Efficacy of super bioavailable itraconazole in the management of dermatophytosis in India

Ramesh M.; Dinesh Hawelia; Gayatri Bharadwaj; Gautam Dethe; Biswajit Aich; Krishna C. Veligandla; Rahul Rathod; Bhavesh P. Kotak

doi:10.18203/issn.2455-4529.IntJResDermatol20233185

Authors

Ramesh M. Oxford Medical College, Bangalore, Karnataka, India
Dinesh Hawelia AMRI Hospitals, Salt Lake, Kolkata, West Bengal, India
Gayatri Bharadwaj Dr. Gayatri’s Cosmetic Clinic, Dombivli, Thane, Maharashtra, India
Gautam Dethe Sparsh Skin Clinic, Seawoods, Navi Mumbai, Maharashtra, India
Biswajit Aich Department of Medical Affairs, Dr Reddy’s Laboratories Ltd, Hyderabad, Telangana, India
Krishna C. Veligandla Department of Medical Affairs, Dr Reddy’s Laboratories Ltd, Hyderabad, Telangana, India
Rahul Rathod Department of Medical Affairs, Dr Reddy’s Laboratories Ltd, Hyderabad, Telangana, India
Bhavesh P. Kotak Department of Medical Affairs, Dr Reddy’s Laboratories Ltd, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20233185

Keywords:

Mycoses, Antifungal agents, ITZ

Abstract

Itraconazole (ITZ) is a commonly prescribed oral antifungal agent in India and has a low minimum inhibitory concentration when compared to other oral antifungals. However, clinicians have reported inconsistent clinical responses despite its high skin levels, which may be due to variations in pelletization parameters, which affect its bioavailability and serum levels. Conventional ITZ has a maximum bioavailability of 55%; however, this is unpredictable and inconsistent. In contrast, the novel ITZ formulation, super bioavailable ITZ (ITZ-SB), has targeted drug release in the small intestine, resulting in predictable serum levels with minimal interindividual variability. This makes it a potentially useful drug in treating recalcitrant dermatophytosis. This expert opinion highlights the benefits of novel ITZ-SB with the incorporation of SUBA® technology. The SUBA® technology improves the bioavailability of poorly soluble drugs by ‘solid dispersion’ in polymer to increase drug absorbency. This technology also has potential to reduce variability in absorption and adverse effects. Benefits of this technology include more predictable clinical response and lower drug quantities necessary to achieve therapeutic blood levels, making it a promising treatment option for recalcitrant dermatophytosis. Fixtral SB, which uses this technology, is a novel weapon in the arsenal of treatments for superficial mycoses.

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