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Sporanox (itraconazole) is a potent azole antifungal medication used in a range of fungal infections. It can be used in patients age 18 and up; use in younger patients has not been studied well and should not be attempted without doctor involvement.

This product is usually used to treat:

• Aspergillosis (caused by fungi of the genus Aspergillus)
• Blastomycosis (caused by Blastomyces dermatitidis)
• Coccidioidomycosis (caused by Coccidioides immitis or Coccidioides posadasii)
• Histoplasmosis (caused by Histoplasma capsulatum)
• Paracoccidioidomycosis (caused by Paracoccidioides brasiliensis)
• Onychomycosis (infection of toenails or fingernails)
• Oral or esophageal candidiasis (caused by fungi of the genus Candida)

In simpler terms, it's usually used to treat fungal infections of the lungs or fingernails and toenails. Sporanox can be used in both immunocompromised and non-immunocompromised patients to treat all but nail fungus; for nail fungus it's suitable for non-immunocompromised patients only.

Sporanox is also available in a few formulas:

• Oral solution - primarily used to treat oral or esophageal candidiasis. Taken on an empty stomach. Not interchangeable with other formulations.
• Tablets - used only for treating toenail fungus. Taken with a meal. Not interchangeable with oral solution.
• Capsules - the most common and versatile formulation, used for everything except oral or esophageal candidiasis. Taken with a meal. Not interchangeable with oral solution.

The oral solution is no longer available in the USA. It can be found elsewhere, but it's probably easier for patients to buy an alternative product. The rest of this article will focus on capsules.

Taking Sporanox

Sporanox is relatively well-tolerated by most patients, and when it does produce side effects they're generally similar to those produced by other antifungals. Like most antifungals the medication is poorly absorbed on an empty stomach; it's important that capsules are taken with a meal.

It is critical that capsules be swallowed whole; they should not be opened. Capsules are fairly complex to ensure release and absorption is maximized.

Treatment begins with the offending fungi being identified. If it's susceptible to Sporanox, dosage and duration of treatment depends on the condition being treated and it's severity, which often depends on how long the infection has been present in the body.

Dosage typically ranges from 100 to 400 mg per day, sometimes as high as 600 mg. Any dose higher than 200 mg is usually divided into two or more daily doses, with the exception of treating toenail fungus. In all cases except fingernails, toenails, and oral or esophageal candidiasis, treatment can vary widely:

• Start with 200 mg per day.
• In more severe infections this may be increased to 400 mg per day.
• In life-threatening cases, 600 mg per day may be given for the first three days, before being reduced to 200 or 400 mg for the remainder of treatment.
• Treatment should continue for three months to one year, sometimes longer, until screens for the fungus show it has been eradicated.

To treat fingernail fungus:

• Take 200 to 400 mg per day for one week.
• Stop taking the medication for three weeks.
• Take 200 to 400 mg per day for another week.

And toenail fungus:

• Take 200 mg once per day for twelve consecutive weeks.

It's important that treatment continue until the infection is cleared up; failure to complete treatment, in addition to leaving the patient vulnerable to reinfection, contributes to antifungal resistance.

Patients taking Sporanox will likely be subjected to regular screenings to monitor for developing side effects. If potentially severe side effects are found, the patient will likely be switched to a different antifungal. Patients should be alert for symptoms of liver impairment, including jaundice, pale stools, abdominal pain (especially if it radiates to the back), and severe fatigue.

Sporanox can interact with other medications, sometimes severely. Check with a doctor or pharmacist before mixing treatments while taking Sporanox.