Antifungal Sporanox (itraconazole)
The brand name of Sporanox is itraconazole which is an azole antifungal substance.
Composition of Sporanox
Itraconazole is a 1:1:1: racemic mixture of two enantiomeric pairs, each having 3 chiral centers. The chemical formula of itraconazole is C35H38Cl2N8O4. The molar mass of this compound is 705.64 g/mol. It is very less soluble in alcohols, insoluble in water and soluble in dichloromethane. Sporanox capsules consist of 100 mg itraconazole having a coating of sugar sphere (made of maize starch, purified ware and sucrose).
Uses of Sporanox
Sporanox capsules are used for the treatment of the below mentioned fungal infections in non-immunocompromised and immunocompromised patients:
- Pulmonary and extrapulmonary blastomycosis.
- Histoplasmosis which includes non-meningeal histoplasmosis and chronic cavitary pulmonary disease.
- Pulmonary & extrapulmonary aspergillosis in patients who are sensitive to amphotericin B treatment.
Sporanox capsules are also used to treat the non-immunocompromised patients for the following fungal infections:
- Onychomycosis of the fingernail because of tinea unguium (dermatophytes).
- Toenail onychomycosis with/without the involvement of fingernail caused due to dermatophytes.
How to Use Sporanox
Sporanox capsules must be taken with a full meal to obtain maximal absorption. The capsules have to be swallowed as a whole. The recommended dose for the treatments of histoplasmosis and blastomycosis is 200 mg (2 capsules) daily. To treat aspergillosis, a daily dose of 200-400 mg has to be taken. For the treatment of onychomycosis, the recommended dosage is 200 mg once in a day for 12 consecutive weeks.
Sporanox has been related to cause serious hepatotoxicity comprising of liver death and failure in rare cases. Treatment should be discontinued if the clinical symptoms related to liver disease are developed. You should reassess the benefits and risks of Sporanox capsules before use. Some serious side-effects are as follows:
- Abdominal Pain
- Decreased libido
- Abnormal hepatic function
- Impotence in males
- Gastrointestinal problems
Some adverse reactions unusually reported include gastritis, constipation, insomnia, depression, adrenal insufficiency, menstrual disorder, tinnitus, breast pain in mail and gynecomastia.
Contraindications of Sporanox
Sporanox should not be giver the treatment of onychomycosis in patients having ventricular dysfunction like congestive heart failure (CHF). Coadministrations of Substrates of CYP3A4 are contraindicated with the use of Sporanox. Increase of plasma concentrations for the following medications: dofetilide, methadone, disopyramide, quinidine, dronedarone, ergot alkaloids, lurasidone etc. For patients having hypersenstitivity to itraconazole and other azole antifungals, the use of Sporanox is contraindicated.
Sporanox and Pregnancy
It is not clearly known whether the drug causes any danger to the unborn baby or not. Therefore itraconazole should be used for the treatment of the fungal infections in pregnant women only when the advantages overpower the potential risks. For treating onychomycosis in pregnant women, Sporanox should not be administered. Itraconazole can pass into the breast milk, pregnant women should not use Sporanox tablets.
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