Recommended Dosage of Sporanox (Itraconazole) for Fungal Infections
For fungal infections, itraconazole (Sporanox) dosage varies by infection type: 200 mg daily for cutaneous/lymphocutaneous infections (3-6 months), 200 mg twice daily for osteoarticular/pulmonary/systemic infections (12+ months), and specific pulse regimens for onychomycosis. 1
Dosage by Infection Type
Cutaneous and Lymphocutaneous Infections
- 200 mg orally daily for 2-4 weeks after all lesions have resolved, typically for a total of 3-6 months 1
- For non-responders, increase to 200 mg twice daily 1
- Serum levels should be checked after 2 weeks of therapy to ensure adequate drug exposure 1
Osteoarticular Infections
- 200 mg orally twice daily for at least 12 months 1
- In severe cases, initial therapy with amphotericin B (lipid formulation 3-5 mg/kg daily) followed by itraconazole 200 mg twice daily to complete 12 months of therapy 1
Pulmonary Infections
- For less severe disease: 200 mg orally twice daily for at least 12 months 1
- For severe disease: Initial amphotericin B followed by itraconazole 200 mg twice daily to complete 12 months 1
Onychomycosis
- For fingernail infections: 400 mg daily for 1 week per month, repeated for 2 months 1
- For toenail infections: 400 mg daily for 1 week per month, repeated for 3-4 months 1, 2
- Continuous therapy with 200 mg daily for 3 months is an alternative regimen 2
Candidal Infections
- For invasive candidal onychomycosis: Same dosage as for dermatophytes (400 mg daily for 1 week per month) 1
- For vaginal candidiasis: 400 mg daily for 1 day or 200 mg daily for 3 days 2
Tinea Cruris
- 100 mg once daily for 2 weeks 3
Administration Guidelines
- Itraconazole capsules should be taken with food to enhance absorption 1, 3
- Itraconazole solution is better absorbed when taken on an empty stomach 1, 3
- For doses >200 mg/day, administer in two divided doses 1
- For some regimens, a loading dose is recommended: 200 mg three times daily for 3 days 1
- Avoid concomitant use of agents that decrease stomach acidity with itraconazole capsules 1
Special Considerations
- For immunocompromised patients (especially AIDS), lifelong suppressive therapy with itraconazole 200 mg daily may be required 1
- Drug interactions are significant with warfarin, certain antihistamines, antipsychotics, anxiolytics, digoxin, cisapride, cyclosporine, and statins 3
- Decreased efficacy may occur with concomitant use of H2 blockers, phenytoin, and rifampicin 3
- Pregnant women should avoid itraconazole due to potential teratogenic effects 1
- For children, dosages of 6-10 mg/kg daily (maximum 400 mg daily) have been used 1
Treatment Outcomes and Monitoring
- Success rates of 90-100% have been reported for cutaneous and lymphocutaneous infections 1
- For onychomycosis, mycological cure rates of approximately 70-80% have been reported 2
- Clinical improvement is often seen within 4 weeks of starting therapy 1
- Monitor liver function tests as transient changes in liver function occur in 1-2% of patients 4
- Relapse rates of 20-30% may occur after completion of therapy for onychomycosis 2
Itraconazole has proven to be a valuable antifungal agent with broad-spectrum activity against dermatophytes, yeasts, and systemic fungal pathogens, with generally good tolerability at recommended doses 4, 5.