Itraconazole
Pronunciation: (eye-TRAH-koe-na-zole).
- Generic name
- itraconazole
- Brand names
- Canditral, Itrafungol, Itral, Sporanox, Sporanox Oral Solution, Tolsura
- Drug class
- Antifungal (Triazole antifungal agent)
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What itraconazole is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how itraconazole works
Itraconazole inhibits the fungal cytochrome P450 enzyme 14α-demethylase, which is essential for the synthesis of ergosterol, a key component of fungal cell membranes. This disruption leads to increased membrane permeability and ultimately fungal cell death. It is fungistatic or fungicidal depending on the concentration and organism. (1)
What itraconazole is used for
Blastomycosis (pulmonary and extrapulmonary) — FDA-approved, in immunocompromised and non-immunocompromised patients
Blastomycosis (pulmonary and extrapulmonary) — FDA-approved, in immunocompromised and non-immunocompromised patients (2)
Histoplasmosis (chronic cavitary pulmonary disease; disseminated, non-meningeal) — FDA-approved, in immunocompromised and non-immunocompromised patients
Histoplasmosis (chronic cavitary pulmonary disease; disseminated, non-meningeal) — FDA-approved, in immunocompromised and non-immunocompromised patients (2)
Aspergillosis (pulmonary and extrapulmonary) — FDA-approved in patients who are intolerant of or refractory to amphotericin B
Aspergillosis (pulmonary and extrapulmonary) — FDA-approved in patients who are intolerant of or refractory to amphotericin B (2)
Onychomycosis (fungal nail infection) of toenails and/or fingernails — FDA-approved, only in non-immunocompromised patients
Onychomycosis (fungal nail infection) of toenails and/or fingernails — FDA-approved, only in non-immunocompromised patients (2)
Before taking itraconazole
Do not take / not appropriate for
- Contraindicated in patients with known hypersensitivity to itraconazole or other azole antifungals, patients with ventricular dysfunction or a history of heart failure, and those taking drugs that can cause life-threatening interactions (e.g., quinidine, dofetilide, cisapride, pimozide, certain statins). (Contraindication) (2)
Tell your clinician about
(2)How to take itraconazole
- General Instructions: Take itraconazole exactly as prescribed by your healthcare provider.. Adult Dosing: Dosing varies by indication. Blastomycosis/histoplasmosis: 200 mg daily, may be increased up to 400 mg/day if needed. Aspergillosis: 200-400 mg daily. Onychomycosis of the toenails: 200 mg once daily for 12 weeks. Onychomycosis of the fingernails: 200 mg TWICE daily for 1 week, then a 3-week break with no drug, then repeat the 1-week course once more (a 'pulse' schedule, not a continuous 6-week course).. Pediatric Dosing: Use in children is limited and should be determined by a pediatric specialist. Dosing is based on body weight and the specific infection.. Administration: Capsules should be taken with a full meal to enhance absorption. The oral solution should be taken on an empty stomach. Swallow capsules whole; do not crush or chew.. If You Are Considering Stopping Early: Seek medical advice first; completing the full prescribed course, even if symptoms improve, is generally important for these infections, and the clinician managing your care can advise on whether it is appropriate to stop early — for example, if signs of heart failure or liver problems appear (swelling, shortness of breath, unusual fatigue, or yellowing of the skin/eyes), contact your doctor promptly so they can decide on stopping.. Storage: Store at 15-25°C (59-77°F), protected from light and moisture. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take an extra dose to make up for a missed one.
