Itraconazole Pulse Therapy for Onychomycosis

Abstract

Itraconazole (Sporanox by Janssen) is a triazole antifungal agent. In September 1995, it was approved for the treatment of onychomycosis caused by dermatophytes of the toenail with or without fingernail involvement. FDA-labeled itraconazole therapy for onychomycosis consists of 200 mg by mouth daily for twelve consecutive weeks, with reported mycological cure rates of 54 percent. Pulse therapy, defined as a three- or four-month cycles of 200 mg of itraconazole twice daily for one week, followed by three weeks off the drug, has been shown to be a promising treatment option that deserves consideration. Cure rates have been as good, or better than the standard therapy. Recurrence has not been a problem and adverse drug effects have been few and mild. Decreased drug treatment cost are incurred with pulse therapy.