Cardiovascular adverse effects during itraconazole therapy.

Itraconazole has been widely used in the treatment of fungal disease including chronic necrotising pulmonary aspergillosis (CNPA) [1, 2]. Its use has been associated with occasional reports of adverse cardiovascular events including congestive heart failure [3], hypertension (HT) [4], premature ventricular contractions [5] and even ventricular fibrillation [6]. However, these adverse effects have been considered to be uncommon, if not rare, occurrences. From September, 1992 to April, 2001, the US Food and Drug Administration received only 59 reports of potential cases of congestive heart failure with the administration of itraconazole [3]. Despite the recommendation that itraconazole should not be used for treatment of onychomycosis in patients with evidence of ventricular dysfunction and that monitoring of symptoms and signs of heart failure is required during itraconazole therapy, the association of itraconazole and heart failure is still considered to be controversial [7].