Itraconazole

(BAN, USAN, rINN)
Synonyms: Itraconazol; Itraconazolum; Itrakonatsoli; Itrakonazol; Itrakonazolas; Oriconazole; R-51211. (±)-2sec-Butyl-4-[4-(4-{4-[(2R * ,4S * )2-(2,4-dichlorophenyl)-2-(1H-1,2,4-triazol-1-ylmethyl)-1,3-dioxolan-4-ylmethoxy]phenyl}-piperazin-1-yl)phenyl]-2,4-dihydro1,2,4-triazol-3-one.
Cyrillic synonym: Итраконазол.

💊 Chemical information

Chemical formula: C35H38Cl2N8O4 = 705.6.
CAS — 84625-61-6.
ATC — J02AC02.
ATC Vet — QJ02AC02.

Pharmacopoeias.

In Eur..

Ph. Eur. 6.2

(Itraconazole). A white or almost white powder. Practically insoluble in water; very slightly soluble in alcohol; freely soluble in dichloromethane; sparingly soluble in tetrahydrofuran. Protect from light.

💊 Adverse Effects

The most common adverse effects associated with itraconazole include dyspepsia, abdominal pain, nausea, vomiting, constipation, diarrhoea, headache, and dizziness. Others include allergic reactions such as pruritus, rash, urticaria, and angioedema. Isolated cases of the Stevens-Johnson syndrome have been associated with itraconazole. An increase in liver enzyme values has occurred in some patients and cases of hepatitis and cholestatic jaundice have been observed, especially in those treated for more than one month. There have been rare cases of liver failure and death. Heart failure and pulmonary oedema have been reported rarely and serious cardiovascular events including arrhythmias and sudden death have been attributed to drug interactions in patients receiving itraconazole (see Interactions, below). Alopecia, oedema, and hypokalaemia have also been associated with prolonged use. Menstrual disorders and peripheral neuropathy have been reported in a few patients.

Incidence of adverse effects.

Itraconazole 50 to 400 mg daily for a median of 5 months was considered to be well tolerated in 189 patients with systemic fungal infections.1 Of 86 patients with underlying disease, including 49 with AIDS, 16 with diabetes, and 23 with malignancy, nausea and vomiting occurred in 19 patients, hypertriglyceridaemia in 16, hypokalaemia in 11, and elevated liver enzyme values in 13. The role of itraconazole in hypertriglyceridaemia could not be assessed because all the samples were not drawn in the fasting state and hypertriglyceridaemia is a complication of HIV infection. Gynaecomastia occurred in 2 patients, 1 of whom also took spironolactone. Rash occurred in 4 patients. Of 49 patients taking itraconazole 100 to 400 mg daily for up to 39 months, 23 did not experience adverse effects during treatment,2 while 6 had nausea and vomiting, 5 developed oedema, and 2 developed hypertension; 3 of the patients who developed oedema and 1 who became hypertensive were diabetic. Three patients stopped itraconazole, 1 due to vomiting, 1 to leucopenia, and 1 to nephrotic syndrome. The patient with nephrotic syndrome had pre-existing oedema and hypertension; the syndrome cleared when itraconazole was stopped.
1. Tucker RM, et al. Adverse events associated with itraconazole in 189 patients on chronic therapy. J Antimicrob Chemother 1990; 26: 561–6
2. Graybill JR, et al. Itraconazole treatment of coccidioidomycosis. Am J Med 1990; 89: 282–90.

Effects on the heart.

