Itraconazole is an antifungal medicine used to treat several forms of aspergillosis. It belongs to a group of medicines called triazole antifungals. It does not usually make people feel better immediately: its purpose is to reduce or control the fungal infection over time.
What is itraconazole used for?
Your specialist may prescribe itraconazole for conditions including:
- chronic pulmonary aspergillosis (CPA)
- allergic bronchopulmonary aspergillosis (ABPA)
- Aspergillus bronchitis
- severe asthma with fungal sensitisation (SAFS)
It is not the right medicine for everyone. The choice depends on your diagnosis, other medicines, test results and how well you tolerate treatment.
What benefits might I notice?
For people with CPA, itraconazole may help control fungal activity, stabilise symptoms and reduce the risk of the infection progressing. For people with ABPA, it may reduce the amount of fungal material in the airways and, for some people, reduce the need for steroid treatment.
Benefits are often gradual. Your clinical team will judge whether it is helping by looking at your symptoms, scans, blood tests and other results.
How to take itraconazole
Itraconazole comes in more than one formulation. Capsules are normally taken straight after a full meal, while the oral solution is usually taken on an empty stomach. Follow the instructions on your own pharmacy label exactly.
Do not swap capsules for liquid, or change the way you take them, without speaking to your specialist team or pharmacist. The different formulations are absorbed differently.
Medicines that can reduce absorption
Acid-reducing medicines, including proton pump inhibitors such as omeprazole and lansoprazole, H2 blockers, and indigestion remedies or antacids, can reduce absorption of itraconazole capsules. This does not necessarily mean you must stop them: your team may be able to adjust the timing, formulation or treatment plan. Ask before making any change.
Why monitoring matters
Itraconazole levels in the blood can vary considerably between people. Your team may arrange therapeutic drug monitoring (TDM), especially after starting treatment, changing the dose or formulation, or if the medicine does not seem to be working as expected.
You will also usually have liver blood tests before treatment and at intervals during longer courses. These checks help your team make sure you are getting enough medicine to work, without exposing you to unnecessary risk.
Interactions: an essential safety check
Itraconazole can interact with many prescription medicines, over-the-counter products and herbal remedies. Some interactions can be serious.
Always tell your doctor, pharmacist and aspergillosis team about everything you take, including inhalers, steroids, blood-thinning medicines, cholesterol medicines, sleeping tablets, heart medicines, transplant or immune-suppressing medicines, vitamins and herbal products.
Do not start, stop or change another medicine without checking first. This includes St John’s wort, which can make itraconazole less effective. Avoid grapefruit and grapefruit juice unless your own pharmacist or specialist has advised otherwise.
Possible side effects
Many people tolerate itraconazole well. Possible side effects include:
- feeling or being sick
- indigestion, stomach discomfort or diarrhoea
- headache
- tiredness
- rash or itching
Contact your clinical team promptly if you notice:
- tingling, numbness, burning pain or weakness in your hands or feet
- new ankle or leg swelling, unexpected weight gain, worsening breathlessness or palpitations
- persistent nausea, vomiting, loss of appetite or marked tiredness
- dark urine, pale stools, yellow skin or eyes, or pain in the upper right side of your abdomen
- a new or worsening rash
Seek urgent medical help for severe breathlessness, chest pain, fainting, swelling of the face or throat, or a severe blistering or peeling rash.
Practical reminders
- Take itraconazole exactly as prescribed.
- Do not alter the dose or stop treatment suddenly unless your prescribing team tells you to.
- Keep your blood-test and clinic appointments.
- Tell your pharmacist that you take itraconazole whenever a new medicine is suggested.
- If you are having side effects or finding the routine difficult, contact your team early. Often there are options to discuss.
Key message
Itraconazole can be an important treatment for aspergillosis, but it works best when it is taken consistently and monitored carefully. Regular blood tests and a thorough check of your other medicines are a normal and important part of safe treatment.
This page is general information and does not replace advice from your own specialist team.
Further information
- Electronic Medicines Compendium: patient information leaflets
- Report suspected side effects through the MHRA Yellow Card scheme
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