A recent clinical study performed at MiraVista Diagnostics revealed that 95% of dogs and cats receiving itraconazole compounded from bulk powder had a subtherapeutic blood concentration of itraconazole.
Generic pelletized itraconazole (both FDA approved and non-FDA approved) produced similar blood concentration levels in dogs and cats as compared to brand name itraconazole (Sporanox by Janssen Pharmaceuticals) capsules or oral solution. Some animals in the generic and the brand name groups demonstrated subtherapeutic levels or potentially toxic levels.
ISSUES WITH COMPOUNDED ITRACONAZOLE
Antifungal therapeutic drug monitoring (TDM) measures itraconazole blood concentration levels and provides quantifiable feedback for treatment response, dosage, duration and frequency.
Leverage a reliable veterinary itraconazole bioassay to achieve therapeutic levels and mitigate risks associated with antifungal drug treatment. Here are the most common adverse responses to itraconazole treatment:
SUBTHERAPEUTIC ITRACONAZOLE CONCENTRATIONS
POTENTIALLY TOXIC BLOOD LEVELS OF ITRACONAZOLE
INAPPROPRIATE ITRACONAZOLE DOSING & DURATION
(1) Renschler JS, Albers AJ, Sinclair-Mackling HR and Wheat LJ. Comparison of compounded, generic and innovator-formulated itraconazole in dogs and cats. J Am Anim Hosp Assoc (in press).
(2) J.A. Smith, M.G. Papich, G. Russell and M.A. Mitchell. Effects of compounding on pharmacokinetics of itraconazole in black-footed penguins (Spheniscus demersus). J Zoo Wildlife Med 2010; 41(3): 487-495.