Itraconazole capsules should not be used for treatment of onychomycosis in patients with evidence of ventricular dysfunction, including CHF or history of CHF.
Discontinue itraconazole if signs or symptoms of CHF occur. IV itraconazole (no longer commercially available in the US) caused negative inotropic effects in healthy individuals and in dogs.
Concomitant use with cisapride (currently commercially available in the US only under a limited-access protocol), pimozide, quinidine, dofetilide, or levomethadyl (no longer commercially available in the US) is contraindicated. Itraconazole is a potent inhibitor of CYP3A4 isoenzymes and may increase plasma concentrations of drugs metabolized by CYP3A4. Serious cardiovascular events, including QT prolongation, torsades de pointes, ventricular tachycardia, cardiac arrest, and/or sudden death have occurred in patients using cisapride, pimozide, levomethadyl, or quinidine concomitantly with itraconazole and/or other CYP3A4 inhibitors. (See Interactions.)
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