Fungal Infections can be Tough to Eradicate

Ensure Complete Eradication with Itroze Caps (Itraconazole 100mg)

Itraconazole Capsules are an azole antifungal. It works by killing sensitive fungi.

Itraconazole – Clinical Pharmacology

Pharmacokinetic Characteristics: Peak plasma concentrations of Itraconazole are reached within 2 to 5 hours following oral administration. As a consequence of non-linear pharmacokinetics, Itraconazole accumulates in plasma during multiple dosing. Steady-state concentrations are generally reached within about 15 days, with Cmax  values of 0.5 mcg/ml, 1.1 mcg/ml and 2.0 mcg/ml after oral administration of 100 mg once daily, 200 mg once daily and 200 mg b.i.d., respectively. The terminal half-life of Itraconazole  generally  ranges  from  16  to  28 hrs  after  single  dose  and  increases  to 34 to 42 hrs   with   repeated   dosing. Once treatment is stopped, Itraconazole plasma concentrations decrease to an almost undetectable concentration within 7 to 14 days, depending on the dose and duration of treatment. Itraconazole mean total plasma clearance following intravenous administration is 278 ml/min. Itraconazole clearance decreases at higher doses due to saturable hepatic metabolism.

Absorption: Itraconazole is rapidly absorbed after oral administration. Peak plasma concentrations of Itraconazole are reached within 2 to 5 hrs following an oral capsule dose. The observed absolute oral bioavailability of Itraconazole is about 55%.

The oral bioavailability of Itraconazole is maximal when Itraconazole capsules are taken immediately after a full meal. Absorption of Itraconazole capsules is reduced in subjects with reduced gastric acidity, such as subjects taking medications known as gastric acid secretion suppressors (e.g., H2-receptor antagonists, proton pump inhibitors) or subjects with achlorhydria caused by certain diseases.

Distribution: Most of the Itraconazole in plasma is bound to protein (99.8%), with albumin being the main binding component (99.6% for the hydroxy-metabolite). It has also a marked affinity for lipids. Only 0.2% of the Itraconazole in plasma is present as free drug. Itraconazole is distributed in a large apparent volume in the body (>700 L), suggesting extensive distribution into tissues. Concentrations in lung, kidney, liver, bone, stomach, spleen and muscle were found to be two to three times higher than corresponding concentrations in plasma, and the uptake into keratinous tissues, skin in particular, up to four times higher. Concentrations in the cerebrospinal fluid are much lower than in plasma.

Metabolism: Itraconazole is extensively metabolized by the liver into a large number of metabolites. In vitro studies have shown that CYP3A4 is the major enzyme involved in the metabolism of Itraconazole. The main metabolite is hydroxy-Itraconazole, which has in vitro anti-fungal activity comparable to Itraconazole; though plasma concentrations of this metabolite are about twice those of Itraconazole.

Excretion: Itraconazole is excreted mainly as inactive metabolites in urine (35%) and in feces (54%) within one week of an oral solution dose. Renal excretion of Itraconazole and the active metabolite hydroxy-Itraconazole account for less than 1% of an intravenous dose. Based on an oral radio-labeled dose, fecal excretion of unchanged drug ranges from 3% to 18% of the dose.

As re-distribution of Itraconazole from keratinous tissues appears to be negligible, elimination of Itraconazole from these tissues is related to epidermal regeneration. Contrary to plasma, the concentration in skin persists for 2 to 4 weeks after discontinuation of a 4-week treatment and in nail keratin – where Itraconazole can be detected as early as 1 week after start of treatment for at least six months after the end of a 3-month treatment period.