Itraconazole

By Medically reviewed by hellodoktor

Generic Name: Itraconazole Brand Name(s): Generics only. No brands available.

Uses

What is Itraconazole used for?

Itraconazole is used to treat a variety of fungal infections. It belongs to a class of drugs known as azole antifungals. It works by stopping the growth of fungi.

How should I take Itraconazole?

Take this medication by mouth with a full meal as directed by your doctor, usually once or twice daily. Swallow the capsules whole.

Take itraconazole 2 hours before or 1 hour after antacids. Antacids may decrease the absorption of this medication. Also, take this medication with an acidic drink (such as cola) if you have decreased or no stomach acid (achlorhydria) or if you take drugs that decrease stomach acid (for example, H2 blockers such as ranitidine, proton pump inhibitors such as omeprazole). Consult your doctor or pharmacist for more details.

The dosage and length of treatment are based on your medical condition and response to treatment. Take this medication exactly as prescribed by your doctor. Some conditions may require you to take this medication in cycles (twice daily for 1 week, then stopping the medication for 3 weeks).

For the best effect, take this antifungal at evenly spaced times. To help you remember, take this medication at the same time(s) every day. Mark your calendar with a reminder if you are taking this medication in cycles.

Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

The capsule/tablet and solution forms of this medication deliver different amounts of medication and may be used for different purposes. Do not switch between the different forms of this drug without your doctor’s permission and directions.

Tell your doctor if your condition does not get better or if it gets worse.

How do I store Itraconazole?

Itraconazole is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Itraconazole in the bathroom or the freezer. There may be different brands of Itraconazole that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Itraconazole down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Itraconazole?

Before taking itraconazole, tell your doctor or pharmacist if you are allergic to it; or to other azole antifungals (such as ketoconazole); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, heart disease (such as heart failure, coronary artery disease, heart valve disease), lung disease (such as chronic obstructive pulmonary disease-COPD), decreased or no stomach acid (achlorhydria).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be at greater risk for hearing loss while using this drug.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor. This medication should not be used to treat fungal nail infections if you are pregnant or could become pregnant during treatment. Women of childbearing age should start this medication 2 to 3 days after the start of their periods to make sure that they are not pregnant. Discuss the use of reliable forms of birth control while taking this medication and for 2 months after stopping treatment.

Itraconazole passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Itraconazole during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Itraconazole. Itraconazole is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Itraconazole?

Nausea/vomiting, diarrhea, headache, stomach upset, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: numbness/tingling of arms/legs, hearing loss, mental/mood changes (such as depression).

Itraconazole has rarely caused very serious (possibly fatal) liver disease. Tell your doctor right away if you develop symptoms of liver disease, such as: nausea/vomiting that doesn’t stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine.

Itraconazole can commonly cause a mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. Get medical help right away if you develop any rash.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Itraconazole?

Itraconazole interacts with many medications. Other medications can affect the removal of itraconazole from your body, which may affect how itraconazole works. Examples include efavirenz, isoniazid, nevirapine, rifamycins (such as rifabutin), certain drugs used to treat seizures (such as phenytoin), among others.

Itraconazole may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Itraconazole?

This drug may make you dizzy. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana. Alcohol may also increase the risk of serious liver problems.

Itraconazole may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Itraconazole?

Itraconazole may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Itraconazole.

What is the dose of Itraconazole for an adult?

Usual Adult Dose for Blastomycosis

Loading dose: 200 mg orally 3 times a day for the first 3 days of therapy

Maintenance dose: 200 mg orally once or twice a day

Duration of therapy: At least 3 months and until clinical parameters and laboratory tests indicate the active fungal infection has subsided

Comments:

-Capsule formulation

-A loading dose should be used in life-threatening situations.

-If no obvious improvement or if evidence of progressive fungal disease at 200 mg/day, the dose should be increased in 100 mg increments to a maximum of 400 mg/day.

