The influence of food on the pharmacokinetics of itraconazole in patients with superficial fungal infection

Abstract

Itraconazole in a new, orally active triazole, which is related to ketoconazole and which is active against dermatophytes and Candida and Cryptococcus organisms. It is more potent than ketoconazole, is better absorbed with food, and does not suppress testosterone or cortisol synthesis. In previous studies, daily 200 mg doses of itraconazole for 5 days cleared 80% of cases of pityriasis versicolor, and 90% of dermatophyte infections were cleared by daily 100 mg doses administered for 1 month. Twenty patients with superficial dermatophyte, Candida albicans, and pityriasis versicolor infections were treated with doses of 50 or 100 mg per day; in the first group of 10 patients, the drug was administered before breakfast and the other 10 patients were given their dose with breakfast. Itraconazole concentration was determined by high-performance liquid chromatography 3 hours after administration of first and last doses. Our findings showed that although treatment with 50-mg doses led to poorer results and lower plasma levels than 100-mg doses, taking the drug with breakfast gave much better results than taking it before.