Between September 1992, when itraconazole was approved in the USA, and April 2001, the FDA had received 58 reports of potential cases of heart failure associated with itraconazole.1 There had been 28 patients admitted to hospital, and 13 had died. However, a causal relationship was difficult to prove. Overall, 43 patients had risk factors or diseases which might confound an association between the use of itraconazole and development of heart failure. Unpublished studies in dogs and humans had suggested a negative inotropic effect with intravenous itraconazole. In August 2001, the UK CSM published a similar alert.2 By this time, about 67 million patients worldwide had received itraconazole and there had been 75 spontaneously reported cases of suspected heart failure and an additional 63 reports of oedema suggestive of heart failure associated with oral formulations; there had been only 1 report of suspected heart failure in the UK. The CSM considered that the risk of heart failure with itraconazole was low, especially in young healthy patients receiving short courses of treatment (e.g. for vulvovaginal candidiasis). However, the risks appeared to be higher for older patients, patients with pre-existing heart disease or risk factors for heart failure, and for those receiving high doses and longer treatment courses (e.g. for onychomycosis). The CSM2 therefore advised caution when prescribing itraconazole to patients at risk of heart failure, whereas the FDA1 contraindicated it for the treatment of onychomycosis in patients with evidence of ventricular dysfunction.
1. Ahmad SR, et al. Congestive heart failure associated with itraconazole. Lancet 2001; 357: 1766–7
2. Committee on Safety of Medicines. Cardiodepressant effect of itraconazole (Sporanox). Current Problems 2001; 27: 11–12. Also available at: http://www.mhra.gov.uk/home/ idcplg?IdcService=GET_FILE&dDocName=CON007456& RevisionSelectionMethod=LatestReleased (accessed 04/06/06)

💊 Precautions

Itraconazole has caused abnormalities in fetal development in rodents and is therefore contra-indicated in pregnancy. For further information, see Pregnancy, under Precautions of Fluconazole. Itraconazole should be avoided in patients with hepatic impairment. Liver function should be monitored if treatment lasts more than one month or if there are symptoms suggestive of hepatitis. Treatment should be stopped if abnormal liver function is detected. Plasmaitraconazole concentrations should be monitored in patients with active liver disease and the dosage adjusted if necessary. Dose adjustments may also be required in some patients with renal impairment. Licensed product information warns that the use of intravenous preparations of itraconazole formulated with hydroxypropylbetadex is contra-indicated in patients with a creatinine clearance of less than 30 mL/minute. Itraconazole should be stopped if neuropathy develops. Itraconazole should not be used for the treatment of less severe fungal infections such as onychomycosis in patients with evidence of, or a history of, ventricular dysfunction such as heart failure. Hypochlorhydria, which may be present in patients with AIDS, can reduce absorption of itraconazole. In this case absorption may be improved by giving itraconazole with an acidic drink, such as a cola beverage.

Breast feeding.

Breast feeding while receiving itraconazole is not recommended by the manufacturer although only small amounts of itraconazole are distributed into breast milk.

💊 Interactions

Enzyme-inducing drugs such as carbamazepine, isoniazid, nevirapine, phenobarbital, phenytoin, rifabutin, or rifampicin may decrease plasma concentrations of itraconazole sufficiently to reduce its effectiveness. Conversely, enzyme inhibitors such as clarithromycin, erythromycin, HIV-protease inhibitors, including ritonavir-boosted HIV-protease inhibitors, may increase plasma concentrations of itraconazole. Use of drugs that reduce stomach acidity, such as antimuscarinics, antacids, proton pump inhibitors, and histamine H 2 -receptor antagonists, may reduce the absorption of itraconazole. Like other triazole antifungals, itraconazole is a potent inhibitor of the cytochrome P450 isoenzyme CYP3A4, and may increase plasma concentrations of other drugs reliant upon it for their metabolism. This increases the risk of adverse effects and such combinations should be given with caution and careful monitoring, if at all. Drugs so affected may include:
antiarrhythmics such as dofetilide and quinidine
antiepileptics such as carbamazepine (which in turn decreases the concentration of the antifungal, see above)
antihistamines such as astemizole and terfenadine
the antimycobacterial rifabutin (which again also decreases antifungal concentrations)
antineoplastics such as busulfan, docetaxel, and the vinca alkaloids
antipsychotics such as pimozide and sertindole
anxiolytics and sedatives such as buspirone
benzodiazepines such as alprazolam, diazepam, midazolam, and triazolam
calcium channel blockers such as verapamil, and the dihydropyridines felodipine, nifedipine, and nisoldipine (see also below)
cardiac glycosides such as digoxin
some corticosteroids such as budesonide, dexamethasone, fluticasone and methylprednisolone
the coumarin anticoagulant warfarin
ergot alkaloids such as dihydroergotamine, ergometrine, ergotamine, and methylergometrine
the gastrointestinal prokinetic cisapride
HIV-protease inhibitors such as indinavir, ritonavir, and saquinavir (concentrations of the antifungal may be increased in turn by indinavir, ritonavir, or co-formulated lopinavir-ritonavir, but not by saquinavir)
immunosuppressants such as ciclosporin, sirolimus, and tacrolimus
opioids such as alfentanil and levacetylmethadol
some oral hypoglycaemics
the phosphodiesterase inhibitors sildenafil and vardenafil
statins (HMG Co-A reductase inhibitors) such as atorvastatin, lovastatin, and simvastatin
Where drugs metabolised via CYP3A4 also prolong the QT interval, the risk of serious cardiovascular effects such as torsade de pointes means that the combination should be avoided; this includes astemizole, cisapride, dofetilide, levacetylmethadol, pimozide, quinidine, sertindole, and terfenadine. Care is also required with calcium channel blockers, which may increase the risk of congestive heart failure if given together, and nisoldipine in particular is considered contra-indicated. Use with the statins is also best avoided because of the risk of muscle damage.
1. Baciewicz AM, Baciewicz FA. Ketoconazole and fluconazole drug interactions. Arch Intern Med 1993; 153: 1970–6
2. Lomaestro BM, Piatek MA. Update on drug interactions with azole antifungal agents. Ann Pharmacother 1998; 32: 915–28
3. Venkatakrishnan K, et al. Effects of the antifungal agents on oxidative drug metabolism: clinical relevance. Clin Pharmacokinet 2000; 38: 111–80.

