Side Effects of Itraconazole

The prescription drug itraconazole treats a range of fungal infections. The medication, marketed under the brand name Sporanox by Ortho-McNeil and as a generic product by Sandoz, can cause serious heart problems, as well as many other unwelcome side effects such as nausea, rash and swelling. Itraconazole also has potentially fatal interactions with several other medications.

Uses

• Itraconazole has U.S. Food and Drug Administration-approved indications for clearing up aspergillus, Blastomyces dermatitidis and dermatophyte infections of the blood, lungs, fingernails, toenails, and other internal body tissues such as the mouth and throat. The dose will range between 200 mg and 600 mg in capsule, oral solution or intravenous injection form per day, depending on the severity and nature of the infection. Itraconazole therapy will last for at least three months or until no evidence of the fungus remains.

Common Side Effects

• Patients taking itraconazole for internal fungal infections during clinical trials of the medication most often reported nausea, rash, vomiting, swelling (edema), headache, high blood pressure, fatigue, fever and itchiness (pruritis) as side effects. Itraconazole taken for nail fungus most often produced elevated liver enzymes, gastrointestinal disorders, high triglycerides, increased appetite, rash, and rhinitis and sinusitis.

Rare Side Effects

• Side effects that occurred in fewer than 3 percent of all patients taking itraconazole included abdominal pain, anorexia, constipation, dizziness, impotence and decreased libido, insomnia, low potassium levels (hypokalemia), menstrual disorders, muscle pain (myalgia), and vertigo.

Warnings

• Patients with congestive heart failure cannot take itraconazole to treat nail fungus, and patients with liver disease should not take the medication unless death may result from a fungal infection. Rarely, itraconazole use has been associated with fatal liver failure.

Interactions

• Taking itraconazole with any of the following medications can lead to abnormal heartbeat, cardiac arrest and even death:

  • Dofetilide (Tikosyn from Pfizer)
  • Ergot alkaloids
  • Midazolam
  • Nisoldipine (e.g., Sular from Sciele)
  • Pimozide (Orap from Teva)
  • Quinidine
  • Triazolam (e.g., Halcion from Pfizer)

  Less serious interactions can occur with dozens of other drugs, including atorvastatin (Lipitor from Pfizer), budesonide (e.g., Pulmicort from AstraZeneca), carbamazepine (e.g., Tegretol from Novartis), clarithromycin (e.g., Biaxin from Abbott), cyclosporine, docetaxel (Taxotere from sanofi aventis), fentanyl, isoniazid, oral diabetes medications, ritonavir (Norvir from Abbott), and warfarin.