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Congestive Heart Failure Exacerbation Secondary to Itraconazole Therapy

Liedtke, Michelle D. PharmD; Vandaveer, Julie K. PharmD; Greenfield, Ronald A. MD; Lockhart, Staci M. PharmD

Infectious Diseases in Clinical Practice: November 2011 - Volume 19 - Issue 6 - p e19-e20
doi: 10.1097/IPC.0b013e3182156810
Case Reports

Itraconazole is a commonly prescribed antifungal agent that has been associated with the occurrence of congestive heart failure (CHF) symptoms. There is currently a black box warning related to itraconazole stating that its use is contraindicated for the treatment of onychomycosis in patients with left ventricular dysfunction or a history of CHF. We report a case of a man presenting with 3 exacerbations of CHF secondary to itraconazole therapy for disseminated histoplasmosis. He was successfully treated with posaconazole with no recurrence of symptoms.

From the University of Oklahoma Health Sciences Center, Oklahoma City, OK.

Correspondence to: Michelle D. Liedtke, PharmD, University of Oklahoma Health Sciences Center College of Pharmacy, 1110 N Stonewall, CPB 206, Oklahoma City, OK 73117. E-mail:

No financial support was received in the preparation of this article. Dr Greenfield is a member of the speaker's bureau of Astellas, Cubist, Ortho-McNeil, and Pfizer. The remaining authors report no potential conflicts of interest.

© 2011 Lippincott Williams & Wilkins, Inc.