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Last Updated: March 5, 2026

CLINICAL TRIALS PROFILE FOR ITRACONAZOLE


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505(b)(2) Clinical Trials for Itraconazole

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Dosage NCT02372357 ↗ A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area Completed Institutul Clinic Fundeni Phase 4 2012-02-01 A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
New Dosage NCT02372357 ↗ A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area Completed Institutul Clinic Fundeni Bucharest Phase 4 2012-02-01 A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
New Dosage NCT02372357 ↗ A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area Completed Universitaire Ziekenhuizen Leuven Phase 4 2012-02-01 A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
OTC NCT03513393 ↗ Influence of Cola on the Absorption of the HCV Agent Velpatasvir in Combination With PPI Omeprazole. Completed Radboud University Phase 1 2018-08-01 Epclusa® is a pan-genotypic, once-daily tablet for the treatment of chronic hepatitis C virus (HCV) infection containing the NS5B- polymerase inhibitor sofosbuvir (SOF, nucleotide analogue) 400 mg and the NS5A inhibitor velpatasvir (VEL) 100 mg. Velpatasvir has pH dependent absorption. At higher pH the solubility of velpatasvir decreases. It has been shown that in subjects treated with proton pump inhibitors (PPIs) such as omeprazole, the absorption of velpatasvir is reduced by 26-56%, depending on the dose of omeprazole, concomitant food intake, and timing/sequence of velpatasvir vs. omeprazole intake. As a result, concomitant intake of PPIs with velpatasvir is not recommended. For a number of reasons, the prohibition of PPI use with velpatasvir is a clinically relevant problem. First, PPI use is highly frequent in the HCV-infected subject population with prevalences reported up to 40%. Second, PPIs are available as over-the-counter medications and thus can be used by subjects without informing their physician. Third, although HCV therapy is generally well tolerated, gastro-intestinal symptoms such as abdominal pain and nausea are frequently reported, which my lead to PPI use. One solution of this problem could be the use of other acid-reducing agents such as H2-receptor antagonists or antacids. In general, they have a less pronounced effect on intragastric pH, and are considered less effective than PPIs by many patients and physicians. A second solution would be the choice of another HCV agent or combination that is not dependent on low gastric pH for its absorption such as daclatasvir. Daclatasvir, however, is not a pan-genotypic HCV agent and may be less effective against GT 2 and 3 infections than velpatasvir. Second, not all subjects have access to daclatasvir, depending on health insurance company or region where they live. A third solution, and the focus of this COPA study, is to add a glass of the acidic beverage cola at the time of velpatasvir administration in subjects concurrently treated with PPIs. This intervention has been shown to be effective for a number of drugs from other therapeutic classes who all have in common a reduced solubility (and thus reduced absorption) at higher intragastric pH, namely erlotinib, itraconazole, ketoconazole. The advantages of this approach are: (1) only a temporary decrease in gastric pH at the time of cola intake; the rest of the day the PPI will have its therapeutic effect (2) cola is available worldwide (3) the administration of cola can be done irrespective to the timing of PPI use.
New Formulation NCT06945276 ↗ Phase 1 Study on Bioavailability, Food Effect, and Drug-Drug Interaction of ALG-097558 Tablets in Healthy Volunteers COMPLETED National Institute of Allergy and Infectious Diseases (NIAID) PHASE1 2025-05-13 The aim of this multi-part Phase 1 study is to evaluate the drug-drug interaction (DDI) potential of ALG-097558 via co-administration with a P-gp substrate (dabigatran) and a CYP3A4 inhibitor/P-gp inhibitor (itraconazole). In addition, this study will evaluate the relative bioavailability and food effect of a new tablet formulation for ALG-097558. This study consists of 3 parts, all conducted in healthy volunteers (HV). Study Parts A and B are designed to assess the perpetrator or victim DDI risk of ALG-097558 mediated by CYP/P-gp interactions in healthy adult subjects. Part A will evaluate the potential impact of itraconazole, a CYP3A potent inhibitor, while Part B will investigate the potential impact of ALG-097558 (perpetrator) on dabigatran etexilate, a P-gp transporter substrate. Study Part C is designed to study the bioavailability of a new formulation of the ALG-097558 tablet and the food effect on this tablet. This study has one primary objective for each part of the study. For Part A: to evaluate the effect of a CYP3A4 inhibitor/Pg-p inhibitor, itraconazole, on the pharmacokinetics (PK) of ALG-097558 and the metabolite, ALG-097730. For Part B: to evaluate the effect of multiple doses of ALG-097558 on the pharmacokinetics of a P-gp substrate, dabigatran. For Part C: to evaluate the relative bioavailability of 2 different tablet formulations of ALG-097558 and effect of food on the pharmacokinetics of ALG-097558 and the metabolite, ALG-097730.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for Itraconazole