Overdose
In case of overdose, seek emergency medical attention or contact a poison control center immediately. Symptoms may include headache, nausea, vomiting, abdominal pain, and liver toxicity. Supportive care is the mainstay of treatment. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional. The most common adverse reactions reported in clinical trials, with approximate frequencies:
Nausea
Incidence: About 11% in clinical trials
Rash
Incidence: About 9% in clinical trials
Vomiting
Incidence: About 5% in clinical trials
Edema (swelling)
Incidence: About 4% in clinical trials
Headache
Incidence: About 4% in clinical trials
Diarrhea
Incidence: About 3% in clinical trials
Fatigue
Incidence: About 3% in clinical trials
Fever
Incidence: About 3% in clinical trials
Hypertension
Incidence: About 3% in clinical trials
Signs of heart failure (swelling, shortness of breath, unusual fatigue) or liver problems (dark urine, pale stools, yellowing of skin/eyes)
Incidence: Rare but serious
Serious warnings
BOXED WARNING (FDA), two components — serious
Symptoms: BOXED WARNING (FDA), two components: (1) Congestive heart failure — itraconazole should not be given for onychomycosis (nail fungus) treatment in anyone with evidence of ventricular dysfunction, such as congestive heart failure or a history of it. If signs or symptoms of heart failure (such as swelling, shortness of breath, or unusual fatigue) appear during any itraconazole therapy, contact your doctor promptly — itraconazole is generally discontinued on the treating clinician's decision. (2) Serious drug interactions — itraconazole is contraindicated with numerous other medications because it raises their blood levels to dangerous levels, including: methadone, disopyramide, dofetilide, dronedarone, quinidine, ergot alkaloids (e.g., dihydroergotamine, ergotamine), irinotecan, lurasidone, oral midazolam, pimozide, triazolam, felodipine, nisoldipine, ivabradine, ranolazine, eplerenone, cisapride, naloxegol, lomitapide, lovastatin, simvastatin, avanafil, ticagrelor, finerenone, and voclosporin — some combinations can cause life-threatening heart rhythm problems.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Hepatotoxicity — serious
Symptoms: Hepatotoxicity: rare but serious liver injury has occurred with itraconazole, including liver failure and death. Report symptoms of liver problems (unusual fatigue, loss of appetite, nausea, dark urine, pale stools, or yellowing of the skin/eyes) promptly; itraconazole is generally discontinued if these appear, and restarting it after a prior itraconazole-associated liver injury is strongly discouraged except in life-threatening situations, on the treating clinician's judgment. Can cause severe allergic reactions in rare cases.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: known hypersensitivity to itraconazole or other azole antifungals; ventricular dysfunction or a history of heart failure (see boxed warning); and coadministration with the drugs listed in the boxed warning above. Use with caution in patients with hepatic or renal impairment.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Itraconazole interacts with many medications, including certain statins, antiarrhythmics, benzodiazepines, and drugs metabolized by CYP3A4. It can increase or decrease the effects of other drugs, and some combinations can cause life-threatening arrhythmias or toxicity. Always review your medication list with your healthcare provider before starting itraconazole. | (1) |
| Contraindicated combinations (see boxed warning) | Itraconazole must not be combined with methadone, disopyramide, dofetilide, dronedarone, quinidine, certain ergot alkaloids, irinotecan, lurasidone, oral midazolam, pimozide, triazolam, felodipine, nisoldipine, ivabradine, ranolazine, eplerenone, cisapride, naloxegol, lomitapide, lovastatin, simvastatin, avanafil, ticagrelor, finerenone, or voclosporin — combining these can raise their blood levels to dangerous, sometimes life-threatening levels. | (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Itraconazole is contraindicated for treating onychomycosis (nail fungus) during pregnancy, because that use is not life-threatening and the risk is not justified. For serious systemic fungal infections, it is used only if the potential benefit outweighs the risk, as decided by the treating clinician. Women of childbearing potential should use effective contraception during treatment and for 2 months after the last dose. (2)
Breastfeeding
Itraconazole passes into human breast milk. The expected benefit of treatment for the mother should be weighed against the potential risk to a nursing infant — discuss this with the prescribing clinician. (2)
Children
Frequency: Not applicable. Weight Based: Not recommended for pediatric use. Max Daily Dose: Not applicable. Max Single Dose: Not applicable. Age Restrictions: Safety not established in children; use in children is limited and dosing, if used, is individualized by a pediatric specialist based on body weight and infection. (2)
Renal_impairment
The clinician record advises caution in hepatic or renal impairment; no separate validated fixed-dose-adjustment table was found in the independent literature reviewed, so dosing in organ impairment should be individualized by the treating clinician with monitoring, including of liver function. (2)
Hepatic_impairment
The clinician record advises caution in hepatic or renal impairment; no separate validated fixed-dose-adjustment table was found in the independent literature reviewed, so dosing in organ impairment should be individualized by the treating clinician with monitoring, including of liver function. (2)
Monitoring
(2)Storage
Store at 15-25°C (59-77°F), protected from light and moisture. Keep out of reach of children.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General — FDA label (Sporanox)
Indication: Blastomycosis / histoplasmosis
Dose summary: 200 mg daily; may be increased up to 400 mg/day if needed.