Use: For the treatment of blastomycosis (pulmonary and extrapulmonary) in immunocompromised and non-immunocompromised patients

Infectious Diseases Society of America (IDSA) Recommendations:

Mild to moderate pulmonary or mild to moderate disseminated infection without CNS involvement: 200 mg orally 3 times a day for 3 days, then 200 mg orally once or twice a day

Duration of therapy: 6 to 12 months

Moderately severe to severe pulmonary or moderately severe to severe disseminated infection without CNS involvement (after initial regimen of IV amphotericin B): 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Total duration of therapy:

-Pulmonary infection: 6 to 12 months

-Disseminated extrapulmonary infection: At least 12 months

-Immunocompromised patients: At least 12 months

CNS infection (after initial regimen of IV amphotericin B): 200 mg orally 2 or 3 times a day

Duration of therapy: At least 12 months and until CSF abnormalities resolve

Prevention of recurrence (secondary prophylaxis) in immunosuppressed patients: 200 mg orally once a day

Comments:

-Lifelong suppressive therapy with this drug may be needed if immunosuppression cannot be reversed.

Usual Adult Dose for Histoplasmosis

Loading dose: 200 mg orally 3 times a day for the first 3 days of therapy

Maintenance dose: 200 mg orally once or twice a day

Duration of therapy: At least 3 months and until clinical parameters and laboratory tests indicate the active fungal infection has subsided

Comments:

-Capsule formulation

-A loading dose should be used in life-threatening situations.

-If no obvious improvement or if evidence of progressive fungal disease at 200 mg/day, the dose should be increased in 100 mg increments to a maximum of 400 mg/day.

Use: For the treatment of histoplasmosis (including chronic cavitary pulmonary disease and disseminated, nonmeningeal histoplasmosis) in immunocompromised and non-immunocompromised patients

IDSA Recommendations:

Mild to moderate acute pulmonary infection in patients with symptoms beyond 1 month: 200 mg orally 3 times a day for 3 days, then 200 mg orally once or twice a day

Duration of therapy: 6 to 12 weeks

Moderately severe to severe acute pulmonary infection (after initial regimen of IV amphotericin B): 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Total duration of therapy: 12 weeks

Chronic cavitary pulmonary infection: 200 mg orally 3 times a day for 3 days, then 200 mg orally once or twice a day

Duration of therapy: At least 1 year (18 to 24 months preferred by some clinicians due to risk of relapse)

Mild to moderate progressive disseminated infection: 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Duration of therapy: At least 1 year

Moderately severe to severe progressive disseminated infection (after initial regimen of IV amphotericin B): 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Total duration of therapy: At least 12 months

Infection with symptomatic mediastinal granuloma or with complications (pericarditis, rheumatologic syndromes, symptomatic mediastinal lymphadenitis) that require corticosteroid therapy: 200 mg orally 3 times a day for 3 days, then 200 mg orally once or twice a day

Duration of therapy: 6 to 12 weeks

CNS infection (after initial regimen of IV amphotericin B): 200 mg orally 2 or 3 times a day

Duration of therapy: At least 1 year and until CSF abnormalities resolve and histoplasmal antigen is undetectable

Primary prophylaxis in immunosuppressed patients: 200 mg orally once a day

Prevention of recurrence (secondary prophylaxis): 200 mg orally once a day

Comments:

-The oral solution formulation is preferred, but the capsule formulation may be used.

-Lifelong suppressive therapy with this drug may be needed if immunosuppression cannot be reversed.

CDC, National Institutes of Health (NIH), and IDSA Recommendations for HIV-infected Patients:

Less severe disseminated infection: 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Duration of therapy: At least 12 months

Moderately severe to severe disseminated infection (after initial regimen of IV amphotericin B): 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Total duration of therapy: At least 12 months

Confirmed meningitis (after initial regimen of IV amphotericin B): 200 mg orally 2 or 3 times a day

Duration of therapy: At least 12 months and until CSF abnormalities resolve

Primary prophylaxis: 200 mg orally once a day

Long-term suppressive therapy (secondary prophylaxis): 200 mg orally once a day

Comments:

-Recommended as preferred therapy

-The oral solution formulation is preferred.

