Drawbacks

Adverse events associated with the use of continuous itraconazole for the treatment of onychomycosis are not common, and those experienced are generally mild to moderate in severity. Adverse events include gastrointestinal disorders (for example nausea, abdominal pain), rashes, and central nervous system effects (for example headache).181 185 188-190 Only a small proportion of patients discontinue treatment with the triazole. A number of drugs are contraindicated with itraconazole (see section on itraconazole pulse therapy above). In addition, the triazole has several drug interactions (see section above). Itraconazole is contraindicated in North America in patients with evidence of ventricular dysfunction, for example, congestive heart failure or a history of heart failure. The US package insert suggests that liver function tests be performed in patients receiving continuous therapy for more than 1 month or at any time a patient develops signs and symptoms suggestive of liver disease.155

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