Effects of itraconazole: A Synthesis of Findings from 6 Studies

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Original Abstract of the Article

Major research findings

Itraconazole and fluconazole significantly reduced the clearance of midazolam, affecting the pharmacokinetics of midazolam. 3 This effect was more pronounced with oral midazolam than with intravenous midazolam. 3 Furthermore, itraconazole has been shown to increase the plasma concentrations and effects of triazolam. 4 Itraconazole may be effective in treating systemic mycoses in neutropenic patients. 2 Additionally, itraconazole may be effective in treating Candida and Aspergillus infections in neutropenic patients. 1 Posaconazole has also been shown to affect the pharmacokinetics of midazolam. 5

Benefits and risks

Benefit Summary

Itraconazole may be effective in treating systemic mycoses, Candida infections, and Aspergillus infections in neutropenic patients. 2 1 Furthermore, it may enhance the therapeutic effects of fungal skin diseases when combined with terbinafine. 6

Risk Summary

Itraconazole can reduce the clearance of midazolam, affecting the pharmacokinetics of midazolam and potentially increasing its effects. 3 This effect is particularly pronounced with oral administration. 3 Additionally, caution is advised when combining itraconazole with triazolam, as it can increase the plasma concentrations and effects of triazolam. 4 Dosage adjustments for midazolam may be necessary when itraconazole is co-administered. 3 Furthermore, posaconazole has also been shown to affect the pharmacokinetics of midazolam. 5 Therefore, it is crucial to consult with a pharmacist or doctor if taking itraconazole or posaconazole with midazolam.

Comparison between studies

Commonalities

Multiple studies have shown that itraconazole affects the pharmacokinetics of midazolam. 3 5 Additionally, itraconazole has been shown to potentially be effective in treating fungal infections in neutropenic patients. 2 1

Differences

The extent of the interaction between itraconazole and midazolam varies across studies. 3 5 Additionally, the administration method of itraconazole and co-administered drugs can influence its effects and side effects. 2 1 6

Consistency and contradictions in results

Multiple studies consistently demonstrate that itraconazole affects the pharmacokinetics of midazolam. 3 5 However, the extent of this effect and its clinical significance vary across studies. 3 5

Important considerations for real-world applications

Dosage adjustments for midazolam may be necessary when itraconazole is co-administered. 3 Additionally, special caution is needed when itraconazole is co-administered with triazolam. 4 Consulting with a doctor or pharmacist is crucial when taking itraconazole with midazolam and triazolam.

Limitations of current research

Current research indicates a need for more detailed information about the effects of itraconazole under various circumstances. 3 2 1 5 For instance, research is needed to determine how factors such as the administration method of itraconazole, co-administered drugs, patient age and gender, and renal and hepatic function affect the effects and side effects of itraconazole. 3 2 1 5

Future research directions

More detailed research is required on the effects of itraconazole. 3 2 1 5 Specifically, research is needed to investigate how interactions between itraconazole and other drugs, the administration method of itraconazole, and co-administered drugs affect the effects and side effects of itraconazole. 3 2 1 5

Conclusion

Itraconazole may be effective in treating fungal infections, but it is important to be aware of potential interactions with other drugs such as midazolam. 3 2 1 5 When taking itraconazole, it is important to consult with a doctor or pharmacist and obtain appropriate information.

Literature analysis of 6 papers
Positive Content
2
Neutral Content
3
Negative Content
1
Article Type
6
0
0
0
6
1.

Itraconazole in neutropenic patients.

Author: van't WoutJ W

Fungal infection treatment
Itraconazole absorption

A study of 32 neutropenic patients with fungal infections compared the effectiveness of itraconazole and amphotericin B. Both treatments were effective against Candida infections, with 9 out of 16 patients responding to amphotericin B and 10 out of 16 responding to itraconazole. Itraconazole was more effective against Aspergillus infections, with 6 out of 8 patients responding compared to 2 out of 5 on amphotericin B. While amphotericin B treatment was associated with three deaths from Aspergillus infections, no deaths occurred in the itraconazole group. The study suggests that itraconazole may be a promising treatment for systemic fungal infections in neutropenic patients, although further research is needed.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

[Therapy of systemic mycoses in neutropenic patients using itraconazole. A comparative, randomized study with amphotericin B].

Author: van't WoutJ W, NovakovaI, VerhagenC A, FibbeW E, de PauwB E, van der MeerJ W

Effective against mycoses
Anaemia
Fever
Hypokalaemia
Hypotension
Nephrotoxicity
Renal tubular acidosis
Shivering
Side effects
Thrombocytopenia
Thrombophlebitis

A randomized comparative investigation was carried out to assess the efficacy of amphotericin B and itraconazole in the treatment of systemic mycoses in neutropenic patients.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

3.

The effects of the systemic antimycotics, itraconazole and fluconazole, on the pharmacokinetics and pharmacodynamics of intravenous and oral midazolam.

Author: OlkkolaK T, AhonenJ, NeuvonenP J

Sedation
Increased midazolam effects

Itraconazole and fluconazole, azole antimycotics, significantly increased the effects of oral midazolam, raising its AUC and peak concentration by 3.5-fold and two-fold, respectively. This interaction also led to a profound increase in psychomotor effects. While the interaction with IV midazolam was weak, large doses of IV midazolam could still lead to clinically significant interactions. Using oral midazolam with itraconazole and fluconazole should be avoided.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

The effect of ingestion time interval on the interaction between itraconazole and triazolam.

Author: NeuvonenP J, VarheA, OlkkolaK T

Increased triazolam effects

Itraconazole interacts considerably with triazolam when this hypnotic agent is ingested within 24 hours after itraconazole.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Effects of oral posaconazole on the pharmacokinetic properties of oral and intravenous midazolam: a phase I, randomized, open-label, crossover study in healthy volunteers.

Author: KrishnaGopal, MotonAllen, MaLei, SavantIshani, MartinhoMonika, SeiberlingMichael, McLeodJames

Drug interaction

This study aims to determine how the antifungal drug posaconazole affects the pharmacokinetic properties of midazolam, a short-acting benzodiazepine, due to their potential for drug interactions.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Terbinafine Hydrochloride Combined With Itraconazole for Fungal Skin Diseases: A Randomized Controlled Trial.

Author: ZhangDongxing, LiaoWanqing, ChenCanhua, LaiHongtao, LiuShi

Combined therapy efficacy
Fungal skin diseases treatment

Combined treatment with terbinafine and itraconazole achieved better therapeutic effects in patients with fungal skin diseases compared to monotherapy. The combination group had significantly decreased symptom scores, a higher cure rate, and shorter cure time. No adverse events or relapses were reported during follow-up.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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