Antifungal
Itraconazole is an antifungal medicine used to treat various fungal infections, including those affecting the lungs, skin, and nails. It works by stopping the growth of certain fungi. Because it can affect the heart and liver, it must be used carefully and under medical supervision.
How it worksItraconazole works by inhibiting an enzyme called Cytochrome P450 51, which prevents fungi from growing.
Brand names:SPORANOX, ONMEL, TOLSURA
How to take
For systemic infections like Blastomycosis, the usual dose is 200 mg once daily, though this may be increased up to 400 mg daily. For nail fungus, specific dosing applies. Always swallow capsules whole and take them with a full meal to help your body absorb the medicine properly.
Do not swap itraconazole capsules with the oral liquid version; they are not the same. For life-threatening infections, a doctor may start with a higher 'loading dose'.
Key warnings
Itraconazole has serious warnings regarding congestive heart failure and heart rhythm issues. It should not be used for nail fungus in people with a history of heart failure or ventricular dysfunction. It also has many dangerous interactions with other drugs.
- ·Itraconazole has serious warnings regarding congestive heart failure and heart rhythm issues. It should not be used for nail fungus in people with a history of heart failure or ventricular dysfunction. It also has many dangerous interactions with other drugs.
- ·Liver damage: Itraconazole can cause rare but serious liver failure, even in people without prior liver problems.
- ·Heart rhythm: Using itraconazole with certain other drugs can cause life-threatening heart rhythm changes or sudden death.
Do not use if
- ·Do not use itraconazole for nail fungus if you have congestive heart failure or signs of heart dysfunction.
- ·Do not use itraconazole with certain other medications that interact with the CYP3A4 enzyme.
Side effects
Common
Serious
- ·Liver failure or liver damage
- ·Heart rhythm problems
- ·Sudden death related to heart issues
- ·Signs of congestive heart failure
Seek help if
- ·Signs of liver disease
- ·Signs of heart failure
- ·Abnormal heart rhythms
Interactions
- ·Many drugs that use the CYP3A4 pathway can interact dangerously with itraconazole.
- ·It can increase the levels of drugs like methadone, quinidine, and certain ergot alkaloids in your body.
- ·It can change how your body processes many other medications, potentially making them more toxic or less effective.
Special populations
PregnancyItraconazole can harm an unborn baby. It should only be used during pregnancy if the benefits clearly outweigh the risks to the fetus.
BreastfeedingItraconazole passes into breast milk. Mothers should weigh the benefits of the medicine against the risks to the nursing infant.
PediatricThe safety and effectiveness of itraconazole in children have not been fully established. There is a concern regarding potential effects on bone growth.
GeriatricThere is not enough data on people over 65. Use in older adults should consider their heart, liver, and kidney health, as well as other medications they may be taking.
Talk to your doctor
Monitor
- ·Liver function
- ·Heart rhythm
- ·Signs of congestive heart failure
Questions to ask
- ·Should I have my liver function tested while taking itraconazole?
- ·Is it safe to take itraconazole with my current heart medications?
- ·How long will I need to take this medication for my infection?
- ·Will this medication affect my bone health?
Pharmacokinetics
Practical
OverdoseIf an overdose occurs, seek medical help immediately or contact a poison control center. Dialysis is not effective at removing itraconazole from the body.
Ingredients
Allergens
Inactive
Educational summary derived from FDA labeling, AI-assisted. Not medical advice — consult a healthcare professional. Updated 2026-04-25.