Itraconazole vs Fluconazole – Which Is The Best Candida Albicans Treatment?

Itraconazole is an azole antifungal prescription medicine that fights infections caused by fungus. It works by preventing the growth of a few types of fungi by disrupting the production of the membranes which surround the fungal cells.

Sporanox is the brand name for this drug.

Uses

It was approved by the FDA in 1992 for the treatment of certain fungal infections, including esophageal candidiasis, oral thrush, histoplasmosis (also referred to as Histoplasma capsulatum infection), and oropharyngeal candidiasis.

Dosage

For oral candidiasis, the recommended dose is 100 mg per day for 14 days.

Side Effects And Precautions

Common side effects may include:

  • bloating;
  • stomach upset;
  • headache;
  • dizziness.

Serious side effects may include:

  • breathing problems;
  • yellowing of the eyes or skin;
  • dark urine;
  • unusual weakness;
  • changes in hearing;
  • swelling of ankles, feet, or legs;
  • sudden weight gain;
  • right upper belly pain;
  • loosening of the skin, especially inside the mouth;
  • tingling, pain, numbness in the feet or hands;
  • vomiting;
  • nausea;
  • loss of appetite;
  • light-colored stools;
  • flu-like symptoms;
  • irregular heartbeat;
  • a cough up mucus.

Before you start using this medicine, it is vital that your healthcare specialist knows:

  • if you are pregnant or plan to become pregnant since there are no conclusive studies on whether this drug will harm an unborn baby.
  • if you are taking any other drugs. This also includes complimentary and herbal medicines.
  • if you are allergic to any medicines similar to this one. Symptoms of an allergic reaction include – swelling of lips, face, tongue, or throat; wheezing; shortness of breath; itching; rash.
  • if you have any lung or heart problems because this medicine can cause heart failure, a condition when the heart is unable to pump sufficient blood around the body as it should do.
  • if you have porphyria, a condition caused by problems with how the human body makes heme.
  • if you have any kidney or liver conditions, especially if you take fesoterodine, colchicine, telithromycin, or solifenacin.

Fluconazole

It is a drug that is used intravenously and orally and is a well-established medicine commonly used as a first-line management option for the treatment of C. albicans infections.

Furthermore, it is effective and well-tolerated by most patients, including seniors, children, and people with impaired immunity. It kills the fungi by stopping them from producing ergosterol, a substance that is an important component of fungal cell membranes.

It was patented in 1981 and came into commercial use in 1988. Plus, it is on the World Health Organization’s List of Essential Medicines.

Uses

It is commonly used to prevent fungal infections in patients with a weak immune system as well as to treat fungal infections in various parts of the human body, like – the genitals, mouth, throat, urinary tract, lungs, brain, and other organs.

Dosage

Take this medicine according to your doctor’s orders. The recommended adult dose is 200 mg to 400 mg once per day, for about one month. The recommended dosage for vaginal candidiasis (which affects about 75 percent of women at some point during their lifetime) is 150 mg as a single oral dose. It typically starts to work within one day, however, it may take about 3 days for the symptoms to improve. If the symptoms don’t go in 7 days, contact your healthcare provider.

Even if you feel better after the first few doses, keep using this drug for the full treatment time because the infection may not clear up if you stop taking the complete treatment.

Side Effects And Precautions

Common side effects may include:

  • severe rash, especially in individuals with low immunity;
  • vomiting;
  • headache;
  • changes in the way food tastes;
  • stomach pain;
  • dizziness;
  • upset stomach;
  • diarrhea.

Serious side effects (very rare) may include:

  • seizures;
  • fainting;
  • yellowing of the skin or eyes;
  • vomiting;
  • dark urine;
  • irregular heart rate;
  • light-colored stools;
  • skin peeling;
  • heart palpitations;
  • severe rash;
  • severe skin itching.

Before using this drug, tell your doctor if you have:

  • kidney disease;
  • liver disease;
  • a personal history of Long QT syndrome, a disorder of the heart’s electrical system;
  • heart rhythm disorder;
  • cancer;
  • if you are allergic to other antifungal medicine (like – itraconazole, ketoconazole, posaconazole, miconazole, and voriconazole).
  • HIV or AIDS.