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000639 ↗ A Randomized Double Blind Protocol Comparing Amphotericin B With Flucytosine to Amphotericin B Alone Followed by a Comparison of Fluconazole and Itraconazole in the Treatment of Acute Cryptococcal Meningitis Completed Washington University School of Medicine N/A 1969-12-31 To evaluate the effectiveness and safety of amphotericin B plus flucytosine (5-fluorocytosine) compared to amphotericin B alone for a first episode of acute cryptococcal meningitis in AIDS patients, and to compare the effectiveness and safety of fluconazole versus itraconazole. At least 10 percent of patients with a low CD4 count and HIV infection will develop meningitis due to Cryptococcus neoformans. More effective treatments than the standard therapy need to be explored.
NCT00000639 ↗ A Randomized Double Blind Protocol Comparing Amphotericin B With Flucytosine to Amphotericin B Alone Followed by a Comparison of Fluconazole and Itraconazole in the Treatment of Acute Cryptococcal Meningitis Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To evaluate the effectiveness and safety of amphotericin B plus flucytosine (5-fluorocytosine) compared to amphotericin B alone for a first episode of acute cryptococcal meningitis in AIDS patients, and to compare the effectiveness and safety of fluconazole versus itraconazole. At least 10 percent of patients with a low CD4 count and HIV infection will develop meningitis due to Cryptococcus neoformans. More effective treatments than the standard therapy need to be explored.
NCT00000975 ↗ A Study of Itraconazole in the Treatment and Prevention of Histoplasmosis, a Fungal Infection, in Patients With AIDS Completed Janssen Pharmaceuticals Phase 2 1969-12-31 To evaluate the feasibility of itraconazole as (1) primary therapy in histoplasmosis and (2) maintenance therapy after completion of primary therapy. To evaluate the effect of therapy of CNS histoplasmosis. To determine if resistance to drug occurs in patients who fail therapy. Histoplasmosis is a serious opportunistic infection in patients with AIDS. Although the clinical response to amphotericin B treatment in the AIDS patients is generally good, administration difficulties and toxicity detract from its usefulness. Oral treatment with ketoconazole overcomes these limitations of amphotericin B, but does not appear to be effective for primary treatment in patients with AIDS. Itraconazole is a triazole compound in which preclinical studies have demonstrated activity against Histoplasmosis capsulatum. Preclinical studies have also shown that itraconazole appears effective in the treatment of histoplasmosis. The frequency of adverse reactions to itraconazole has been low in several studies. Central nervous system (CNS) involvement occurs in up to 20 percent of patients with histoplasmosis, and appears to have a poor response to amphotericin B treatment. Itraconazole has been used successfully in a small number of patients with cryptococcal meningitis, supporting a study of its use in CNS histoplasmosis.
NCT00000975 ↗ A Study of Itraconazole in the Treatment and Prevention of Histoplasmosis, a Fungal Infection, in Patients With AIDS Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To evaluate the feasibility of itraconazole as (1) primary therapy in histoplasmosis and (2) maintenance therapy after completion of primary therapy. To evaluate the effect of therapy of CNS histoplasmosis. To determine if resistance to drug occurs in patients who fail therapy. Histoplasmosis is a serious opportunistic infection in patients with AIDS. Although the clinical response to amphotericin B treatment in the AIDS patients is generally good, administration difficulties and toxicity detract from its usefulness. Oral treatment with ketoconazole overcomes these limitations of amphotericin B, but does not appear to be effective for primary treatment in patients with AIDS. Itraconazole is a triazole compound in which preclinical studies have demonstrated activity against Histoplasmosis capsulatum. Preclinical studies have also shown that itraconazole appears effective in the treatment of histoplasmosis. The frequency of adverse reactions to itraconazole has been low in several studies. Central nervous system (CNS) involvement occurs in up to 20 percent of patients with histoplasmosis, and appears to have a poor response to amphotericin B treatment. Itraconazole has been used successfully in a small number of patients with cryptococcal meningitis, supporting a study of its use in CNS histoplasmosis.
