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Itraconazole for Veterinary Use

For Veterinary Practices
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By Evan Ware, DVM

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Basic Information

Itraconazole is an antifungal agent that is used by veterinarians to treat a range of infections. Itraconazole/DMSO eye drops and ophthalmic ointment are used to treat ulcerative keratomycosis of horses, which means an ulcer of the cornea of the eye caused by a fungal infection. This medication is effective only against fungal infections and will be ineffective if used to treat other types of infections, such as those caused by parasites, bacteria, or viruses.

Topical itraconazole can kill the infective fungus at the concentrations that are reached on the surface of the eye. 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 does not dissolve well in water but dissolves well in DMSO.

Veterinary Medicine Uses for Itraconazole

Itraconazole is prescribed by veterinarians to treat fungal infections of the skin, claws, bone, respiratory tract, and brain. The most common uses for this drug include cryptococcosis in cats and dermatophyte infections in both cats and dogs.

Potential Side-Effects of Itraconazole

Itraconazole is a popular antifungal in the veterinary field, as it offers a lower incidence of side effects when compared with other medications in the same classification. The most-common side effects are mild nausea, decrease in appetite, vomiting, and diarrhea.

If the veterinary patient shows signs of jaundice, then the veterinarian should be contacted immediately. The pain and inflammation in the eye can increase after the first day of therapy, as the fungal death can cause increased inflammation.

Drug Interactions with Itraconazole

You should inform your veterinarian of your pet's current medications, as itraconazole can cause an interaction with other drugs. Drugs known to interact with itraconazole include digoxin, antacids, certain antibiotics, cisapride, and cyclosporine.

Precautions for Using Itraconazole

Itraconazole should be used in accordance with veterinary directions. It should not, however, be prescribed to an animal that has shown signs of an allergic reaction or hypersensitivity to it previously.

In rare cases, itraconazole can affect the function of the liver. Watch for signs of jaundice when your pet is taking this medication. The veterinarian also may want to perform routine liver tests if your pet receives this medication long-term.

Keep this and all drugs out of reach of children. Itraconazole/DMSO is a prescription drug and should be used according to your veterinarian's directions. It should only be given to the animal for which it was prescribed. Do not give this medication to a person.

Avoid contact with the medication when administering it to your animal. Wash immediately should you get some of the medication on your hands, skin, or clothing.

DMSO can irritate the skin in some horses.

Corticosteroids generally are not used in horses' eyes with fungal ulcers of the cornea. Never give another eyedrop or medication on your own as it can worsen the condition. Always discuss side effects and treatment options with your veterinarian.

Different strengths or dosage forms of itraconazole/DMSO can have different storage requirements. Read the labeling or ask your pharmacist for the storage requirements of the prescription you receive.

Dosage and Administration of Itraconazole

Itraconazole is prescribed as an oral capsule, but other formulations are available, including oral suspension, ophthalmic solution, and topical applications. The mode with which this drug is administered is determined by the treating veterinarian, along with dosage and frequency.

Since Itraconazole fights a fungal infection, it is very important to finish the course of treatment even if the patient is looking, acting, or feeling better. Fungal infections are more resilient than bacterial infections and usually require a longer course of therapy. Failure to complete the entire prescription can increase the risk of a relapse.

If you miss giving your pet a dose of itraconazole, give the next dose as soon as you remember or, if it is close to the next scheduled dose, return to the regular schedule. Do not double dose to catch up.

Therapy for fungal ulcers needs to be quite aggressive. Many veterinarians recommend that the eye be treated every 2 hours. In some instances, your veterinarian may place a catheter either up through the nose or surgically place one through the eyelid to make treatment easier for both you and your horse.

Administering eye medications to animals can be a struggle and can require patience and practice. Try not to touch the tube or container tip to your horse's eye or eyelid. It is also important not to contaminate the medication by touching the tip with your fingers or hand. Your veterinarian can help you develop a technique that will be effective and minimally stressful for both you and your horse.

If you are giving your horse more than one eye medication, try to allow at least five minutes between medications. Wash your hands after giving your horse this medication.

If you suspect your horse or another animal was overdosed accidentally or has eaten this medication inadvertently, contact your veterinarian or the A.S.P.C.A.'s Animal Poison Control Center at 888.426.4435. Always bring the prescription container with you when you take your pet for treatment.

If you or someone else has accidentally ingested this medication call the National Capital Poison Center at 800.222.1222.

About the Author

Dr. Evan Ware

Dr. Evan Ware is a veterinary practitioner in Phoenix, Arizona. He received both his undergraduate degree in microbiology and his Doctorate of Veterinary Medicine from The Ohio State University.

Dr. Ware is currently the Medical Director of University Animal Hospital (VCA) and is also the owner of two other hospitals, including Laveen Veterinary Center and Phoenix Veterinary Center. His areas of expertise include orthopedic medicine and surgery, veterinary oncology and chemotherapy, and general and advanced soft-tissue surgery.