Immunosuppressants.

Fatal hepatitis occurred in a 68-yearold woman1 after 2 months of use of itraconazole and leflunomide. The authors suggested that the combined hepatotoxicity of both drugs might have accounted for this.
1. Legras A, et al. Fatal hepatitis with leflunomide and itraconazole. Am J Med 2002; 113: 352–3.

Metal ions.

Didanosine in a formulation containing aluminium and magnesium ion buffering agents could reduce the absorption of itraconazole due to the resultant increase in gastric pH.1
1. Moreno F, et al. Itraconazole-didanosine excipient interaction. JAMA 1993; 269: 1508.

💊 Antimicrobial Action

Itraconazole is a triazole antifungal drug that in sensitive fungi inhibits cytochrome P450-dependent enzymes resulting in impairment of ergosterol synthesis in fungal cell membranes. It has a slightly wider spectrum of activity than ketoconazole. It is active against Aspergillus spp., Blastomyces dermatitidis, Candida spp., Coccidioides immitis, Cryptococcus neoformans, Epidermophyton spp., Histoplasma capsulatum, Malassezia furfur, Microsporum spp., Paracoccidioides brasiliensis, Sporothrix schenckii, and Trichophyton spp. Itraconazole also has some antiprotozoal activity against Leishmania spp. Acquired resistance to itraconazole is rare but ketoconazole-resistant strains of Candida albicans have been found to be cross resistant to itraconazole.

Microbiological interactions.

Synergistic antifungal effects were seen in vitro with terbinafine and itraconazole against strains of Candida albicans1 and Scedosporium prolificans.2 For effects on the antifungal activity of azoles when given with amphotericin B.
1. Barchiesi F, et al. In vitro activities of terbinafine in combination with fluconazole and itraconazole against isolates of Candida albicans with reduced susceptibility to azoles. Antimicrob Agents Chemother 1997; 41: 1812–14
2. Meletiadis J, et al. In vitro interaction of terbinafine with itraconazole against clinical isolates of Scedosporium prolificans. Antimicrob Agents Chemother 2000; 44: 470–2.

Resistance.

