The People's Perspective on Medicine

Itraconazole

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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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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