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Tolsura (itraconazole) Disease Interactions

There are 5 disease interactions with Tolsura (itraconazole):


Itraconazole (applies to Tolsura) CHF

Major Potential Hazard, High plausibility. Applicable conditions: 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.


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

Itraconazole (applies to Tolsura) hepatotoxicity

Major Potential Hazard, Low plausibility. Applicable conditions: 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 Therapy should be withdrawn if persistent elevations or worsening of liver enzyme levels occur.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.


  1. "Product Information. Sporanox (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
  2. Lavrijsen A, Balmus K, Nugteren-Huying W, et al "Hepatic injury associated with itraconazole." Lancet 340 (1992): 251-2
  3. Tucker R, Haq Y, Denning D, Stevens D "Adverse events associated with itraconazole in 189 patients on chronic therapy." J Antimicrob Chemother 26 (1990): 561-6
  4. 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
  5. Gallardoquesada S, Luelmoaguilar J, Guanyabenscalvet C "Hepatotoxicity associated with itraconazole." Int J Dermatol 34 (1995): 589
  6. Kim JA, Ahn KJ, Kim JM, Youn JI "Efficacy and tolerability of itraconazole in patients with fingernail onychomycosis: a 6-week pilot study." Curr Ther Res Clin Exp 56 (1995): 1066-75
  7. "Product Information. Sporanox oral solution (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
View all 7 references

Azole antifungals (applies to Tolsura) QT prolongation

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Arrhythmias

Some azole antifungals have been associated with prolongation of the QT interval on the ECG. Rare cases of QT prolongation and torsade de pointes have been reported during postmarketing experience; such reports usually involved seriously ill patients with multiple confounding 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.


Itraconazole (applies to Tolsura) achlorhydria

Moderate Potential Hazard, High plausibility.

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.


  1. "Product Information. Sporanox oral solution (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
  2. Smith D, van de Velde V, Woestenborghs R, Gazzard BG "The pharmacokinetics of oral itraconazole in AIDS patients." J Pharm Pharmacol 44 (1992): 618-9
  3. 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
  4. Zimmermann T, Yeates RA, Laufen H, Pfaff G, Wildfeuer A "Influence of concomitant food intake on the oral absorption of two triazole antifungal agents, itraconazole and fluconazole." Eur J Clin Pharmacol 46 (1994): 147-50
  5. Van Peer A, Woestenborghs R, Heykants J, et al "The effects of food and dose on the oral systemic availability of itraconazole in healthy subjects." Eur J Clin Pharmacol 36 (1989): 423-6
  6. Hardin TC, Graybill JR, Fetchick R, et al "Pharmacokinetics of itraconazole following oral administration to normal volunteers." Antimicrob Agents Chemother 32 (1988): 1310-3
  7. "Product Information. Sporanox (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
View all 7 references

Itraconazole (applies to Tolsura) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

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.

Tolsura (itraconazole) drug interactions

There are 481 drug interactions with Tolsura (itraconazole)

Tolsura (itraconazole) alcohol/food interactions

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

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.