For a discussion of increasing resistance of Candida spp. to azoles, see under Antimicrobial Action of Fluconazole. Decreased susceptibility to itraconazole and crossresistance to fluconazole has been reported in C. albicans isolated from patients with AIDS given long-term prophylaxis with itraconazole.1 Aspergillus fumigatus resistant to itraconazole has also been seen.2,3
1. Goldman M, et al. Does long-term itraconazole prophylaxis result in in vitro azole resistance in mucosal Candida albicans isolates from persons with advanced human immunodeficiency virus infection? Antimicrob Agents Chemother 2000; 44: 1585–7
2. Denning DW, et al. Itraconazole resistance in Aspergillus fumigatus. Antimicrob Agents Chemother 1997; 41: 1364–8
3. Dannaoui E, et al. Acquired itraconazole resistance in Aspergillus fumigatus. J Antimicrob Chemother 2001; 47: 333–340.

💊 Pharmacokinetics

Itraconazole is absorbed from the gastrointestinal tract when given orally either as capsules containing itraconazole coated onto sugar spheres or as an oral liquid formulated with hydroxypropylbetadex. Absorption from the capsule formulation is enhanced by an acidic gastric environment and is greatest when doses are taken with food; absorption from the oral liquid is not dependent on an acid environment, and absorption is greatest in the fasting state. Peak plasma concentrations are achieved between 1.5 and 5 hours after a dose of either formulation, and steady state is reached within 15 days during daily dosing. Peak plasma concentrations at steady state of about 2 micrograms/mL have been reported after daily doses of 200 mg. Bioavailability increases with doses of 100 to 400 mg in such a manner as to suggest that itraconazole undergoes saturable metabolism. Itraconazole is highly protein bound; only 0.2% circulates as free drug. Itraconazole is widely distributed but only small amounts diffuse into the CSF. Concentrations attained in the skin, sebum, pus, and many organs and tissues are several times higher than simultaneous plasma concentrations. Therapeutic concentrations of itraconazole remain in the skin and mucous membranes for 1 to 4 weeks after the drug is stopped. Small amounts are distributed into breast milk. Itraconazole is metabolised in the liver mainly by cytochrome P450 isoenzyme CYP3A4. The major metabolite, hydroxyitraconazole, has antifungal activity comparable with that of itraconazole. Itraconazole is also excreted as inactive metabolites in the bile or urine; 3 to 18% is excreted in the faeces as unchanged drug. Small amounts are eliminated in the stratum corneum and hair. Itraconazole is not removed by dialysis. The elimination half-life following a single 100-mg dose has been reported as 20 hours, increasing to 30 to 40 hours with continued use.

