Itraconazole

Itraconazole is a prescription medication used to treat fungal infections of the toenails and fingernails. Itraconazole belongs to a group of drugs triazoles. It works by slowing the growth of fungi that cause infection.

This medication comes in capsule form. It is usually either taken once a day for 12 weeks, or twice a day for one week (PulsePak).

Common side effects of itraconazole are skin rash, high liver test results, and digestive system problems.

Itraconazole is a prescription medicine used to treat fungal infections of the toenails and fingernails. It is also used to treat some types of fungal infections in other areas of your body. 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Itraconazole may be found in some form under the following brand names:

• Hyphanox

• Onmel

• Sporanox

• Tolsura

The most common side effects that cause people to stop treatment either for a short time or completely include: skin rash, high triglyceride test results, high liver test results, and digestive system problems (such as nausea, bloating, and diarrhea).

Stop itraconazole and call your doctor or get medical assistance right away if you have a severe allergic reaction. Symptoms of an allergic reaction may include skin rash, itching, hives, shortness of breath or difficulty breathing, and/or swelling of the face. Very rarely, an oversensitivity to sunlight, a tingling sensation in the limbs or a severe skin disorder can occur. If any of these symptoms occur, stop taking itraconazole and contact your doctor.

Stop itraconazole and call your doctor right away if you develop shortness of breath; have unusual swelling of your feet, ankles or legs; suddenly gain weight; are unusually tired; cough up white or pink phlegm; have unusual fast heartbeats; or begin to wake up at night. In rare cases, patients taking itraconazole could develop serious heart problems, and these could be warning signs of heart failure.

Stop itraconazole and call your doctor right away if you become unusually tired; lose your appetite; or develop nausea, abdominal pain, or vomiting, a yellow color to your skin or eyes, or dark colored urine or pale stools (bowel movements). In rare cases, patients taking itraconazole could develop serious liver problems and these could be warning signs.

Stop itraconazole and call your doctor right away if you experience any hearing loss symptoms. In very rare cases, patients taking Sporanox have reported temporary or permanent hearing loss.

Call your doctor right away if you develop tingling or numbness in your extremities (hands or feet), if your vision gets blurry or you see double, if you hear a ringing in your ears, if you lose the ability to control your urine or urinate much more than usual.

Additional possible side effects include upset stomach, vomiting, abdominal pain, constipation, headache, fever, inflammation of the pancreas, menstrual disorders, erectile dysfunction, dizziness, muscle weakness or pain, painful joints, unpleasant taste, or hair loss. These are not all the side effects of itraconazole. Your doctor or pharmacist can give you a more complete list.

Tell your doctor and pharmacist the name of all the prescription and non-prescription medicines you are taking, including dietary supplements and herbal remedies. 

Never take itraconazole if you:

• are taking any of the medicines listed below. Dangerous or even life-threatening abnormal heartbeats could result:
  • quinidine (such as Cardioquin, Quinaglute, Quinidex)
  • dofetilide (such as Tikosyn)
  • cisapride (such as Propulsid)
  • pimozide (such as Orap)
  • methadone (such as Dolophine)
  • levacetylmethadol (such as Orlaam)
• are taking any of the following medicines:
  • lovastatin (such as Mevacor, Advicor, Altocor)
  • simvastatin (such as Zocor)
  • triazolam (such as Halcion)
  • midazolam (such as Versed)
  • nisoldipine (such as Sular)
  • felodipine (such as Plendil)
  • ergot alkaloids (such as Migranal, Ergonovine, Cafergot, Methergine)
• have ever had an allergic reaction to itraconazole or any of the other ingredients in itraconazole. Ask your doctor or pharmacist for a list of these ingredients.

Taking itraconazole with certain other medicines could lead to serious or life-threatening medical problems. For example, taking fentanyl, a strong opioid narcotic pain medicine, with itraconazole could cause serious side effects, including trouble breathing, that may be life-threatening. Tell your doctor and pharmacist the name of all the prescription and non-prescription medicines you are taking. Your doctor will decide if itraconazole is the right treatment for you.

Itraconazole is used to treat fungal nail infections. However, itraconazole is not for everyone. Do not take itraconazole for fungal nail infections if you have had heart failure, including congestive heart failure. You should not take itraconazole if you are taking certain medicines that could lead to serious or life-threatening medical problems. If you have had heart, lung, liver, kidney or other serious health problems, ask your doctor if it is safe for you to take itraconazole.

Tell your doctor and pharmacist the name of all the prescription and non-prescription medicines you are taking, including dietary supplements and herbal remedies. See "Drug Interactions".

Also tell your doctor about any other medical conditions you have had, especially heart, lung, liver or kidney conditions. Never take itraconazole if you:

• have had heart failure, including congestive heart failure.
• have ever had an allergic reaction to itraconazole or any of its ingredients. Ask your doctor or pharmacist for a list of these ingredients.

Never take itraconazole if you have a fungal nail infection and are pregnant or planning to become pregnant within 2 months after you have finished your treatment.

If you are able to become pregnant, you should use effective birth control during itraconazole treatment and for 2 months after finishing treatment. Ask your doctor about effective types of birth control.

Tell your doctor if you are breastfeeding or plan to breastfeed. Itraconazole is excreted in human breast milk and may harm your nursing baby.

Always take itraconazole during or right after a full meal.

Your doctor will decide the right dose for you. Depending on your infection, you will take itraconazole once a day for 12 weeks, or twice a day for 1 week in a "pulse" dosing schedule. You will receive either a bottle of capsules or a PulsePak. Do not skip any doses. Be sure to finish all your itraconazole as prescribed by your doctor.

If you have ever had liver problems, your doctor should do a blood test to check your condition. If you haven't had liver problems, your doctor may recommend blood tests to check the condition of your liver because patients taking itraconazole can develop liver problems.

If you forget to take or miss doses of itraconazole, ask your doctor what you should do with the missed doses.

Itraconazole PulsePak

If you use the PulsePak, you will take itraconazole for 1 week and then take no itraconazole for the next 3 weeks before repeating the 1-week treatment. This is called "pulse dosing." The itraconazole PulsePak contains enough medicine for one "pulse" (1 week of treatment).

The itraconazole PulsePak comes with special instructions. It contains 7 pouches-one for each day of treatment. Inside each pouch is a card containing 4 capsules. Looking at the back of the card, fold it back along the dashed line and peel away the backing so that you can remove 2 capsules.

• Take 2 capsules in the morning and 2 capsules in the evening. This means you will take 4 capsules a day for 7 days. At the end of 7 days, you will have taken all of the capsules in the PulsePak box.
• After you finish the PulsePak, do not take any itraconazole for the next 3 weeks. Even though you are not taking any capsules during this time, itraconazole working inside your nails to help fight the fungal infection.
• You will need more than one "pulse" to treat your fungal nail infection. When your doctor prescribes another pulse treatment, be sure to get your refill before the end of week 4.

If you think you took too much itraconazole, call your doctor or local poison control center, or go to the nearest hospital emergency room right away.

Keep all medicines, including itraconazole, out of the reach of children.

Store itraconazole and the PulsePak at room temperature in a dry place away from light.

Congestive Heart Failure, Cardiac Effects and Drug Interactions:

Itraconazole should not be administered for the treatment of onychomycosis in patients with evidence of ventricular dysfunction such as congestive heart failure (CHF) or a history of CHF. If signs or symptoms of congestive heart failure occur during administration of itraconazole, discontinue administration. When itraconazole was administered intravenously to dogs and healthy human volunteers, negative inotropic effects were seen.

Drug Interactions