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Canadian Journal of Infectious Diseases
Volume 5, Issue 4, Pages 179-183
Brief Communication

Itraconazole: Precautions Regarding Drug Interactions and Bioavailability

Michael PE Puttick2 and Peter Phillips1

1Department of Medicine, St Paul’s Hospital, Vancouver, British Columbia, Canada
2Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia, Canada

Received 14 October 1993; Accepted 1 February 1994

Copyright © 1994 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective: To describe patients with fungal infections in whom drug interactions and bioavailability problems were associated with itraconazole treatment failure.

Design: Retrospective chart review.

Setting: Two tertiary care university-affiliated teaching hospitals.

Population Studied: Itraconazole-treated patients between 1990 and 1992.

Main Results: Four patients treated with itraconazole were identified in whom suboptimal serum itraconazole levels were associated with relapse of disseminated histoplasmosis, treatment failure of invasive aspergillosis or development of superficial mycoses. Low serum itraconazole levels were associated with concurrent therapy with rifampin or agents inhibiting gastric acid secretion, with administration of itraconazole capsule contents through a nasogastric tube or with the presence of aids.

Conclusions: It is recommended that serum itraconazole levels be measured in patients with potentially life-threatening mycoses if coexistent factors may interfere with itraconazole therapy.