extrapulmonary)Dosage and routes:•Adult: PO 200 mg qd with food; may increase to 400 mg qd if needed; divide doses over 200 mg in two dosesAvailable forms: Caps 100 mgSide effects/adverse reactions:GU: Gynecomastia, impotence, decreased libidoINTEG: Pruritus, fever, rash, CNS: Headache, dizziness, insomnia, somnolence, depressionGI: Nausea, vomiting, anorexia, diarrhea, cramps, abdominal pain, flatulence, GI bleeding, hepatotoxicityMISC: Edema, fatigue, malaise, hypertension, hypokalemia, tinnitusContraindications: Hypersensitivity, lactation, fungal meningitis, coadministration with terfenadinePrecautions: Hepatic disease, achlorhydria or hypochlorhydine (drug-induced), children, pregnancy (C)Pharmacokinetics:PO: Peak 3-5 hr, half-life 60 hr; metabolized in liver; excreted in bile, feces; requires acid pH for absorption; distributed poorly to CSF; highly protein boundInteractions/incompatibilities:•Do not use with terfenadine: may result in rare instance of life-threatening dysrhythmias and death•Hepatotoxicity: other hepatotoxic drugs•Itraconazole increases levels of cyclosporine•Decreased action of itraconazole: antacids, H2-receptor antagonists, isoniazid, rifampin•Increased anticoagulant effect: coumarin anticoagulants•Severe hypoglycemia: oral hypoglycemics•Concomitant administration with phenytoin may result in decreased levels of itraconazole; effects of phenytoin may be increasedNURSING CONSIDERATIONSAssess:•I&O ratio•Liver studies (ALT, AST, bilirubin) if on long-term therapy•For allergic reaction: rash, photosensitivity, urticaria, dermatitis•For hepatotoxicity: nausea, vomiting, jaundice, clay-colored stools, fatigueAdminister:•In the presence of acid products only; do not use alkaline products or antacids within 2 hr of drug; may give coffee, tea, acidic fruit juices•With food to decrease GI symptoms•With hydrochloric acid if achlorhy...