💊 Uses and Administration

Itraconazole is a triazole antifungal given orally for the treatment of oropharyngeal and vulvovaginal candidiasis, for pityriasis versicolor, for dermatophytoses unresponsive to topical treatment, for onychomycosis, and for systemic infections including aspergillosis, blastomycosis, candidiasis, chromoblastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, paracoccidioidomycosis, and sporotrichosis. It is also given for the prophylaxis of fungal infections in immunocompromised patients. The place of itraconazole in the treatment of fungal infections is discussed in the various sections under Choice of Antifungal. Doses of itraconazole oral liquid and capsules are not equivalent and may not be used interchangeably. In the UK, itraconazole oral liquid is licensed for use in oral and oesophageal candidiasis in a dose of 200 mg daily for 1 week; it may be taken as a single daily dose, or, preferably, in 2 divided doses, the liquid being retained in the mouth for 20 seconds before swallowing. If there is no response after a week, treatment may be continued for a further week. In the USA, a similar regimen is licensed for oropharyngeal candidiasis, but in oesophageal candidiasis an alternative regimen of 100 mg daily for at least 3 weeks is preferred, although the dose may be increased to 200 mg daily if necessary. For patients with fluconazole-resistant infections the dose in the UK is 100 to 200 mg twice daily for 2 weeks; if there is no response, 100 mg twice daily may be given for a further 2 weeks. In the USA the recommended dose is 100 mg twice daily. Itraconazole oral liquid is also licensed in the UK for prophylaxis of susceptible fungal infections in immunocompromised patients, in doses of 5 mg/kg daily, in 2 divided doses. The following oral doses all apply to itraconazole capsules. The dose in oropharyngeal candidiasis is 100 mg (or 200 mg in patients with AIDS or neutropenia) daily for 15 days. Vulvovaginal candidiasis may be treated with itraconazole 200 mg twice daily for 1 day. Pityriasis versicolor may be treated with itraconazole 200 mg daily for 7 days. For dermatophytoses the dose is 100 mg daily for 15 days or 200 mg daily for 7 days in tinea corporis or tinea cruris; doses are 100 mg daily for 30 days or 200 mg twice daily for 7 days in tinea pedis or tinea manuum. For nail infections the dose is 200 mg daily for 3 months or pulse therapy with 200 mg twice daily for 7 days repeated once (for fingernails) or twice (for toenails) after drug-free intervals of 21 days. For systemic infections, itraconazole capsules are given in usual doses of 100 to 200 mg once daily, increased to 200 mg twice daily for invasive or disseminated infections, including cryptococcal meningitis. In life-threatening infections a loading dose of 200 mg three times daily for 3 days has been given. A dose of 200 mg daily is used for primary or secondary prophylaxis in neutropenic patients or those with AIDS. Absorption may be impaired in these patients and monitoring of plasma concentrations is advised with an increase in dose to 200 mg twice daily if necessary. This higher dose is recommended routinely by some authorities in the USA such as the Centers for Disease Control and Prevention. Itraconazole may also be given by intravenous infusion in a dose of 200 mg given twice daily over 1 hour for two days, then 200 mg daily thereafter.
1. Haria M, et al. Itraconazole: a reappraisal of its pharmacological properties and therapeutic use in the management of superficial fungal infections. Drugs 1996; 51: 585–620
2. Pierard GE, et al. Itraconazole. Expert Opin Pharmacother 2000; 1: 287–304
3. Stevens DA (ed). Managing fungal infections in the 21st century: focus on itraconazole. Drugs 2001; 61 (suppl 1): 1–56
4. Slain D, et al. Intravenous itraconazole. Ann Pharmacother 2001; 35: 720–9
5. Boogaerts M, Maertens J. Clinical experience with itraconazole in systemic fungal infections. Drugs 2001; 61 (suppl 1): 39–47
6. Maertens J, Boogaerts M. The place for itraconazole in treatment. J Antimicrob Chemother 2005; 56 (suppl 1): i33–i38
7. Potter M. Strategies for managing systemic fungal infection and the place of itraconazole. J Antimicrob Chemother 2005; 56 (suppl 1): i49–i54.

Administration.

HIGH DOSES. Doses of itraconazole 600 mg daily in two divided doses for 3 to 16 months were used in 8 patients with systemic mycoses resistant to conventional therapy.1 Two patients with AIDS and cryptococcal meningitis failed to respond and 2 who responded initially later relapsed or developed progressive disease when the dose was reduced. The main adverse effects were hypokalaemia, hypertension, and oedema possibly associated with adrenal suppression. In a patient with cerebral aspergillosis, itraconazole 800 mg daily for 5 months then 400 mg daily for a further 4 ⁄ months produced complete resolution of cerebral lesions.2
1. Sharkey PK, et al. High-dose itraconazole in the treatment of severe mycoses. Antimicrob Agents Chemother 1991; 35: 707–13
2. Sánchez C, et al. Treatment of cerebral aspergillosis with itraconazole: do high doses improve the prognosis? Clin Infect Dis 1995; 21: 1485–7.

Administration in children and neonates.

