Comparison of Compounded, Generic, and Innovator-Formulated Itraconazole in Dogs and Cats

Journal of the American Animal Hospital Association
Janelle RenschlerLawrence Joseph Wheat

Abstract

The triazole antifungal itraconazole may be cost prohibitive in brand name form; therefore, compounded and generic products are often used as alternatives. Itraconazole blood concentrations have not been studied in clinical patients receiving these formulations. Itraconazole bioassay was performed on serum/plasma from 95 dogs and 20 cats receiving itraconazole (compounded from bulk powder, generic pelletized, or brand name) for systemic mycosis treatment. Mean itraconazole concentration was lower in the compounded group (n = 42) as compared with the generic (n = 40) or brand name (n = 33) groups (0.5 µg/mL versus 8.3 µg/mL and 6.5 µg/mL, respectively; P < .001). No statistical difference was observed between itraconazole concentrations in the generic and brand name groups. Forty animals (95.2%) in the compounded group had subtherapeutic (<1.0 µg/mL) values. All cats in this group (n = 10) had undetectable itraconazole concentrations. Some animals in the generic and brand name groups had subtherapeutic values (12.5 and 12.1%, respectively) or potentially toxic values (>10 µg/mL; 37.5 and 24%, respectively). Compounded itraconazole should be avoided, but generic itraconazole appears to serve as a reasonable alternative to brand n...Continue Reading

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Citations

Apr 15, 2020·Journal of Veterinary Pharmacology and Therapeutics·Gregory ScottCraig A Harms
Sep 30, 2020·Brazilian Journal of Microbiology : [publication of the Brazilian Society for Microbiology]·Isabella Dib Ferreira GremiãoLeila M Lopes-Bezerra
Jul 28, 2019·Journal of Fungi·James Riddell, L Joseph Wheat
Apr 26, 2020·Brazilian Journal of Microbiology : [publication of the Brazilian Society for Microbiology]·Stefanie Bressan WallerMário Carlos Araújo Meireles
Sep 19, 2019·Journal of Veterinary Pharmacology and Therapeutics·Carrie L CavettJennifer M Reinhart
May 15, 2021·BMC Veterinary Research·Romy M HeilmannKatherine Scott
Nov 16, 2021·Journal of the American Veterinary Medical Association·Stephanie L ShaverTodd D Carter

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