{"hq_id":"hq-c-org-002106","name":"Itraconazole","context":"human_adult","risk_level":"moderate","schema":"legacy","note":"Synthesis unavailable: compound lacks vectorizable regulatory classifications. Raw safety data returned.","data":{"risk_level":"moderate","summary":"Itraconazole is a broad-spectrum triazole antifungal active against dermatophytes, yeasts (Candida, Cryptococcus), dimorphic fungi (Histoplasma, Blastomyces, Coccidioides), and Aspergillus. Mechanism: CYP51 inhibition (same as fluconazole) but with broader spectrum. Key distinguishing feature: FDA black box warning for congestive heart failure — itraconazole has negative inotropic effects and should not be used in patients with ventricular dysfunction or CHF history. Mechanism of cardiotoxicity: direct inhibition of cardiac L-type calcium channels and mitochondrial function in cardiomyocytes. Other safety concerns: hepatotoxicity (including fatal cases); potent CYP3A4 inhibition causing numerous drug interactions (statins, benzodiazepines, calcium channel blockers, immunosuppressants — contraindicated with many common drugs); peripheral neuropathy with prolonged use; hypokalemia. Oral bioavailability is variable and formulation-dependent: capsules require acid pH (take with food/cola), while oral solution is better absorbed on empty stomach. Superseded by voriconazole for invasive aspergillosis but remains first-line for histoplasmosis, blastomycosis, and sporotrichosis.","source_refs":["aletheia_fungi_batch_2026"]},"meta":{"synthesis_version":"n/a","timestamp":"2026-07-27T02:41:17.553Z"},"_notice":"ALETHEIA output is reference data, not professional advice. Not a substitute for primary agency sources or qualified professionals. See https://aletheia.holisticquality.io/disclaimer.","_disclaimer_url":"https://aletheia.holisticquality.io/disclaimer","available_contexts":["human_adult"]}