Note

A recent Danish study established that there is a possible increased risk of miscarriage linked with the oral use of this drug. Also, it can increase the concentration of the following drugs in the blood – cyclosporine, Dilantin (phenytoin), Glucotrol (triazolam), Retrovir (zidovudine), tolbutamide, Sublimaze (fentanyl), Invirase (saquinavir), glipizide, celecoxib, midazolam, simvastatin, atorvastatin, and lovastatin.

Itraconazole vs Fluconazole – Which Is The Best Candida Albicans Treatment?

Itraconazole capsules are indicated and effective for the treatment of a variety of systemic and localized fungal infections in adults, but Fluconazole still remains a first-line antifungal agent of choice for the treatment of yeast infections.

This is most likely due to its superior safety profile and efficacy as well as to its lower cost, its range of formulations. More importantly, it can be used for seniors, children, and people with impaired immunity.

Other Drugs Used for Candida Infections

C.albicans is normally present on the skin and in the gastrointestinal tract and mouth without causing any problems. In women, this yeast is also present in the vagina.

The problems occur when there is an overgrowth of Candida. The infection it causes is called candidiasis. It can affect the mouth, skin, stomach, vagina, and urinary tract.

Symptoms

Common symptoms may include:

  • joint pain;
  • powerful sugar cravings;
  • skin rashes;
  • acne;
  • irritability;
  • unusual weakness;
  • poor immune health;
  • frequent bloating;
  • recurrent yeast infections;
  • frequent urinary tract infections;
  • difficulty concentrating;
  • brain fog;
  • nail fungus.

Causes

  • HIV\AIDS;
  • type 2 Diabetes Mellitus;
  • maintaining poor vaginal hygiene;
  • weakened immune system;
  • use of implanted tubes and devices which penetrate into the body;
  • hormonal changes due to menstrual cycle;
  • certain types of drugs, like – antibiotics (they lower the number of good bacteria in the vagina), birth control pills, and steroids;
  • emotional stress;
  • pregnancy;
  • a natural reaction to another person’s genital chemistry;
  • hormonal contraceptives;
  • sleeping less than 7 hours per night;
  • poor nutrition;
  • wearing clothing that keeps the vaginal area moist and warm.

The good news is that most yeast infections can be easily treated with prescription or OTC drugs. Here is a complete list:

#1 Terbinafine HCL

It is an anti-fungal medication that was approved by the FDA in 1992. This medicine is only available as a topical ointment or as an oral medication. It is typically used to treat infections of the scalp, ringworm, athlete’s foot (tinea pedis), jock itch, and other fungal infections. Lamisil is the brand name of this medicine.

#2 Nystatin

It is an oral anti-fungal medication that is available by a prescription. It is generally used to treat fungal infections of the skin, mouth, vagina, and intestinal tract.

There are numerous brand names of this medicine, including – Mycostatin, Bio-Statin, and Nilstat. They work by binding to ergosterol, a specific compound found on yeast cell walls.

#3 Amphotericin-B

It is an antifungal medication that was initially produced from Streptomyces nodosus in 1955 and it is on the WHO’s List of Essential Medicines.

Similar to nystatin, Amphotericin-B is very safe and not absorbed systemically when taken by mouth. Although both are fungicidal medicines, Amphotericin-B is considerably more potent than nystatin. Therefore, this drug is typically used for life-threatening fungal infections and not for use in treating a minor fungal infection of the esophagus, mouth, or vagina.

Note – the injectable and IV forms of this drug are toxic. Nevertheless, their use is restricted to the treatment of life-threatening systemic fungal infections.

#4 Micafungin

It is an echinocandin antifungal drug that is used to treat invasive fungal infections, like – abscesses, candidemia, and esophageal candidiasis. It works by inhibiting the synthesis of an integral component of the fungal cell wall, called 1,3-beta-D-glucan.

This drug is injected into a vein through an IV. Do not self-inject this drug if you do not completely understand how to give the injection.

Images credit – @Getty & Shutterstock

READ THIS NEXT: Budesonide vs Albuterol

References

https://academic.oup.com/cid/article/41/10/1473/346940
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502198/

Leave a Comment