Itraconazole and hydroxyitraconazole

Triazole antifungal assay service: Itraconazole
Clinical details: 
Itraconazole is used for the prophylaxis and treatment of invasive fungal infections (IFIs). The development of IFIs in patients being treated for haematological malignancies is associated with increased morbidity and mortality. As diagnosis of IFIs may be difficult, targeted prophylactic therapy is important in high-risk patients. Itraconazole is metabolised to hydroxyitraconazole, a pharmacologically active metabolite. Treatment failure has been associated with lower average plasma concentration of itraconazole (and hydroxyitraconazole) and thus monitoring plasma concentration may help in dose optimisation. In addition, hepatic metabolism of itraconazole shows significant inter- and intra-patient variation, and there is no clear dose-plasma concentration relationship. A pre-dose target plasma itraconazole concentration of 0.5 mg/L or more has been suggested for effective prophylaxis in patients being treated for haematological malignancies. Hydroxyitraconazole concentrations are normally higher than those of itraconazole.
Sample type and Volume required: 
2mL EDTA whole blood or 1 mL plasma or serum (pre-dose or ‘trough’ sample).
Turnaround time: 
5 working days
Storage and transport: 
Please refrigerate (if possible) if not sending immediately. Send by first class post.
Toxicology Department at King's Hospital
020 3299 5881
King's College Hospital
Bessemer Wing - 3rd Floor
Denmark Hill
London SE5 9RS
For clinical advice or interpretation of results, please contact the laboratory in the first instance.

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Last updated: 03/10/2022