9 mins read

Itraconazole is used to treat certain types of fungal infections. It stops fungi from growing. Common side effects include nausea, vomiting, diarrhea, constipation, and headache. Serious side effects can include liver damage and nerve problems. Itraconazole interacts with many other medicines. Tell your healthcare provider about all of the medicines you take before taking itraconazole. Itraconazole comes as a capsule and oral liquid.

Uses

What is itraconazole used for?

Itraconazole is an antifungal medicine commonly used to treat certain types of fungal infections. 

Itraconazole may not be appropriate for some of the infections listed above, depending on which germs are causing the infection. Fungi in some locations may have developed resistance to itraconazole, which will make it not work as well.

Itraconazole may also be used for other conditions as determined by your healthcare provider.

How does itraconazole work (mechanism of action)?

Itraconazole works by stopping the fungal growth causing the infection.

How is itraconazole supplied (dosage forms)?

Brand and other names

  • Sporanox
  • Tolsura

Dosage forms and strengths

  • 65 mg oral capsules
  • 100 mg oral capsules
  • 10 mg/mL oral solution

How should I store itraconazole?

Oral Capsules. Itraconazole should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from light and moisture. 

Oral Liquid. Itraconazole liquid should be stored at or below 25 C (77 F). Do not freeze.

Side Effects

What are the most common side effects of itraconazole?

The most common side effects of itraconazole are listed below. These side effects may vary depending on the itraconazole product you are prescribed. Tell your healthcare provider if you have any of these side effects that bother you.

  • Nausea, vomiting, stomach pain, diarrhea, or constipation
  • Headache 
  • Rash, itching 
  • Loss of appetite
  • Swelling
  • Fever
  • Menstrual disorder
  • Dizziness
  • Muscle or joint pain
  • Unpleasant taste
  • Hair loss
  • High blood pressure
  • Liver damage (see below)
  • Low potassium levels
  • General feeling of being unwell, tired, sleepy, or not having your usual energy
  • Low sex drive or trouble getting or maintaining an erection
  • Protein in your urine

There may be other side effects of itraconazole that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of itraconazole?

While less common, the most serious side effects of itraconazole are described below, along with what to do if they happen.

Severe Allergic Reactions. Itraconazole may cause allergic reactions, which can be serious. Stop taking itraconazole and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking itraconazole. This can be serious or life-threatening. Stop taking itraconazole and call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Nerve Problems. Nerves are the fibers that carry sensations from your body to the brain. Damage to these nerves, called peripheral neuropathy, can happen in people who are taking itraconazole. Stop taking itraconazole and call your healthcare provider if you develop pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet.

Hearing Loss. Itraconazole may cause hearing loss, which is also called ototoxicity. The hearing loss usually goes away after stopping itraconazole, but may be permanent for some people. Stop taking itraconazole and tell your healthcare provider right away if you have hearing loss or if you hear a ringing or roaring sound in your ears.

Heart Failure. Itraconazole may rarely increase your risk of heart failure. Stop taking itraconazole and tell your healthcare provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness
  • Coughing up pink or white mucus
  • Fast heartbeat
  • Waking up during the night more than usual

Warnings & Precautions

Who should not use itraconazole?

Allergies to Ingredients. People who are allergic to any of the following should not take itraconazole.

  • Itraconazole
  • Sporanox
  • Tolsura
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific itraconazole products they stock.

Heart Failure. You should not take itraconazole to treat fungal nail infections if you have or have a history of heart failure. If you have or have had heart failure, discuss with your healthcare provider whether it is safe for you to take itraconazole to treat other types of fungal infections.

Drug Interactions. Itraconazole should not be taken while you are using certain other medicines. Before taking itraconazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about itraconazole before using it?

Do not take itraconazole unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share itraconazole with other people, even if they have the same condition as you. It may harm them.

Keep itraconazole out of the reach of children.

There are several forms of itraconazole available and they may be used to treat different conditions. These forms may also be absorbed differently. You should not switch between forms of itraconazole without talking to your healthcare provider. Ask your healthcare provider if you are not sure how to take the itraconazole form you are prescribed. 

If you are prescribed itraconazole capsules, you should swallow the capsules whole. Do not chew, crush, or break the capsules.

If you are prescribed itraconazole oral liquid, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

Depending on the itraconazole product you are prescribed and why you are taking it, if you can become pregnant, you may need to use effective forms of birth control while taking itraconazole and for two months after your last dose. Talk with your healthcare provider about your birth control options. See the Pregnancy section for more details.

Itraconazole may sometimes cause dizziness or blurred vision. Do not drive or do other activities that require alertness or coordination until you know how itraconazole affects you.

People who are 65 and older can be at greater risk for some side effects from itraconazole. Talk to your healthcare provider about your risks if you are in this age group.

