Triazole antifungal

Itraconazole

Brand names: Sporanox

Adult dose

Dose: Onychomycosis pulse: 200mg BD for 1 week, repeat after 21 days. Aspergillosis: 200mg OD-BD

Route: PO/IV

Frequency: OD-BD

Clinical pearls

Take capsules WITH food (acidic environment); solution on EMPTY stomach
Therapeutic drug monitoring in invasive infection

Contraindications

Heart failure (incl. hx)
Severe hepatic impairment
Pregnancy
Concurrent QT-prolonging drugs / ergot / many CYP3A4 substrates

Side effects

Heart failure (negative inotrope — black box)
Hepatotoxicity
QT prolongation
Hypokalaemia
Peripheral neuropathy

Interactions

Strong CYP3A4 inhibition — many
Statins (myopathy)
Quinidine/cisapride/dofetilide (avoid)
Tacrolimus/ciclosporin (raised)
Warfarin

Monitoring

LFTs
Trough levels (invasive infection)

Reference: BNF; MHRA Drug Safety Update; https://bnf.nice.org.uk/drugs/itraconazole/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways