Itra
Generic Name
Itraconazole
Manufacturer
Various (e.g., Square Pharmaceuticals Ltd.)
Country
Global (often manufactured in various countries)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| itra 100 mg capsule | ৳ 15.10 | ৳ 90.60 |
Description
Overview of the medicine
Itraconazole is an azole antifungal medication used to treat a variety of fungal infections, including systemic infections, dermatophytoses, and candidiasis.
Uses & Indications
Dosage
Adults
Typically 100-200 mg once or twice daily, depending on the infection. For onychomycosis, pulse therapy (e.g., 200 mg twice daily for 1 week/month for 2-3 months) is common.
Elderly
Dosage adjustment may be considered, especially with liver or renal impairment. Monitor carefully.
Renal_impairment
Use with caution. Dosage reduction may be necessary, particularly in severe impairment (CrCl < 30 mL/min).
How to Take
Take capsules immediately after a full meal to ensure maximum absorption. Swallow whole with water. Do not open or chew.
Mechanism of Action
Itraconazole inhibits fungal cytochrome P450-dependent enzyme lanosterol 14-alpha-demethylase, which is necessary for the biosynthesis of ergosterol, an essential component of the fungal cell membrane. Inhibition of ergosterol synthesis leads to increased cellular permeability and eventual cell death.
Pharmacokinetics
Onset
Therapeutic effects may take days to weeks depending on the infection type.
Excretion
Primarily excreted in faeces (3-18% as unchanged drug) and urine (less than 0.03% as unchanged drug, 34% as metabolites).
Half life
Approximately 20-30 hours (for parent drug), 30-40 hours (for active metabolite hydroxyitraconazole).
Absorption
Well absorbed orally, especially when taken with a full meal. Bioavailability is increased in an acidic environment.
Metabolism
Extensively metabolized in the liver via CYP3A4 to several metabolites, including the active metabolite hydroxyitraconazole.
Side Effects
Contraindications
- Known hypersensitivity to itraconazole or any component of the formulation
- Concomitant use with certain CYP3A4 substrates (e.g., lovastatin, simvastatin, triazolam, midazolam, colchicine in renal/hepatic impairment) due to risk of serious adverse effects
- Congestive heart failure (CHF) or history of CHF, unless the benefits outweigh the risks
- Pregnancy (except for life-threatening or serious infections)
Drug Interactions
Oral anticoagulants (e.g., warfarin)
Increased anticoagulant effect, requiring close monitoring of INR.
Rifampicin, phenytoin, carbamazepine
Decreased itraconazole levels, reducing its efficacy.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy/rhabdomyolysis due to increased statin levels.
Calcium channel blockers (e.g., amlodipine, felodipine)
Increased levels of CCBs, leading to increased risk of hypotension, edema.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, supportive measures should be implemented. Itraconazole is not removed by hemodialysis. Gastric lavage may be considered.
Pregnancy & Lactation
Pregnancy Category C. Itraconazole should not be used during pregnancy unless the benefits outweigh the potential risks to the fetus. It is excreted in breast milk; therefore, breastfeeding is not recommended during treatment.
Side Effects
Contraindications
- Known hypersensitivity to itraconazole or any component of the formulation
- Concomitant use with certain CYP3A4 substrates (e.g., lovastatin, simvastatin, triazolam, midazolam, colchicine in renal/hepatic impairment) due to risk of serious adverse effects
- Congestive heart failure (CHF) or history of CHF, unless the benefits outweigh the risks
- Pregnancy (except for life-threatening or serious infections)
Drug Interactions
Oral anticoagulants (e.g., warfarin)
Increased anticoagulant effect, requiring close monitoring of INR.
Rifampicin, phenytoin, carbamazepine
Decreased itraconazole levels, reducing its efficacy.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy/rhabdomyolysis due to increased statin levels.
Calcium channel blockers (e.g., amlodipine, felodipine)
Increased levels of CCBs, leading to increased risk of hypotension, edema.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, supportive measures should be implemented. Itraconazole is not removed by hemodialysis. Gastric lavage may be considered.
Pregnancy & Lactation
Pregnancy Category C. Itraconazole should not be used during pregnancy unless the benefits outweigh the potential risks to the fetus. It is excreted in breast milk; therefore, breastfeeding is not recommended during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years (varies by manufacturer, check packaging)
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of itraconazole for various fungal infections since its introduction.
Lab Monitoring
- Liver function tests (baseline and periodically during prolonged therapy)
- Electrolyte levels (especially potassium)
- Serum itraconazole levels (in specific situations, e.g., suspected malabsorption or drug interactions)
Doctor Notes
- Assess cardiac risk factors before initiating therapy.
- Monitor LFTs and electrolytes periodically.
- Counsel patients on adherence and potential drug interactions, especially with OTC medications.
Patient Guidelines
- Take with a full meal for best absorption.
- Complete the full course of treatment as prescribed, even if symptoms improve.
- Report any signs of liver problems (e.g., unusual fatigue, dark urine, yellowing skin/eyes) or heart failure (e.g., shortness of breath, swelling of ankles/feet) to your doctor immediately.
- Avoid antacids within 2 hours of taking itraconazole capsules.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up.
Driving Precautions
May cause dizziness or visual disturbances. Patients should be cautioned about driving or operating machinery until they are certain itraconazole does not adversely affect them.
Lifestyle Advice
- Maintain good hygiene to prevent recurrence of fungal infections.
- Wear breathable clothing and footwear for skin/nail infections.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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