Itraconazol

Itraconazole is a broad-spectrum triazole antifungal used for dermatophyte infections (including nail fungus), systemic fungal infections, and as prophylaxis in immunocompromised patients. It inhibits the fungal enzyme lanosterol 14-alpha-demethylase, disrupting ergosterol synthesis and weakening the fungal cell membrane. For nail infections, pulse therapy (one week per month for two to three months) is the standard approach.

How to Take Itraconazole

Take itraconazole capsules immediately after a full meal for the best absorption. The medication requires an acidic stomach environment to be absorbed properly, so taking it with food is important. The oral solution, on the other hand, should be taken on an empty stomach and swirled around the mouth before swallowing, for oral fungal infections.

Complete the full course prescribed by your doctor. Treatment duration depends on the type of infection, skin infections may require two to four weeks, while nail infections often need three months or more. Take at the same time each day.

Dermatophyte nail infection (pulse therapy): 200 mg twice daily for 1 week, then 3 weeks off; repeat for 2 cycles (fingernails) or 3 cycles (toenails). Systemic infections: 100 to 200 mg once or twice daily.

Common Side Effects

Common side effects include:

• Nausea or stomach discomfort
• Abdominal pain
• Headache
• Skin rash
• Raised liver enzymes

Itraconazole can affect liver function, particularly with long courses of treatment. Your doctor may recommend liver function blood tests during prolonged therapy. Contact your doctor if you develop yellowing of the skin or eyes, dark urine, or persistent fatigue, as these can be signs of liver problems.

Monitor liver function during prolonged treatment. Itraconazole is a potent CYP3A4 inhibitor with many drug interactions. Negative inotropic effect: do not use in heart failure.

Contraindicated in heart failure, concurrent use with certain CYP3A4 substrates (simvastatin, lovastatin, midazolam, triazolam, ergot alkaloids), pregnancy, and known hypersensitivity to itraconazole.