Usual Adult Dose for Aspergillosis – Aspergilloma

Loading dose: 200 mg orally 3 times a day for the first 3 days of therapy

Maintenance dose: 200 mg orally once or twice a day

Duration of therapy: At least 3 months and until clinical parameters and laboratory tests indicate the active fungal infection has subsided

Comments:

-Capsule formulation

-A loading dose should be used in life-threatening situations.

Use: For the treatment of aspergillosis (pulmonary and extrapulmonary) in immunocompromised and non-immunocompromised patients intolerant of, or refractory to, amphotericin B

IDSA Recommendations:

Invasive aspergillosis: 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Empirical and preemptive antifungal therapy: 200 mg orally twice a day

Prophylaxis against invasive aspergillosis: 200 mg orally twice a day

Comments:

-Recommended as alternative (salvage) therapy for invasive aspergillosis and prophylaxis against invasive aspergillosis in patients intolerant of, or refractory to, primary antifungal therapy

-Recommended as primary therapy for empirical and preemptive antifungal therapy

Usual Adult Dose for Aspergillosis – Invasive

Loading dose: 200 mg orally 3 times a day for the first 3 days of therapy

Maintenance dose: 200 mg orally once or twice a day

Duration of therapy: At least 3 months and until clinical parameters and laboratory tests indicate the active fungal infection has subsided

Comments:

-Capsule formulation

-A loading dose should be used in life-threatening situations.

Use: For the treatment of aspergillosis (pulmonary and extrapulmonary) in immunocompromised and non-immunocompromised patients intolerant of, or refractory to, amphotericin B

IDSA Recommendations:

Invasive aspergillosis: 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Empirical and preemptive antifungal therapy: 200 mg orally twice a day

Prophylaxis against invasive aspergillosis: 200 mg orally twice a day

Comments:

-Recommended as alternative (salvage) therapy for invasive aspergillosis and prophylaxis against invasive aspergillosis in patients intolerant of, or refractory to, primary antifungal therapy

-Recommended as primary therapy for empirical and preemptive antifungal therapy

Usual Adult Dose for Oral Thrush

Oropharyngeal candidiasis: 200 mg orally once a day

Duration of therapy: 1 to 2 weeks

Oropharyngeal candidiasis unresponsive/refractory to treatment with fluconazole tablets: 100 mg orally twice a day

Comments:

-Oral solution formulation

-The oral solution should be vigorously swished in the mouth (10 mL at a time) for several seconds and swallowed.

-Clinical signs/symptoms of oropharyngeal candidiasis generally resolve within several days.

-Only the oral solution has demonstrated efficacy for oral and/or esophageal candidiasis.

-Clinical response for oropharyngeal candidiasis unresponsive/refractory to fluconazole will be seen in 2 to 4 weeks in patients responding to therapy; patients may be expected to relapse shortly after discontinuing therapy.

IDSA Recommendations:

Oropharyngeal candidiasis: 200 mg orally per day

Duration of therapy for uncomplicated infection: 7 to 14 days

Comments:

-Oral solution formulation

-Recommended as alternative therapy for refractory infection

CDC, NIH, and IDSA Recommendations for HIV-infected Patients:

Oropharyngeal candidiasis (initial episodes): 200 mg orally per day

Duration of therapy: 7 to 14 days

Secondary prophylaxis (suppressive therapy): 200 mg orally per day

Comments:

-Oral solution formulation

-Recommended as alternative oral therapy

-Secondary prophylaxis not routinely recommended.

Usual Adult Dose for Esophageal Candidiasis

100 mg orally once a day

Duration of therapy: At least 3 weeks and for 2 weeks after symptoms resolve

Comments:

-Oral solution formulation

-Doses up to 200 mg/day may be used based on clinical judgment of patient response.

-The oral solution should be vigorously swished in the mouth (10 mL at a time) for several seconds and swallowed.

-Only the oral solution has demonstrated efficacy for oral and/or esophageal candidiasis.

IDSA Recommendations: 200 mg orally per day

Duration of therapy: 14 to 21 days

Comments:

-Oral solution formulation

-Recommended as alternative therapy for refractory infection

CDC, NIH, and IDSA Recommendations for HIV-infected Patients: 200 mg orally per day

Duration of therapy: 14 to 21 days

Comments:

-Oral solution formulation

-Recommended as preferred therapy

Usual Adult Dose for Onychomycosis – Toenail

200 mg orally once a day

Duration of therapy: 12 consecutive weeks

Comments:

-Capsule or tablet formulation

-Capsules: With or without fingernail involvement

-Diagnosis should be confirmed before starting therapy; appropriate nail specimens for laboratory testing (KOH preparation, fungal culture, nail biopsy) should be obtained.

Uses:

-Capsules: For the treatment of onychomycosis of the toenail (with or without fingernail involvement) due to dermatophytes (tinea unguium) in non-immunocompromised patients

-Tablets: For the treatment of onychomycosis of the toenail due to Trichophyton rubrum or T mentagrophytes in non-immunocompromised patients

Usual Adult Dose for Onychomycosis – Fingernail

Treatment pulse: 200 mg orally twice a day for 1 week

Comments:

-Capsule formulation

-Fingernails only

-Diagnosis should be confirmed before starting therapy; appropriate nail specimens for laboratory testing (KOH preparation, fungal culture, nail biopsy) should be obtained.

-The recommended dosing regimen is 2 treatment pulses, which are separated by 3 weeks without treatment; the manufacturer product information should be consulted for further guidance.

Use: For the treatment of onychomycosis of the fingernail due to dermatophytes (tinea unguium) in non-immunocompromised patients

Usual Adult Dose for Coccidioidomycosis

IDSA Recommendations: 200 mg orally 2 or 3 times a day

Duration of therapy:

-Uncomplicated coccidioidal pneumonia: 3 to 6 months

-Diffuse pneumonia and chronic progressive fibrocavitary pneumonia: At least 1 year

CDC, NIH, and IDSA Recommendations for HIV-infected Patients:

Mild infection (e.g., focal pneumonia): 200 mg orally twice a day

Severe nonmeningeal infection (diffuse pulmonary or severely ill patients with extrathoracic disseminated disease) – acute phase: 400 mg orally per day

Meningeal infection: 200 mg orally twice a day

Chronic suppressive therapy (secondary prophylaxis): 200 mg orally twice a day

Comments:

-Recommended as preferred therapy for mild infections and chronic suppressive therapy

-Preferred therapy for severe nonmeningeal infections includes treatment with IV amphotericin B until clinical improvement followed by a triazole; as alternative therapy, some experts add a triazole (this drug preferred for bone disease) to amphotericin B therapy and continue the triazole after amphotericin B is stopped.

-Recommended as alternative therapy for meningeal infections; a specialist should be consulted.

Usual Adult Dose for Sporotrichosis

IDSA Recommendations:

Cutaneous or lymphocutaneous infection:

-Recommended dose: 200 mg orally once a day

-If patients do not respond: 200 mg orally twice a day

Duration of therapy: 2 to 4 weeks after all lesions resolve (usually 3 to 6 months total)

Osteoarticular infection: 200 mg orally twice a day

Total duration of therapy: At least 12 months

Less severe pulmonary infection: 200 mg orally twice a day

Duration of therapy: At least 12 months

Meningeal infection, disseminated infection, or severe or life-threatening pulmonary infection (after initial regimen of IV amphotericin B): 200 mg orally twice a day

Total duration of therapy: At least 12 months

Prevention of recurrence of meningeal infection or disseminated infection (secondary prophylaxis) in patients with AIDS and other immunosuppressed patients: 200 mg orally once a day

Comments:

-Recommended as preferred therapy

-The oral solution formulation is preferred.

Usual Adult Dose for Cryptococcosis

IDSA Recommendations:

Mild to moderate pulmonary infection (nonmeningeal) in immunocompetent patients: 200 orally twice a day

Duration of therapy: 6 to 12 months

Maintenance (suppressive) and prophylactic therapy in HIV-infected patients: 200 mg orally twice a day

Duration of therapy: At least 1 year

Comments:

-Recommended as alternative therapy; fluconazole is preferred.

