イトラコナゾール

使用用途

• Histoplasmosis
• Cryptococcosis
• Blastomycosis
• Coccidiomycosis
• Sporotrichosis
• Cryptococcosis (mild to moderate, no CNS involvement)
• Coccidioidomycosis
• Generalized dermatophytosis (Microsporum canis)
• Generalized dermatophytosis (Alternative)
• Dermatophyte granuloma
• Dermatophytosis (Pulse therapy)
• General use (fungal infections)
• Dermatophytosis (Microsporum canis)
• Guttural pouch mycosis, mycotic rhinitis or osteomyelitis

投与方法

考えられる副作用

• Anorexia (most common in dogs)
• Hepatotoxicity (increased ALT, jaundice)
• Ulcerative skin lesions/vasculitis (dogs at high doses)
• Limb edema (dogs at high doses)
• Erythema multiforme (rare)
• Toxic epidermal necrolysis (rare)
• Vomiting
• Weight loss
• Depression (especially in cats and African grey parrots)
• Diarrhoea
• Anorexia
• Salivation
• Depression and apathy
• Abdominal pain

注意事項と禁忌

• Hypersensitivity to itraconazole or other azole antifungals
• Hepatic impairment (relative contraindication)
• Achlorhydria or hypochlorhydria (relative contraindication)
• Reduced cardiac function (relative, due to potential negative inotropic effects)
• Pregnancy
• Liver disease (avoid use if present)
• Use with caution in patients with hepatic impairment, achlorhydria, or reduced cardiac function (due to potential negative inotropic effects). African grey parrots are extremely sensitive to itraconazole and can develop severe anorexia and depression; reduced dosages or alternative antifungals are recommended. **Do not use compounded capsules from bulk powders**, as they may not yield an absorbable dosage form, leading to treatment failure in life-threatening infections. Safety during pregnancy is not established (teratogenic and embryotoxic in lab animals at high doses).

薬物相互作用

• Amphotericin B: May be antagonistic against Aspergillus or Candida; clinical importance unclear.
• Antacids: May reduce oral absorption of itraconazole; administer itraconazole at least 1 hour before or 2 hours after antacids.
• Benzodiazepines (alprazolam, diazepam, midazolam, triazolam): Itraconazole may increase benzodiazepine levels.
• Buspirone: Plasma concentrations may be elevated.
• Busulfan: Itraconazole may increase levels.
• Calcium-channel blockers (amlodipine, verapamil): Itraconazole may increase levels.
• Cisapride: Increased cisapride levels and possibility for toxicity; concurrent use contraindicated in humans.
• Clomipramine: May decrease metabolism and increase clomipramine levels.
• Corticosteroids: May inhibit the metabolism of corticosteroids; potential for increased adverse effects.
• Cyclophosphamide: May inhibit metabolism of cyclophosphamide and its metabolites; potential for increased toxicity.

よくある質問