What should I tell my healthcare provider before using itraconazole?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if itraconazole is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart problems, including heart failure
  • Liver problems
  • Kidney problems
  • Lung problems, including cystic fibrosis or chronic obstructive pulmonary disease (COPD)
  • A weakened immune system, including HIV or AIDS
  • Achlorhydria, which is when your stomach does not have enough acid
  • Body swelling, known as edema

Pregnancy. Some forms of itraconazole may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant, contact your healthcare provider right away.

Breastfeeding. Itraconazole passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take itraconazole while breastfeeding.

Interactions

Does itraconazole interact with foods or drinks?

Oral Capsules. You should take itraconazole capsules with a full meal to help the medicine be absorbed by your body. 

Oral Solution. You should take itraconazole liquid on an empty stomach, if possible, to help the medicine be absorbed by your body.

It is unknown if drinking alcohol will affect itraconazole, but heavy drinking can slow your immune response and make it harder for your body to fight infection. The risk of dizziness, tiredness, and liver damage may also be increased if you drink alcohol while taking itraconazole.

Does itraconazole interact with other medicines (drug interactions)?

Itraconazole interacts with many other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. 

In particular, make sure that you discuss if you are using any of the following before taking itraconazole.

  • An opioid, such as oxycodone, methadone, or fentanyl, which is a medicine used for certain types of pain
  • Disopyramide, dronedarone (Multaq), or dofetilide, which is a medicine used to control your heart rate or rhythm (antiarrhythmic)
  • Isavuconazole (Cresemba), which is a medicine for fungal infections
  • An ergot, such as ergotamine (Ergomar) or dihydroergotamine (Migranal or Trudhesa), which is a medicine used to treat migraine
  • Lurasidone (Latuda), which is a medicine for certain mental health conditions
  • A benzodiazepine, such as alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium and others), lorazepam (Ativan and others), midazolam, or triazolam (Halcion), which is a medicine used for anxiety, muscle spasms, or seizures
  • A calcium channel blocker, such as felodipine, nisoldipine, diltiazem (Cardizem CD and others), or verapamil (Verelan, Verelan PM), which is a medicine used for high blood pressure and other conditions
  • An alpha-blocker, such as terazosin, doxazosin, alfuzosin, or prazosin, which is a medicine that may be used for high blood pressure and/or difficulty peeing due to an enlarged prostate
  • A medicine to reduce stomach acid, such as an antacid, an H2 blocker (such as cimetidine, famotidine, or nizatidine), or a proton pump inhibitor (such as esomeprazole, lansoprazole, omeprazole, pantoprazole, or rabeprazole)
  • Ivabradine (Corlanor), which is commonly used for heart failure
  • Medicines within the past two weeks that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as pimozide or quinidine
  • Ranolazine (Aspruzyo Sprinkle), which is a medicine used for chest pain
  • Naloxegol (Movantik), which is used to treat constipation from pain medicines
  • Lomitapide (Juxtapid) or a statin, such as atorvastatin (Lipitor and others), lovastatin, simvastatin, or rosuvastatin (Crestor), which is a medicine to lower cholesterol
  • A phosphodiesterase-5 (PDE-5) inhibitor, such as avanafil (Stendra), which is a medicine used for erectile dysfunction
  • A blood thinner or antiplatelet medicine, such as ticagrelor (Brilinta), apixaban (Eliquis), rivaroxaban (Xarelto), warfarin, or cilostazol, which is a medicine used to prevent blood clots
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Finerenone (Kerendia) or voclosporin (Lupkynis), which is a medicine used for kidney problems
  • Fesoterodine (Toviaz) or solifenacin (Vesicare), which is a medicine used for bladder problems 
  • Eliglustat (Cerdelga), which is a medicine used to treat Gaucher’s disease
  • Venetoclax (Venclexta), irinotecan (Camptosar), or other medicines used to treat cancer
  • Tolvaptan (Samsca, Jynarque), which is a medicine used for low sodium levels
  • Eplerenone (Inspra), which is commonly used for heart failure and high blood pressure
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • A selective serotonin reuptake inhibitor (SSRI), tricyclic antidepressant, or antipsychotic, which is a medicine for certain mental health conditions
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
  • Colchicine, which is commonly used for gout
  • A nonsteroidal anti-inflammatory drug (NSAID), such as meloxicam, which is used for pain and swelling
  • A medicine for influenza, HIV, AIDS, or hepatitis C
  • A macrolide or fluoroquinolone antibiotic, which is a medicine used for bacterial infections
  • Any medicine for seizures, such as carbamazepine, phenytoin, or phenobarbital

Many other medicines may alter the blood levels of itraconazole, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with itraconazole. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much itraconazole?

If you or someone else has used too much itraconazole, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of itraconazole?

It is important to complete your prescribed course of itraconazole, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to itraconazole or other similar medicines.

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 only take the next dose. Do not take double or extra doses.