Composition
Cap 100 mg: ltraconazole 100 mg.
Indications & Dosage
Vulvovaginal candidiasis: Adult: 200 mg twice daily for 1 day Prophylaxis for recurrent: Adult: 50-100 mg daily for 6 months. Oral or oesophageal candidiasis that has not responded to fluconazole: Adult: 100-200 mg twice daily for 2 weeks (continue for another 2 weeks if no response; the higher dose should not be used for longer than 2 weeks). Systemic candidiasis where other antifungal drugs in appropriate or ineffective: Adult: 100-200 mg once daily; or 200 mg twice daily in invasive or disseminated disease. Pityriasis versicolor: Adult: 200 mg once daily for 7 days. Tineapedis, Tineamanuum: Adult: 100 mg once daily for 30 days, alternatively 200 mg twice daily for 7 days. Tineacorporis, Tineacruris: Adult: 100 mg once daily for 15 days, alternatively 200 mg once daily for 7 days. Onychomycosis: Adult: 200 mg once daily for 3 months, alternatively 200 mg twice daily for 7 days, subsequent courses repeated after 21-day intervals; fingernails 2 courses, toe nails 3 courses. Aspergillosis: Adult: 200 mg twice daily. Histoplasmosis: Adult: 200 mg 3 times a day for 3 days, then 200 mg 1-2 times a day. Systemic cryptococcosis including cryptococcal meningitis where other antifungal drugs inappropriate or ineffective: Adult: 200 mg once daily, dose increased in invasive or disseminated disease and in cryptococcal meningitis, increased to 200 mg twice daily. To prevent relapse of underlying fungal infection in HIV-infected patients and prophylaxis in neutropenia when standard therapy inappropriate: Adult: 200 mg once daily, then increased to 200 mg twice daily, dose increased only if low plasma-itraconazole concentration Prophylaxis of deep fungal infections in patients with haematological malignancy or undergoing bone-marrow transplantation (when standard therapy inappropriate): Adult: 5 mg/kg daily in 2 divided doses, to be started before transplantation or before chemotherapy (taking care to avoid interaction with cytotoxic drugs) and continued until neutrophil count recovers, safety and efficacy not established in elderly patients.
Contraindications
Acute porphyrias, heart failure
Precautions
History of liver disease, liver toxicity with other drug therapy, caution is advised to patients at high risk of heart failure; patients receiving high doses and longer treatment courses, older adults and those with cardiac disease, patients with chronic lung disease (including chronic obstructive pulmonary disease) associated with pulmonary hypertension, patients receiving treatment with negative in otropic drugs, e.g. calcium channel blockers. Itraconazole should be avoided in patients with ventricular dysfunction or a history of heart failure unless the infection is serious. Contraception must be used during and 1 month after treatment.
Interactions
Rifampicin, cyclosporin, H2 antagonists, antacids.
Pregnancy
Caution advised
Lactation
Not recommended.
Side Effects
Abdominal pain, diarrhoea, dyspnea, headache, hepatitis, hypokalaemia, nausea, rash, taste disturbances, vomiting, dizziness, dyspepsia, flatulence, menstrual disorder, myalgia, oedema, peripheral neuropathy (discontinue treatment), arthralgia, blood pressure changes, confusion, drowsiness, hepatotoxicity, renal impairment, thrombocytopenia, tremor. Rare: erectile dysfunction, heart failure, hypertriglyceridaemia, leucopenia