💡 Γρήγορη Απάντηση
Itratuf is itraconazole 100 mg oral capsule — a triazole antifungal for dermatophyte nail and skin infections, oropharyngeal/oesophageal candidiasis, histoplasmosis, blastomycosis, and aspergillosis (alternative to voriconazole). Capsule absorption requires gastric acid — take with food and acidic drink; PPIs and H2-blockers reduce absorption substantially. Strong CYP3A4 inhibitor — many drug interactions. Mandatory ECG / heart-failure screening — itraconazole has a negative inotropic effect.
WHO-GMP
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Διακριτική συσκευασία
plain envelope
Παγκόσμια αποστολή
to most countries
🔒 Why order Itratuf from MedsBase
- πιστοποιημένο από τη WHO-GMP κατασκευαστή — sourced from a regulated facility, finished pack with batch number and expiry.
- Διακριτική συσκευασία — plain envelope, no medication name on the outside.
- Παγκόσμια αποστολή to most countries with Reshipment Assurance.
- Loyalty points — 1 point per $1 spent (excludes peptides/shipping); 100 points = $5 off your next order.
Uses & indications
Itratuf (itraconazole 100 mg, Maneesh Pharma) is a broad-spectrum triazole antifungal active against dermatophytes, yeasts (Candida), dimorphic fungi (Histoplasma, Blastomyces, Sporothrix, Paracoccidioides), and most Aspergillus species. The capsule is the standard oral formulation; a separate oral solution exists with different food-rules (taken on an empty stomach) and is the preferred form for oesophageal candidiasis.
| Ενδείξεις | Typical regimen |
|---|---|
| Onychomycosis (toenail) | Pulse: 200 mg twice daily × 1 week per month, repeat × 3 pulses (or continuous 200 mg/day × 12 weeks) |
| Onychomycosis (fingernail) | Pulse: 200 mg twice daily × 1 week per month × 2 pulses |
| Tinea pedis / cruris / corporis | 100 mg/day × 15 days OR 200 mg/day × 7 days |
| Pityriasis versicolor | 200 mg/day × 7 days |
| Oropharyngeal candidiasis | 100–200 mg/day × 7–14 days |
| Histoplasmosis / blastomycosis | 200 mg twice daily × 6–12 months (induction with amphotericin B in severe disease) |
| Aspergillosis (after voriconazole / amphotericin B) | 200 mg twice daily, duration depends on response |
How to take — the absorption rule matters
- Swallow whole — do not crush or chew.
- Take at the same times each day to keep blood levels steady.
- Do not stop early — onychomycosis pulse therapy needs all 3 pulses even though nails take months to look normal.
- If you take an antacid, separate by at least 2 hours.
Πώς λειτουργεί
Itraconazole inhibits fungal CYP51 (14-α-demethylase), blocking conversion of lanosterol to ergosterol and weakening the fungal cell membrane. Compared to fluconazole, itraconazole is more lipophilic — it concentrates in skin, nails, and adipose tissue at concentrations 4–10× plasma levels, and persists in the nail bed for weeks after dosing. This is why pulse-dosing works for onychomycosis: you only need 1 week of dosing per month because the drug stays in the nail.
Side effects & monitoring
| Συχνότητα | Typical effects |
|---|---|
| Common (≥1/100) | Nausea, abdominal pain, diarrhoea, headache, transient LFT rise, rash, peripheral oedema |
| Ασυνήθιστες | Hypokalaemia, dizziness, menstrual disorders, alopecia, paraesthesia |
| Σπάνια αλλά σοβαρή | Hepatotoxicity (FDA black-box: stop if jaundice, dark urine, persistent nausea), congestive heart failure (FDA black-box: avoid in symptomatic LV dysfunction), severe skin reactions (SJS/TEN), peripheral neuropathy, hearing loss |
Drug interactions — itraconazole is a strong CYP3A4 inhibitor
| Φάρμακο | Αποτέλεσμα | Action |
|---|---|---|
| PPIs / H2-blockers / antacids | Reduce capsule absorption | Take with cola; or use oral solution; or hold acid-suppression |
| Rifampicin / rifabutin / phenytoin / carbamazepine / phenobarbital | CYP3A4 induction → low itraconazole levels | Avoid combination — switch antifungal class |
| Simvastatin / atorvastatin / lovastatin | Statin levels rise → rhabdomyolysis | Stop statin during itraconazole; or switch to pravastatin / rosuvastatin |
| Quinidine, dofetilide, pimozide, cisapride, terfenadine | QT prolongation → torsades | Αντενδεικνύεται |
| Midazolam (oral), triazolam, alprazolam | Excessive sedation | Avoid; use lorazepam (non-CYP) |
| Tacrolimus / ciclosporin / sirolimus | Levels rise — toxicity | Reduce dose 50%; trough monitoring |
| Βαρφαρίνη | INR rises | Monitor INR; reduce warfarin |
| Vinca alkaloids (vincristine, vinblastine) | Neurotoxicity, ileus | Avoid combination |
| Buprenorphine, fentanyl | Increased opioid effect | Reduce opioid dose; monitor sedation |
| Apixaban, rivaroxaban, edoxaban | DOAC levels rise — bleeding | Avoid combination; bridge with LMWH |
Who should not take itraconazole
- Symptomatic congestive heart failure or ventricular dysfunction (for onychomycosis indication especially).