-The oral solution formulation is preferred.

-Primary prophylaxis not routinely recommended.

Usual Adult Dose for Cryptococcal Meningitis – Immunosuppressed Host

CDC, NIH, and IDSA Recommendations for HIV-infected Patients:

Consolidation therapy: 200 mg orally twice a day

Duration of therapy: At least 8 weeks

Comments:

-Recommended as alternative therapy; fluconazole is preferred.

-Consolidation therapy should begin after at least 2 weeks of successful induction therapy and should be followed by maintenance therapy.

Usual Adult Dose for Vaginal Candidiasis

Vulvovaginal candidiasis: 200 mg orally twice a day for 1 day

Comments:

-Capsule formulation

CDC, NIH, and IDSA Recommendations for HIV-infected Patients:

Uncomplicated vulvovaginal candidiasis: 200 mg orally per day for 3 to 7 days

Comments:

-Oral solution formulation

-Recommended as alternative therapy

Usual Adult Dose for Microsporidiosis

CDC, NIH, and IDSA Recommendations for HIV-infected Patients:

Disseminated infection due to Trachipleistophora or Anncaliia: 400 mg orally per day

Comments:

-This drug may be useful when used in conjunction with albendazole.

Usual Adult Dose for Systemic Fungal Infection

IDSA Recommendations:

Empirical therapy: 200 mg orally twice a day

Comments:

-Recommended as alternative therapy for suspected invasive candidiasis in neutropenic patients

Usual Adult Dose for Fungal Infection Prophylaxis

IDSA Recommendations:

Antifungal prophylaxis for patients with chemotherapy-induced neutropenia: 200 mg orally twice a day

Comments:

-Recommended as alternative therapy

Usual Adult Dose for Tinea Versicolor

Study (n=36)

200 mg orally once a day for 7 days

Usual Adult Dose for Paracoccidioidomycosis

200 mg orally once a day for 6 months

Renal Dose Adjustments

Caution is recommended.

Liver Dose Adjustments

Caution is recommended.

Dose Adjustments

Some experts recommend adjusting dose based on drug serum levels and/or drug interactions.

What is the dose of Itraconazole for a child?

Usual Pediatric Dose for Blastomycosis

IDSA Recommendations for Children:

Mild to moderate infection: 10 mg/kg orally per day

Maximum dose: 400 mg/day

Duration of therapy: 6 to 12 months

Moderately severe to severe infection (after initial regimen of IV amphotericin B): 10 mg/kg orally per day

Maximum dose: 400 mg/day

Total duration of therapy: 12 months

Usual Pediatric Dose for Histoplasmosis

IDSA Recommendations for Children:

Acute pulmonary infection: 5 to 10 mg/kg/day orally in 2 divided doses

Maximum dose: 400 mg/day

Progressive disseminated infection (after initial regimen of IV amphotericin B): 5 to 10 mg/kg/day orally in 2 divided doses

Maximum dose: 400 mg/day

Total duration of therapy: 3 months; longer therapy may be needed for patients with severe disease, immunosuppression, or primary immunodeficiency syndromes

Prevention of recurrence (secondary prophylaxis): 5 mg/kg orally per day

Maximum dose: 200 mg/day

Comments:

-The oral solution formulation is generally used.

-Lifelong suppressive therapy with this drug may be needed if immunosuppression cannot be reversed.

CDC, NIH, IDSA, Pediatric Infectious Diseases Society (PIDS), and American Academy of Pediatrics (AAP) Recommendations for HIV-exposed and HIV-infected Children:

Acute primary pulmonary infection: 2 to 5 mg/kg orally 3 times a day for 3 days, then 2 to 5 mg/kg orally twice a day

Maximum dose: 200 mg/dose

Duration of therapy: 12 months; 12 weeks may be sufficient for patients with functional cellular immunity

Mild disseminated infection: 2 to 5 mg/kg orally 3 times a day for 3 days, then 2 to 5 mg/kg orally twice a day

