Get urgent medical advice
- Sudden breathing difficulty, facial swelling or another severe allergic reaction
- Blistering, peeling or widespread severe skin reaction
- Breathlessness, unexpected weight gain, leg or abdominal swelling, or waking breathless at night
- Marked appetite loss, unusual tiredness, abdominal pain, dark urine, pale stools or jaundice
- Severe upper-abdominal pain with nausea or vomiting, which may indicate pancreatitis
- New hearing loss, significant visual disturbance, numbness, tingling or weakness
itraconazole in pregnancy
These products must not be used during pregnancy for non-life-threatening indications. Use is reserved for life-threatening infection when maternal benefit outweighs potential fetal harm. Human evidence is limited. Pregnancy, planned pregnancy or exposure during treatment requires prompt specialist prescriber review.
itraconazole while breastfeeding
A small amount enters breast milk. The selected oral and intravenous products must not be used during breastfeeding, so essential systemic treatment requires specialist assessment of alternatives and feeding options.
itraconazole interactions
Itraconazole strongly inhibits CYP3A4 and transport proteins, while some medicines markedly reduce its exposure. This list is not exhaustive.
Rifampicin, rifabutin, carbamazepine, phenytoin, phenobarbital and St John’s wort
Can substantially reduce itraconazole concentrations and effectiveness; co-administration is generally not recommended.
Simvastatin and lovastatin
Itraconazole can greatly increase exposure and muscle-toxicity risk; these combinations are contraindicated.
Common questions about itraconazole
Answers are fully visible for fast scanning and source review.
Should itraconazole oral solution be taken with food?
No. Take the selected oral solution without food and avoid eating immediately afterwards because food reduces absorption.
Are itraconazole capsules and oral solution interchangeable?
Not automatically. The oral solution has higher bioavailability than conventional capsules and different food instructions, so any change requires clinical review.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.