- Pregnancy (animal teratogenicity, contraindicated except in serious systemic mycoses).
- Concurrent QT-prolonging drugs listed above.
- Concurrent simvastatin/atorvastatin/lovastatin at full dose.
- Severe hepatic impairment or active hepatitis.
Pregnancy & breastfeeding
Itraconazole is contraindicated in pregnancy for onychomycosis (a non-life-threatening indication). For systemic mycoses (histoplasmosis, blastomycosis, aspergillosis), benefits may outweigh risks — discuss with a specialist. Effective contraception is required during therapy and for 2 months after the last dose. Itraconazole is excreted in breast milk at low levels — short courses may be compatible; prolonged maintenance therapy is not recommended during breastfeeding.
Συχνές Ερωτήσεις
How long until my nail looks normal?
The drug clears the fungus in 12 weeks but the dead nail keeps growing out for months. Toenails take 9–12 months to look fully normal; fingernails 4–6 months. Photo at month 0, 3, 6, 12 to track progress objectively.
What is ‘pulse therapy’ and why does it work?
Itraconazole concentrates in the nail at 4–10× plasma levels and persists for weeks after dosing. Pulse therapy = 200 mg twice daily for 1 week, then 3 weeks off, repeat × 3. Cumulative cure rate for toenails ~70%, similar to continuous dosing but with less drug exposure and lower cost.
Why does my doctor want an ECG before I start?
Itraconazole has a negative inotropic effect and can prolong QT. Patients with risk factors (existing heart failure, age > 70, previous cardiotoxic chemotherapy) should have a baseline ECG. Look for prolonged QTc > 500 ms — itraconazole would be avoided.
Can I take itraconazole with my omeprazole?
Itraconazole capsule absorption is reduced by 40–60% on a PPI. Either: (a) hold the PPI during the 1-week pulse, (b) take itraconazole with a cola to provide acid, or (c) switch to itraconazole oral solution (different formulation, taken on empty stomach), or (d) use terbinafine instead (no acid requirement).
Itraconazole vs terbinafine for toenail fungus — which is better?
For dermatophyte onychomycosis (the common cause), terbinafine 250 mg daily × 12 weeks has a slightly higher cure rate (~76% vs ~63%) and fewer drug interactions. Itraconazole pulse is preferred when the cause is mixed (dermatophyte + non-dermatophyte mould or Candida) or when terbinafine is contraindicated.
Will my toenail fall off?
No — the dead, fungus-affected nail grows out from the cuticle. As new healthy nail grows in, the old discoloured portion is gradually clipped away over 9–12 months.
Can I drink alcohol while taking itraconazole?
Both itraconazole and alcohol stress the liver. Limit alcohol intake during therapy, especially during a 12-week continuous course. Avoid heavy drinking entirely. There is no acute disulfiram-like reaction.
What about pregnancy if I am of childbearing potential?
Itraconazole is teratogenic in animals. Use effective contraception during therapy and for 2 months after the last dose (the half-life from skin/nail compartment is long). Onychomycosis is rarely treated during pregnancy — wait until after delivery and breastfeeding.
Why do I need LFTs before starting?
Itraconazole can cause hepatotoxicity including rare fatal cases. Baseline LFTs let you spot pre-existing abnormality. Repeat LFTs at 1 month if continuous; or at any sign of jaundice/dark urine/persistent nausea. Stop drug if AST/ALT > 3× ULN.
What if I miss a dose during pulse therapy?
Take it as soon as you remember on the same day. If you miss a whole day, do not double up — the next day’s dose is sufficient. If you miss 2+ days during a 1-week pulse, complete the pulse and continue with the planned schedule.
Αποθήκευση
Store capsules at 15–25 °C in the original blister, protected from light and moisture. Do not use after expiry. Keep out of reach of children.
Other Antifungal Medications you may be interested in
If Itratuf is unavailable, here are alternatives — same molecule from a different manufacturer, terbinafine for straightforward dermatophyte nail/skin infections, or fluconazole for Candida.
- Zimig (terbinafine 250 mg) — First-line for dermatophyte onychomycosis; ~76% cure rate.
- Sporanox (itraconazole 100 mg) — Pulse therapy for non-dermatophyte mould or mixed Candida onychomycosis.
- Grisovin FP (griseofulvin) — Tinea capitis caused by Microsporum (paediatric).
- Loceryl (amorolfine 5%) — Topical lacquer for mild distal-edge nail fungus.
- Zocon (fluconazole 150 mg) — Standard oral therapy for Candida (vaginal, oral, oesophageal thrush).
























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