Maximum dose: 200 mg/dose

Duration of therapy: 12 months

Consolidation therapy for moderately severe to severe disseminated infection (after initial regimen of IV amphotericin B): 2 to 5 mg/kg orally 3 times a day for 3 days, then 2 to 5 mg/kg orally twice a day

Maximum dose: 200 mg/dose

Duration of therapy: 12 months

Consolidation therapy for CNS infection (after initial regimen of IV amphotericin B): 2 to 5 mg/kg orally 3 times a day for 3 days, then 2 to 5 mg/kg orally twice a day

Maximum dose: 200 mg/dose

Duration of therapy: At least 12 months and until CSF abnormalities resolve and histoplasmal antigen is undetectable

Secondary prophylaxis (suppressive therapy): 5 to 10 mg/kg orally per day

Maximum dose: 200 mg/dose

Comments:

-Recommended as preferred therapy

-The oral solution formulation is preferred.

-Consolidation therapy should be followed by chronic suppressive therapy.

CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents:

Less severe disseminated infection: 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Duration of therapy: At least 12 months

Moderately severe to severe disseminated infection (after initial regimen of IV amphotericin B): 200 mg orally 3 times a day for 3 days, then 200 mg orally twice a day

Total duration of therapy: At least 12 months

Confirmed meningitis (after initial regimen of IV amphotericin B): 200 mg orally 2 or 3 times a day

Duration of therapy: At least 12 months and until CSF abnormalities resolve

Primary prophylaxis: 200 mg orally once a day

Long-term suppressive therapy (secondary prophylaxis): 200 mg orally once a day

Comments:

-Recommended as preferred therapy

-The oral solution formulation is preferred.

Usual Pediatric Dose for Oral Thrush

IDSA Recommendations:

Oropharyngeal candidiasis in patients 5 years or older: 2.5 mg/kg orally twice a day

Comments:

-Oral solution formulation

CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children:

Fluconazole-refractory oropharyngeal candidiasis: 2.5 mg/kg orally twice a day

Maximum dose: 400 mg/day

Duration of therapy: 7 to 14 days

Secondary prophylaxis: 2.5 mg/kg orally twice a day

Comments:

-Oral solution formulation

-Recommended as alternative therapy for fluconazole-refractory infection

-Secondary prophylaxis not routinely recommended.

CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents:

Oropharyngeal candidiasis (initial episodes): 200 mg orally per day

Duration of therapy: 7 to 14 days

Secondary prophylaxis (suppressive therapy): 200 mg orally per day

Comments:

-Oral solution formulation

-Recommended as alternative oral therapy

-Secondary prophylaxis not routinely recommended.

Usual Pediatric Dose for Esophageal Candidiasis

IDSA Recommendations:

5 years or older: 2.5 mg/kg orally twice a day

Comments:

-Oral solution formulation

CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: 2.5 mg/kg orally twice a day

Duration of therapy: At least 3 weeks and for at least 2 weeks after symptoms resolve

Comments:

-Oral solution formulation

-Recommended as preferred therapy

CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: 200 mg orally per day

Duration of therapy: 14 to 21 days

Comments:

-Oral solution formulation

-Recommended as preferred therapy

Usual Pediatric Dose for Coccidioidomycosis

CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children:

Mild to moderate nonmeningeal infection (e.g., focal pneumonia): 2 to 5 mg/kg orally 3 times a day for 3 days, then 2 to 5 mg/kg orally twice a day

Maximum dose: 200 mg/dose

Duration of therapy: Determined by rate of clinical response

Lifelong suppression (secondary prophylaxis): 2 to 5 mg/kg orally twice a day

Maximum dose: 200 mg/dose

Comments:

-Recommended as alternative therapy for secondary prophylaxis and mild to moderate nonmeningeal infections

-Preferred therapy for severe illness with respiratory compromise due to diffuse pulmonary or disseminated nonmeningeal infection includes treatment with IV amphotericin B; after patient is stabilized, an azole (this drug preferred for bone infections) can be substituted and continued for a total duration of therapy of 1 year; some experts start an azole during amphotericin B therapy.

CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents:

Mild infection (e.g., focal pneumonia): 200 mg orally twice a day

Severe nonmeningeal infection (diffuse pulmonary or severely ill patients with extrathoracic disseminated infection) – acute phase: 400 mg orally per day

Meningeal infection: 200 mg orally twice a day

Chronic suppressive therapy (secondary prophylaxis): 200 mg orally twice a day

Comments:

-Recommended as preferred therapy for mild infections and chronic suppressive therapy

-Preferred therapy for severe nonmeningeal infections includes treatment with IV amphotericin B until clinical improvement followed by a triazole; as alternative therapy, some experts add a triazole (this drug preferred for bone disease) to amphotericin B therapy and continue the triazole after amphotericin B is stopped.

-Recommended as alternative therapy for meningeal infections; a specialist should be consulted.

Usual Pediatric Dose for Cryptococcosis

CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children:

Suppressive therapy (secondary prophylaxis): 5 mg/kg orally once a day

Maximum dose: 200 mg/dose

Duration of therapy: At least 1 year

Comments:

-Recommended as alternative therapy; fluconazole is preferred.

-Oral solution formulation

Usual Pediatric Dose for Cryptococcal Meningitis – Immunosuppressed Host

CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children:

Consolidation therapy for CNS infection: 2.5 to 5 mg/kg orally 3 times a day for 3 days, then 5 to 10 mg/kg/day orally in 1 or 2 divided doses

Maximum dose:

-Loading dose: 200 mg/dose

-Maintenance dose: 400 mg/day

Duration of therapy: At least 8 weeks

Comments:

-Recommended as alternative therapy; fluconazole is preferred.

-The oral solution formulation is preferred.

-Consolidation therapy should begin after at least 2 weeks of successful induction therapy and should be followed by secondary prophylaxis.

CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents:

Consolidation therapy: 200 mg orally twice a day

Duration of therapy: At least 8 weeks

Comments:

-Recommended as alternative therapy; fluconazole is preferred.

-Consolidation therapy should begin after at least 2 weeks of successful induction therapy and should be followed by maintenance therapy.

Usual Pediatric Dose for Vaginal Candidiasis

CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents:

Uncomplicated vulvovaginal candidiasis: 200 mg orally per day for 3 to 7 days

Comments:

-Oral solution formulation

-Recommended as alternative therapy

Usual Pediatric Dose for Microsporidiosis

CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents:

Disseminated infection due to Trachipleistophora or Anncaliia: 400 mg orally per day

Comments:

-This drug may be useful when used in conjunction with albendazole.

Usual Pediatric Dose for Sporotrichosis

IDSA Recommendations for Children:

Cutaneous or lymphocutaneous infection: 6 to 10 mg/kg orally per day

Maximum dose: 400 mg/day

Disseminated infection (after initial regimen of IV amphotericin B): 6 to 10 mg/kg orally per day

Maximum dose: 400 mg/day

Comments:

-Recommended as preferred therapy

-The oral solution formulation is preferred.

Usual Pediatric Dose for Tinea Capitis

Continuous regimen:

Trichophyton tonsurans and T violaceum (endothrix) species: 5 mg/kg/day orally for 2 to 4 weeks

Microsporum canis (ectothrix) species: 5 mg/kg/day orally for 4 to 6 weeks

Pulse regimen:

T tonsurans, T violaceum (endothrix), and M canis (ectothrix) species: 5 mg/kg/day orally for 1 week followed by a 3-week period off of treatment

Comments:

-Capsule formulation recommended for pulse regimen.

-Patient is evaluated on week 4 from the start of therapy for clinical response; if evidence of tinea capitis remains, additional pulse therapies may be required up to a maximum of 3 pulses.

How is Itraconazole available?

Itraconazole is available in the following dosage forms and strengths:

  • Oral capsule,
  • Oral tablet,
  • Compounding powder,
  • Oral solution,
  • Intravenous kit

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Itraconazole, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: March 5, 2018 | Last Modified: September 12, 2019

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