Sporanox: Advanced Antifungal Treatment for Systemic Infections
| Product dosage: 100mg | |||
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Sporanox (itraconazole) is a broad-spectrum triazole antifungal agent designed for the systemic treatment of a wide range of fungal infections. It is indicated for both immunocompetent and immunocompromised patients, offering a potent therapeutic option against invasive and superficial mycoses. Its lipophilic properties ensure extensive tissue penetration, making it effective in hard-to-reach anatomical sites. Prescribed under medical supervision, Sporanox represents a cornerstone in antifungal therapy due to its reliability and well-documented efficacy.
Features
- Active ingredient: Itraconazole 100 mg per capsule
- Formulation: Oral capsules with hydroxypropyl-β-cyclodextrin for enhanced bioavailability
- Spectrum: Broad activity against dermatophytes, yeasts, molds, and endemic fungi
- Pharmacokinetics: High tissue penetration with concentration in skin, nails, and lungs exceeding plasma levels
- Administration: Once or twice daily dosing depending on indication
- Availability: Prescription-only medication in most jurisdictions
Benefits
- Effectively eradicates systemic fungal infections, reducing morbidity and risk of dissemination
- High cure rates in onychomycosis and dermatophytoses, improving patient quality of life
- Suitable for long-term therapy with established safety profiles in monitored use
- Prevents recurrence of certain fungal infections when used as prophylaxis in high-risk patients
- Offers an oral alternative to intravenous antifungals in appropriate cases, facilitating outpatient management
- Demonstrated efficacy in histoplasmosis, blastomycosis, and aspergillosis, filling a critical therapeutic niche
Common use
Sporanox is commonly prescribed for the treatment of blastomycosis, histoplasmosis (including chronic cavitary pulmonary disease and disseminated nonmeningeal histoplasmosis), and aspergillosis in patients who are intolerant of or refractory to amphotericin B therapy. It is also used for fungal infections of the toenails and fingernails (onychomycosis) caused by dermatophytes, as well as oral and esophageal candidiasis. Off-label uses may include treatment of sporotrichosis, chromoblastomycosis, and certain cases of cryptococcosis, though these require careful clinical evaluation.
Dosage and direction
Dosage must be individualized based on infection type, patient weight, and renal/hepatic function. For systemic fungal infections like blastomycosis and histoplasmosis, a loading dose of 200 mg three times daily for the first 3 days is recommended, followed by 200 mg once or twice daily. Treatment typically continues for a minimum of 3 months until clinical parameters and laboratory tests indicate resolution. For onychomycosis, pulsed dosing is often employed: 200 mg twice daily for 1 week per month, repeated for 2-3 months depending on infection site (toenails generally require an additional pulse). Capsules should be taken with a full meal to maximize absorption.
Precautions
Hepatic function should be monitored in all patients receiving Sporanox, as rare cases of serious hepatotoxicity have been reported. Use with caution in patients with pre-existing liver disease or elevated transaminases. Cardiac function should be assessed prior to initiation due to risk of negative inotropic effects; avoid in patients with ventricular dysfunction or history of heart failure. Electrolyte imbalances, particularly hypokalemia and hypomagnesemia, should be corrected before and during therapy. Sporanox is not recommended during pregnancy unless the potential benefit justifies the potential risk to the fetus.
Contraindications
Sporanox is contraindicated in patients with known hypersensitivity to itraconazole or any excipient in the formulation. Coadministration with certain drugs metabolized by CYP3A4 is strictly contraindicated due to risk of life-threatening arrhythmias: these include quinidine, dofetilide, pimozide, levacetylmethadol, and ergot alkaloids. It is also contraindicated in patients with evidence of ventricular dysfunction such as congestive heart failure (CHF) or a history of CHF. Concurrent use with CYP3A4 substrates like triazolam, oral midazolam, lovastatin, or simvastatin is contraindicated.
Possible side effect
Common adverse reactions include nausea, abdominal pain, dyspepsia, and headache. Elevated liver enzymes may occur in up to 5% of patients. Less frequently, rash, pruritus, dizziness, and peripheral edema have been reported. Serious side effects include clinical hepatitis, cholestasis, and fulminant liver failure (rare), Stevens-Johnson syndrome, hypokalemia, hypertension, and hearing loss. Cases of congestive heart failure and pulmonary edema have been documented, particularly in patients with cardiac risk factors.
Drug interaction
Sporanox is a potent inhibitor of CYP3A4 and P-glycoprotein, leading to numerous clinically significant interactions. Coadministration with cisapride, ergot alkaloids, or HMG-CoA reductase inhibitors metabolized by CYP3A4 (e.g., simvastatin, lovastatin) is contraindicated. Dose adjustments or alternatives are required when using with warfarin, digoxin, cyclosporine, tacrolimus, midazolam, triazolam, certain antiretrovirals, and calcium channel blockers. Concomitant use with enzyme inducers like rifampin, phenytoin, or carbamazepine may significantly reduce itraconazole plasma concentrations.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Consistency in dosing is important to maintain therapeutic drug levels, particularly given the drug’s pharmacokinetics.
Overdose
There is no specific antidote for itraconazole overdose. Symptoms may include exaggerated adverse effects such as nausea, vomiting, diarrhea, hepatotoxicity, and hypertension. In cases of recent ingestion, gastric lavage and administration of activated charcoal may be considered. Supportive measures should be instituted, with particular attention to electrolyte balance, hepatic function, and cardiac monitoring. Hemodialysis is unlikely to be effective due to high protein binding.
Storage
Store Sporanox capsules at room temperature (15–25°C or 59–77°F) in their original container, protected from light and moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging.
Disclaimer
This information is intended for healthcare professionals and educated patients as a summary of product characteristics. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations and to discuss potential risks and benefits based on individual health status and concurrent medications. Dosage and administration should strictly follow prescribing information and clinical guidelines.
Reviews
Clinical studies and post-marketing surveillance indicate high physician satisfaction with Sporanox for indicated systemic mycoses, noting its efficacy and generally manageable side effect profile when appropriately monitored. Some reviews highlight the convenience of oral administration compared to intravenous alternatives. Criticisms occasionally mention gastrointestinal side effects and the necessity for therapeutic drug monitoring in certain populations. Overall, it remains a valued option in the antifungal armamentarium.