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Onmel (itraconazole) Disease Interactions

There are 5 disease interactions with Onmel (itraconazole):

Major

Itraconazole (Includes Onmel) ↔ Chf

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction, Fluid Retention, Heart Disease, Chronic Obstructive Pulmonary Disease

Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction have been observed following intravenous administration in healthy volunteers. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing use for onychomycosis and/or systemic fungal infections. Therapy with itraconazole should not be administered for the treatment of onychomycosis in patients with evidence of ventricular dysfunction such as CHF or a history of CHF. It is also not recommended for other indications in such patients unless benefit clearly outweighs the risk. Cautious use is advised in patients with risk factors for CHF, including cardiac disease such as ischemic and valvular disease; significant pulmonary disease such as chronic obstructive pulmonary disorder; and renal disease and other edematous disorders. These patients should be informed of and monitored for signs and symptoms of CHF during treatment.

References

  1. "Product Information. Sporonox (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
Major

Itraconazole (Includes Onmel) ↔ Hepatotoxicity

Severe Potential Hazard, Low plausibility

Applies to: Liver Disease

The use of itraconazole has been rarely associated with hepatotoxicity. Reversible idiosyncratic hepatitis and fatalities have been reported, the latter occurring primarily in patients with serious underlying medical conditions and taking multiple concomitant medications. Liver function tests should be performed periodically in patients with preexisting hepatic abnormalities, particularly when itraconazole therapy is administered continuously for more than one month. Therapy should be withdrawn if persistent elevations or worsening of liver enzyme levels occur. Because itraconazole is also extensively metabolized by the liver, patients with liver disease should be monitored carefully during treatment with itraconazole, and the dosing adjusted or discontinued if necessary.

References

  1. "Product Information. Sporanox (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
  2. Haria M, Bryson HM, Goa KL "Itraconazole: a review of its pharmacological properties and therapeutic use in the management of superficial fungal infections." Drugs 52 (1996): 253
  3. Lavrijsen A, Balmus K, Nugteren-Huying W, et al "Hepatic injury associated with itraconazole." Lancet 340 (1992): 251-2
View all 7 references
Moderate

Azole Antifungals (Includes Onmel) ↔ Qt Prolongation

Moderate Potential Hazard, Moderate plausibility

Applies to: Long QT Syndrome, Arrhythmias

Most of the azole antifungals have been associated with prolongation of the QT interval. There have been postmarketing rare reports of QT prolongation, and torsade de pointes usually involving patients with risk factors such as structural heart disease, electrolyte abnormalities, and concomitant medications. These drugs should be administered with caution to patients with potentially proarrhythmic conditions. Concomitant use with other medications that have potential to increase the risk of cardiotoxicity should be avoided.

Moderate

Itraconazole (Includes Onmel) ↔ Achlorhydria

Moderate Potential Hazard, High plausibility

Applies to: Achlorhydria

The absorption of itraconazole from the capsule formulation diminishes with decreased gastric acidity. Patients with achlorhydria should be advised to take itraconazole capsules with 8 oz. of a cola beverage, which has been shown to enhance absorption in AIDS patients with relative or absolute achlorhydria.

References

  1. "Product Information. Sporanox oral solution (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
  2. Wishart JM "The influence of food on the pharmacokinetics of itraconazole in patients with superficial fungal infection." J Am Acad Dermatol 17 (1987): 220-3
  3. Hardin TC, Graybill JR, Fetchick R, et al "Pharmacokinetics of itraconazole following oral administration to normal volunteers." Antimicrob Agents Chemother 32 (1988): 1310-3
View all 7 references
Moderate

Itraconazole (Includes Onmel) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Limited data are available on the use of oral itraconazole in patients with renal impairment. Caution is advised when using itraconazole in these patients. A dose reduction may be needed.

Onmel (itraconazole) drug Interactions

There are 576 drug interactions with Onmel (itraconazole)

Onmel (itraconazole) alcohol/food Interactions

There is 1 alcohol/food interaction with Onmel (itraconazole)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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