Itraconazole dosage

[HannahBenson]

My Pulmonologist has reduced my itraconazole from 400 a day to 200 a day...He said my blood levels show that I could clearly reduce. I must get levels tested a lot as want to make sure this is still working but now I am worried that lowering the dose may cause a drug resistance. I wonder is better to take the high dosage for a longer period (I just finished three months) or to lower now that my drug levels have reached a point where the drug is working. Is there such a thing as itraconazole maintenance with a low dose? Is anyone on a maintenance anti fungal?

Hannah Benson

[GAtherton Administrator Fungal Infection Trust]

Itraconazole has very unpredictable pharmacokinetics which means that one person might need 200mg to stay within an effective drug level rangein their blood while another might need 400mg a day. If you doctor has checked your blood levels and suggested that you reduce your dose to 200mg a day that suggests that you are one of those who absorbs itraconazole a little better than others. 200mg a day is the level that you need to stay within the effective range of this drug, resistance is only encouraged when you drop below that level.

[HannahBenson in reply to GAtherton]

Hi ..

My pulmonologist said that my levels came in at 1.7 so I can stay at 200 mg a day intraconazole...the problem is that it seems to have stopped working. I am on the lower dose 3 weeks and upped my pred. from 5 to 10. Now...my congestion is so severe as well as itchy all over my back and head (had that when my aeosinophils got very high...all of this went away when on 400mg. of itra. ...all have returned and on a higher Pred. dosage. I am thinking that this 1.7 blood level may not be enough for me. Perhaps my Dr. thinks this is sufficient...I really don't know what levels work for me and what are too high. I probably should have stayed at 400 as it was working then. I have a family funeral to go to and will probably have to go on a burst of a higher dose of Pred. just to be able to get there. My concern is the Itra. dosage ...it is not working at 200 a day. Can you advise and does anyone ever go back up from 200 to 400 when there level is 1.7? Thank you...Hannah