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Generic Name: Itraconazole
Brand Name(s):
Information updated: April 1, 2000
Overview
Sporanox is a relatively recent antifungal medicine used to treat certain
serious fungal infections such as Histoplasmosis as well as toe- or fingernail
fungus.
It is also prescribed for treatment and maintenance therapy of
fungal infections in patients with HIV.
Side Effects and Interactions
Side effects that have been reported with
Sporanox include nausea, vomiting, diarrhea, and stomach pain.
Liver
enzymes occasionally become elevated. Patients with liver disease or those
taking Sporanox for more than a month at a times should be tested periodically
for liver enzyme levels.
Other side effects may include rash, swelling of
the arms or legs, high blood pressure, dizziness upon standing up suddenly,
fatigue, headache, sexual difficulties, and low potassium levels.
Report
any side effects to the physician promptly.
Sporanox inhibits the CYP 450
3A4 enzyme in the liver and the wall of the intestine. Drugs metabolized by this
enzyme could reach dangerously high levels if they were given the same day as
Sporanox.
These include Seldane, Hismanal, and Propulsid. These
interactions can be lethal and must be avoided.
Other drugs that may
interact with Sporanox include certain calcium channel blockers such as Plendil,
Procardia, and Sular; heart drugs such as Coumadin, Lanoxin, or quinidine;
Halcion, oral midazolam (not available in the U.S.), oral blood-sugar-lowering
medicines such as DiaBeta, and the transplant drugs cyclosporine and tacrolimus.
Such combinations should be avoided whenever possible. Careful
monitoring is required if both drugs are needed.
A few women becoming
pregnant while on birth control pills were taking Sporanox. Although this is not
a confirmed interaction, backup contraception is advised.
Sporanox
requires stomach acid for proper absorption, which is why it should be taken
with a meal when stomach acid is at its peak.
Medications such as
Zantac, Tagamet, or Prilosec that can substantially reduce stomach acidity may
interfere with Sporanox being well absorbed. This can be counteracted to a large
measure by swallowing the pills with an acidic beverage such as cola.
Dilantin, Videx (ddI), and rifampin can all lower Sporanox blood levels
and may interfere with effectiveness.
Check with your physician and
pharmacist to make sure Sporanox is safe in combination with any other drug you
may take.
Special Precautions
Sporanox interacts with a number of other medications in potentially life-threatening ways. It should not be taken by anyone who is taking one of those medicines.
Taking the Medicine
For best absorption, Sporanox should be taken with a meal.
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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio.
© 2000