Renal context: No separate validated fixed renal-dose-adjustment table found; dosing individualized with monitoring. (2)
General — FDA label (Sporanox)
Indication: Aspergillosis
Dose summary: 200-400 mg daily.
Renal context: No separate validated fixed renal-dose-adjustment table found. (2)
General — FDA label (Sporanox)
Indication: Onychomycosis (nail fungus)
Dose summary: Toenails: 200 mg once daily for 12 weeks. Fingernails: 200 mg twice daily for 1 week, then a 3-week drug-free pause, then repeat the 1-week course once more (pulse dosing).
Renal context: No separate validated fixed renal-dose-adjustment table found. (2)
Frequently asked questions
What conditions does itraconazole treat?
Itraconazole is used to treat a range of fungal infections, including aspergillosis, blastomycosis, histoplasmosis, and onychomycosis (fungal nail infections).
How long does it take for itraconazole to work?
The time to improvement depends on the type and severity of infection. Nail infections may require several months for full results, while other infections may improve within days to weeks.
Can I take itraconazole with food?
Capsules should be taken with food to improve absorption. The oral solution should be taken on an empty stomach.
Is itraconazole safe during pregnancy?
Itraconazole is contraindicated for treating nail fungus (onychomycosis) during pregnancy. For serious systemic fungal infections, it may be used if the potential benefit justifies the risk, as judged by your doctor. Women who could become pregnant should use effective contraception during treatment and for 2 months after the last dose. Discuss with your doctor if you are pregnant or planning to become pregnant.
What should I do if I experience side effects?
Contact your healthcare provider if you experience mild side effects. Seek immediate medical attention for severe reactions such as difficulty breathing, swelling, or signs of liver problems.
Can itraconazole interact with other medications?
Yes, itraconazole has many potential drug interactions. Always inform your healthcare provider about all medications, supplements, and herbal products you are taking.
How should itraconazole be stored?
Store itraconazole at room temperature, away from moisture and heat. Keep the medication out of reach of children.
What happens if I take too much Itraconazole?
Taking too much Itraconazole can lead to serious side effects such as liver damage, heart problems, and neurological issues. Symptoms may include severe nausea, vomiting, dizziness, or yellowing of the skin/eyes. If an overdose is suspected, it is crucial to seek immediate emergency medical attention. Do not attempt to induce vomiting or self-treat.
Can I drink alcohol while taking Itraconazole?
It is generally advised to avoid or limit alcohol consumption while taking Itraconazole. Both alcohol and Itraconazole are metabolized by the liver, and combining them can increase the risk of liver damage or exacerbate side effects like nausea and dizziness. Always consult your healthcare provider for personalized advice regarding alcohol intake during your treatment.
What is the mechanism of action of itraconazole?
Itraconazole inhibits the fungal cytochrome P450 enzyme 14α-demethylase, which is essential for the synthesis of ergosterol, a key component of fungal cell membranes. This disruption leads to increased membrane permeability and ultimately fungal cell death. It is fungistatic or fungicidal depending on the concentration and organism. (1)
What is the generic name of Itraconazole?
The generic name is itraconazole. It is sold under brand names including Canditral, Itrafungol, Itral, Sporanox, Sporanox Oral Solution, Tolsura.
What class of drug is itraconazole?
Itraconazole is classed as: Antifungal (Triazole antifungal agent).
References
- Itraconazole – Medicine RecordMedGuideGlobal · Global · accessed 2026-08-06 · source 1
- SPORANOX (itraconazole capsules) – prescribing informationU.S. National Library of Medicine DailyMed · United States · accessed 2026-08-06 · source 2
- ITRACONAZOLE CAPSULE [AMNEAL PHARMACEUTICALS LLC] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Itraconazole — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- ITRACONAZOLE — FDA approval record (Drugs@FDA ANDA206741)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- itraconazole — RxNorm normalized drug concept (RXCUI 28031)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient itraconazole names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Tolsura65 mg · mayne pharma commercial llc
- SPORANOX100 mg · janssen pharmaceuticals, inc.
Canada
- SPORANOX