Itraconazole has been used in children in the treatment of tinea capitis.1 Doses were 50 mg daily by mouth for those below 20 kg and 100 mg daily for those weighing 20 kg or more. A review of the use of itraconazole in children2 considered oral itraconazole to be safe and effective against most fungal organisms causing superficial infections. Itraconazole was given to 2 premature infants with disseminated candidiasis in a dose of 10 mg/kg daily in two divided doses for 3 or 4 weeks without adverse effects.3 Treatment was successful in both infants. Although itraconazole oral liquid is not licensed for use in children in the UK, and the capsules are only licensed from 12 years of age, the BNFC suggests the following daily oral doses, given as a single dose (unless otherwise specified): for oropharyngeal candidiasis:
1 month to 12 years of age, 3 to 5 mg/kg (to a maximum of 100 mg) daily for 15 days; up to 200 mg daily may be given to patients with neutropenia or AIDS
12 to 18 years of age, 100 mg (200 mg in those with neutropenia or AIDS) daily for 15 days for dermatophyte infections:
1 month to 12 years of age, 3 to 5 mg/kg daily; this is given to a maximum of 200 mg daily for 7 days (pityriasis versicolor), to a maximum of 100 mg daily for 15 days (tinea corporis and tinea cruris), or to a maximum of 100 mg daily for 30 days (tinea pedis and tinea manuum)
12 to 18 years of age, 200 mg daily for 7 days (pityriasis versicolor); 100 mg daily for 15 days or as in pityriasis (tinea corporis and tinea cruris); or 100 mg daily for 30 days or 200 mg twice daily for 7 days (tinea pedis and tinea manuum) for onychomycosis, from 1 year of age:
1 to 12 years, courses of 5 mg/kg daily for 7 days, repeated after intervals of 21 days to a total of 2 courses for infections of the fingernails and 3 courses for toenail infections
12 to 18 years, either 200 mg daily for 3 months, or courses of 200 mg twice daily for 7 days, repeated after intervals of 21 days to a total of 2 courses for infections of the fingernails and 3 courses for toenail infections for histoplasmosis or for systemic fungal infections such as aspergillosis, candidiasis, and cryptococcosis (including cryptococcal meningitis) where other antifungal drugs are inappropriate or ineffective:
from 1 month of age to 18 years, 5 mg/kg (to a maximum of 200 mg) once or twice daily; the twice daily dose should be used in invasive or disseminated disease or cryptococcal meningitis. For intravenous doses see below for maintenance in AIDS patients to prevent relapse of underlying fungal infection, or for prophylaxis in neutropenia when standard therapy is inappropriate:
from 1 month of age to 18 years, 5 mg/kg (to a maximum of 200 mg) daily, increased to twice daily if plasma-itraconazole concentrations are low for prophylaxis in haematological malignancy or bone-marrow transplantation (in patients expected to become neutropenic), where standard therapy is inappropriate the oral liquid may be given as follows:
from 1 month of age to 18 years, 2.5 mg/kg twice daily, starting before transplantation or chemotherapy and continued until the neutrophil count recovers Like the oral liquid the intravenous product is not licensed in children in the UK; the BNFC suggests the following intravenous doses by infusion in children with systemic fungal infections:
from 1 month of age to 18 years, 2.5 mg/kg (to a maximum of 200 mg) every 12 hours for 2 days, then the same dose once daily for a maximum of 12 days. Doses should be given by diluting 250 mg as the intravenous concentrate in 50 mL of sodium chloride 0.9% and infusing over 60 minutes
1. Möhrenschlager M, et al. Optimizing the therapeutic approach in tinea capitis of childhood with itraconazole. Br J Dermatol 2000; 143: 1011–15
2. Gupta AK, et al. Efficacy and safety of itraconazole use in children. Dermatol Clin 2003; 21: 521–35
3. Bhandari V, Narang A. Oral itraconazole therapy for disseminated candidiasis in low birth weight infants. J Pediatr 1992; 120: 330.

Amoebic infections.

Itraconazole has been suggested for Acanthamoeba keratitis, when it is given orally with topical miconazole.

Leishmaniasis.

When systemic therapy is required for the treatment of leishmaniasis, pentavalent antimonials are most commonly used. The successful use of itraconazole has been reported in a few patients1-4 with cutaneous disease but infections with Leishmania aethiopica may not respond.5 Although a pilot study6 in patients with mucocutaneous leishmaniasis reported benefit with itraconazole this was not confirmed in another study7 where the response was only transient in the majority of patients. Similarly, itraconazole with terbinafine has been found to be ineffective in post kala-azar dermal leishmaniasis.8
1. Albanese G, et al. Cutaneous leishmaniasis: treatment with itraconazole. Arch Dermatol 1989; 125: 1540–2
2. Pialoux G, et al. Cutaneous leishmaniasis in an AIDS patient: cure with itraconazole. J Infect Dis 1990; 162: 1221–2
3. Dogra J, Saxena VN. Itraconazole and leishmaniasis: a randomised double-blind trial in cutaneous disease. Int J Parasitol 1996; 26: 1413–15
4. Consigli J, et al. Cutaneous leishmaniasis: successful treatment with itraconazole. Int J Dermatol 2006; 45: 46–9
5. Akuffo H, et al. The use of itraconazole in the treatment of leishmaniasis caused by Leishmania aethiopica. Trans R Soc Trop Med Hyg 1990; 84: 532–4
6. Amato VS, et al. Use of itraconazole in the treatment of mucocutaneous leishmaniasis: a pilot study. Int J Infect Dis 2000; 4: 153–7
7. Calvopina M, et al. Itraconazole in the treatment of New World mucocutaneous leishmaniasis. Int J Dermatol 2004; 43: 659–63
8. Khalil EAG, et al. Failure of a combination of two antifungal drugs, terbinafine plus itraconazole, in Sudanese post kala-azar dermal leishmaniasis. Trans R Soc Trop Med Hyg 1996; 90: 187–8.

