伊曲康唑

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
• Fungal infections in Ratites
• Fungal diseases
• Aspergillosis (Amazon parrots)
• Aspergillosis (African grey Parrots)
• Blastomycosis (Mice)
• Vaginal candidiasis (Rats)
• Systemic candidiasis (Guinea pigs)
• Malassezia dermatitis
• Pulse therapy for Malassezia dermatitis
• Dermatophytosis
• Dermatophytosis (Pulse therapy)
• Blastomycosis
• Histoplasmosis
• Blastomycosis (Alternative)
• Coccidiomycosis
• Sporotrichosis
• Pythiosis or lagendiosis (after lesion resection)
• Zygomycosis
• Idiopathic lymphoplasmacytic (chronic) rhinitis (LPR)
• Nasal aspergillosis
• Coccidioidomycosis
• General use (fungal infections)

給藥方式

可能的副作用

• 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
• Hepatic toxicosis
• Ulcerative dermatitis
• Limb oedema
• Serious cutaneous drug eruptions (occasional)
• Dose-related suppression of adrenal function

注意事項與禁忌

• 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).

藥物相互作用

• 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.
• Cyclosporine: Increased cyclosporine levels.
• Digoxin: May increase digoxin levels; concurrent use considered contraindicated in humans.
• Fentanyl/Alfentanil: May increase fentanyl or alfentanil levels.
• H2-blockers (ranitidine, famotidine): Increased gastric pH may reduce itraconazole absorption.
• Ivermectin: May increase risk for neurotoxicity.
• Macrolide antibiotics (erythromycin, clarithromycin): May increase itraconazole concentrations.
• Phenobarbital/Phenytoin: May decrease itraconazole levels.
• Proton-pump inhibitors (omeprazole): Increased gastric pH may reduce itraconazole absorption.
• Quinidine: Increased risk for quinidine toxicity.
• Rifampin: May decrease itraconazole levels; itraconazole may increase rifampin levels.
• Sulfonylurea antidiabetic agents (glipizide, glyburide): May increase levels; hypoglycemia possible.
• Vincristine/Vinblastine: May inhibit vinca alkaloid metabolism and increase levels.
• Warfarin: May cause increased prothrombin times in patients receiving warfarin or other coumarin anticoagulants.
• Methylprednisolone: Extends the activity of methylprednisolone
• Antihistamines (e.g., terfenadine): Inhibits metabolism, potentially leading to toxicity
• Oral hypoglycaemics: Inhibits metabolism
• Antiepileptics: Inhibits metabolism
• Ciclosporin: Increases bioavailability and blood levels of ciclosporin (well-documented in cats)
• Glucocorticoids: Inhibits metabolism and increases plasma concentrations
• Omeprazole: Reduces the absorption of itraconazole
• H2 antagonists: Reduces the absorption of itraconazole
• Adsorbents: Reduces the absorption of itraconazole
• Benzodiazepines: Increases plasma concentrations of benzodiazepines
• Vincristine: Increases plasma concentrations of vincristine
• Cefovecin: Datasheet advises against concurrent administration in cats
• Tolfenamic acid: Datasheet advises against concurrent administration in cats

常見問題