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Itraconazole is a triazole antifungal drug which is used in the treatment of systemic fungal infections of dogs, cats and humans. It is also used topically in the treatment of ulcerative keratomycosis of horses. Triazoles are a subgroup of the azole group of drugs. These drugs are fungistatic at the concentrations used systemically and fungicidal at the concentrations that may be achieved topically.
Itraconazole is effective against a filamentous fungi, dimorphic
fungi, and yeasts. The mechanism of action is through the disruption of the oxidative
enzymes of the fungal organism.
Topical itraconazole has been shown to be effective in the treatment of ulcerative keratomycosis. It is particularly effective against Aspergillus, one of the more common fungal pathogens. The ophthalmic preparation of itraconazole contains 1% itraconazole, 30 %DMSO, and artificial tears. This formulation is necessary because itraconazole is relatively insoluble in water.
Therapy for ulcerative keratomycosis needs to be quite aggressive. Many clinicians recommend topical treatment every 2 hours. Some animals with particularly difficult cases of ulcerative keratomycosis may also be treated systemically with oral itraconazole, or oral lufenuron.
• Uveitis may increase after the first day of therapy because of
inflammation due to fungal death.
• DMSO may be topically irritating in some horses.
• Corticosteroids are generally contraindicated in cases of
ulcerative keratomycosis. No drug interactions per se were found.
• No information regarding overdose was found. Itraconazole
is one of the less toxic azole drugs.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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