Trypanosomiasis.

Itraconazole, alone or with allopurinol, may produce beneficial responses in American trypanosomiasis.

💊 Preparations

Proprietary Preparations

Arg.: ITC†; Itrac; Micotenk; Nitridazol; Panastat; Salimidin; Sporanox; Austral.: Sporanox; Austria: Itrabene; Sporanox; Belg.: Sporanox; Braz.: Estiranox; Fungonax; Itracotan; Itrahexal†; Itranax†; Itraspor; Itrazol; Neo Itrax; Sporanox; Spozol; Tracnox†; Traconal; Traconax†; Tracozon; Tranazol†; Tratzol; Traxonol†; Canad.: Sporanox; Chile: Itodal; Sporanox; Teramic; Cz.: Cladostad; Prokanazol; Sporanox; Denm.: Niddazol; Sporanox; Fin.: Sporanox; Fr.: Sporanox; Ger.: Canifug Itra; Itracol; Sempera; Siros; Gr.: Assosept-S; Bevonazole; Brovicton; Deratil; Etrel; Flunol; Idranox; Isoflon; Itrabest; Itracon; Itraconal; Itralfa; Itraviron; Itrazol; Laverio; Lorenzol; Mesmor; Micronazol; Prominox; Soprazon; Sporanox; Sporizole; Stas; Sterginox; Zetilox; Hong Kong: Aranox; Quali-itrazole; Sporanox; Hung.: Cladostad; Omicral; Orungal; India: Candistat; Canditral; Itracan; Indon.: Forcanox; Fungitrazol; Furolnok; Itzol; Nufatrac; Sporacid; Sporanox; Spyrocon; Trachon; Unitrac; Zitrazol; Irl.: Sporanox; Israel: Itranol; Sporanox; Ital.: Sporanox; Trazer; Triasporin; Jpn: Itrizole; Malaysia: Canditral; Inox; Sporanox; Unitrac; Mex.: Carexan; Conamed; Congox; Derusil; Ergospharma; Fitocyd; Fulzoltec†; Fuzoltec; Imazol; Iqcona; Isoporum; Isox; Itranax; Lozartil; Rixtal; Seritral; Silicsan; Sinozol; Solmavin; Sporanox; Steitraz; Trax; Z-Fin; Zolken; Neth.: Trisporal; Norw.: Sporanox; NZ: Sporanox; Philipp.: Sporanox; Pol.: Orungal; Trioxal; Port.: Sporanox; Rus.: Irunine (Ирунин); Orungal (Орунгал); Orungamin (Орунгамин); Orunit (Орунит); Rumycoz (Румикоз); S.Afr.: Adco-Sporozole; Sporanox; Singapore: Canditral†; Sporanox; Spain: Canadiol; Hongoseril; Oromic; Sporanox; Swed.: Sporanox; Switz.: Sporanox; Thai.: Canditral; Icona; Itra; Itracon; Norspor; Spazol; Sporal; Sporlab; Spornar; Turk.: Funit; Itraspor; Sporex; UK: Sporanox; USA: Sporanox; Venez.: Fungosin; Sporanox. Multi-ingredient: Mex.: Sepia; Sporasec; Venez.: Sporasec.
Published November 24, 2018.