From the Guidelines
Itraconazole for candida infections is typically dosed at 200 mg 3 times daily for 3 days, then 200 mg once or twice daily thereafter. The treatment duration and dosage may vary depending on the severity and site of the infection, as well as the patient's response to treatment 1.
Key Considerations
- Itraconazole is generally reserved for patients with mucosal candidiasis, especially those who have experienced treatment failure with fluconazole 1.
- The oral solution is better absorbed on an empty stomach, while the capsule formulation is better absorbed with food 1.
- Histamine receptor antagonists and proton pump inhibitors can decrease the absorption of the capsule formulation, whereas acidic beverages can enhance absorption 1.
- Patients should be monitored for potential drug interactions as itraconazole can interact with many medications, and liver function should be assessed before and during treatment, especially for courses longer than one month.
Treatment Duration
- The treatment duration for itraconazole can vary from 1-2 weeks for oral candidiasis (thrush) to 2-3 weeks for esophageal candidiasis, and at least 2 weeks after symptom resolution for systemic or invasive candidiasis, often lasting 4-6 weeks total.
Important Notes
- Itraconazole works by inhibiting ergosterol synthesis, disrupting fungal cell membrane formation, which makes it effective against Candida species that have developed resistance to fluconazole 1.
- It is essential to carefully consider the influence of itraconazole on a patient's drug regimen due to its potential to inhibit cytochrome P450 enzymes 1.
From the FDA Drug Label
The recommended dosage of SPORANOX ® (itraconazole) Oral Solution for oropharyngeal candidiasis is 200 mg (20 mL) daily for 1 to 2 weeks. The recommended dosage of SPORANOX ® Oral Solution for esophageal candidiasis is 100 mg (10 mL) daily for a minimum treatment of three weeks. Treatment should continue for 2 weeks following resolution of symptoms.
The typical dose of itraconazole for oropharyngeal candidiasis is 200 mg daily for 1 to 2 weeks. For esophageal candidiasis, the typical dose is 100 mg daily for a minimum of 3 weeks, with treatment continuing for 2 weeks after symptoms resolve. 2
From the Research
Itraconazole for Candida Infections
- The typical dose of itraconazole for candida infections is 200 mg/day, as seen in studies 3, 4, 5.
- Treatment duration can vary, with some studies using a 7-day regimen 3, while others use a 14-day regimen 3, 4, 5.
- Itraconazole has been shown to be effective in treating oropharyngeal candidiasis, with clinical response rates of 97% after 14 days of treatment 3.
- The drug has also been used to treat fluconazole-refractory oropharyngeal candidiasis, with a clinical response rate of 65% 5.
- In cases of vulvovaginal candidosis, itraconazole has been used with a 1-day or 3-day regimen, with cure rates of 97.1% and 76.9% for acute and recurrent forms, respectively 6.
Efficacy and Safety
- Itraconazole has been shown to be well tolerated, with few adverse reactions reported 3, 4, 6.
- The drug has a broad spectrum of activity, including a wide variety of Candida species 3, 4.
- However, resistance to itraconazole has been reported, particularly in cases of fluconazole-refractory oropharyngeal candidiasis 5, 7.