What is the appropriate dosing of itraconazole (Sporanox) for tinea capitis?

From the Guidelines

Itraconazole for tinea capitis is typically dosed at 5 mg/kg/day for 2-4 weeks, with a maximum daily dose of 100 mg, as recommended by the British Association of Dermatologists' guidelines for the management of tinea capitis 2014 1.

Key Considerations

• The dosage of itraconazole for tinea capitis is based on the patient's weight, with a recommended dose of 5 mg/kg/day for 2-4 weeks 1.
• The treatment duration may vary depending on the causative organism, with some species requiring longer treatment periods 1.
• Itraconazole is generally considered safe and effective for the treatment of tinea capitis, with activity against both Trichophyton and Microsporum species 1.

Important Administration Instructions

• Itraconazole should be taken with food to enhance absorption 1.
• Patients should be monitored for potential drug interactions, as itraconazole is metabolized through the CYP3A4 pathway 1.
• Liver function tests should be considered before and during treatment, especially for extended therapy 1.

Additional Measures

• Adjunctive treatment with antifungal shampoo (such as ketoconazole or selenium sulfide) twice weekly can help reduce spore shedding and prevent transmission 1.
• Children receiving appropriate therapy should be allowed to attend school or nursery, as recommended by the British Association of Dermatologists' guidelines 1.

From the Research

Itraconazole Dosing for Tinea Capitis

• The recommended dosage of itraconazole for tinea capitis is 5 mg/kg/day, as seen in studies 2, 3, 4.
• The duration of treatment can vary from 2-12 weeks, depending on the severity of the disease and the patient's response to treatment 2, 4, 5.
• In some cases, pulse therapy may be used, with each pulse lasting 1 week and separated by a 2-3 week period without treatment 2, 5.
• The dosage can be adjusted based on the patient's weight, with the following guidelines:
  • More than 40 kg: 200 mg per day (two capsules per day) 2
  • 20-40 kg: 100 mg per day (one capsule per day) 2
  • 10-19 kg: 50 mg per day (one half of a capsule per day) 2
• Itraconazole has been shown to be effective in treating tinea capitis caused by various fungal species, including Trichophyton tonsurans, T. violaceum, and Microsporum canis 2, 3, 4.
• The treatment regimen may need to be individualized based on the patient's response to treatment and the severity of the disease 2, 4, 5.