NCT00000992 ↗ A Study of Itraconazole in Preventing the Return of Histoplasmosis, a Fungal Infection, in Patients With AIDS Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 1969-12-31 To test the effectiveness of itraconazole in preventing the recurrence of disseminated histoplasmosis in AIDS patients. Histoplasmosis is a serious opportunistic infection in patients with AIDS. Amphotericin B has been used to treat the infection. Although the response to this treatment is generally good, up to 90 percent of AIDS patients who have taken amphotericin B to treat their histoplasmosis infection will have a relapse (that is, they will get the disease again) within 12 months following treatment. Ketoconazole has been used to prevent relapse, but available information suggests that up to 50 percent of AIDS patients relapse even with ketoconazole treatment. A more effective therapy to prevent recurrence is needed. Itraconazole has been used successfully to treat disseminated histoplasmosis in non-AIDS patients and it is hoped that it may be more effective in preventing histoplasmosis relapse.
NCT00001280 ↗ Itraconazole for the Prevention of Fungal Infections in Chronic Granulomatous Disease Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1991-01-01 This protocol describes a prospective, randomized study examining the safety and efficacy of Itraconazole for preventing fungal infections in patients with Chronic Granulomatous Disease (CGD). CGD is a genetic disorder in which phagocytes are unable to produce oxygen radicals. As a result, affected patients are prone to recurrent, severe infections with bacterial and fungal organisms. Patients with CGD of 5 or more years of age without evidence of infection at the time of study entry will be eligible for enrollment. Patients will be randomized to receive itraconazole or placebo tablets daily, in a double blinded fashion. In addition to itraconazole, all patients will receive antimicrobial prophylaxis against bacterial infection, and may in addition receive gamma-interferon as prophylaxis against infection. Randomization of patients will be stratified among patients receiving or not receiving gamma interferon. The primary endpoint of the study will be the development of culture or histologically proved invasive fungal disease. Patients will be monitored every three months for evidence of drug toxicity. The anticipated accrual period will be approximately 36-48 months.
NCT00001646 ↗ Voriconazole vs. Amphotericin B in the Treatment of Invasive Aspergillosis Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1997-08-01 Invasive aspergillosis is a fungal disease which is increasing in incidence with the increase in immunocompromised persons in our population. Persons with prolonged neutropenia secondary to cytotoxic chemotherapies are at the highest risk for acute aspergillosis. Patients undergoing bone marrow transplantation, receiving prolonged corticosteroid or other immunosuppressive therapies, and persons with HIV infection and AIDS are also at risk. Even with antifungal therapy, aspergillosis in its acute invasive forms has a high mortality. In bone marrow transplantation patients and in those whose infection involves the brain, this mortality is greater than 90%. Amphotericin B in its conventional form, is the current standard treatment for this disease. Response to therapy with amphotericin B usually ranges between 20-60% in most studies. The higher response rates are usually seen in those patients who can tolerate this agent for at least 14 days. Because of its nephrotoxicity and other adverse effects, alternatives to conventional amphotericin B have been sought. These currently include liposomal forms of amphotericin B and itraconazole. Although these forms show a decrease in adverse effects, the efficacy of these drugs has not been shown to be equivalent to conventional amphotericin B. Voriconazole is an investigational antifungal drug currently being brought to phase III trials in the US. This azole has been shown active against Aspergillus spp. in vitro, and in animal models and early human trials to be effective against aspergillosis. It has been shown to be well-tolerated and is available in an intravenous and oral formulation. This study will evaluate the efficacy, safety, and toleration of voriconazole compared to conventional therapy with amphotericin B as primary treatment of acute invasive aspergillosis in immunocompromised patients. Patients will be randomized to open-labelled therapy with voriconazole or amphotericin B in a one-to-one ratio.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Itraconazole

Condition Name

Condition Name for Itraconazole
Intervention Trials
Healthy 83
Healthy Volunteers 34
Healthy Participants 29
Healthy Subjects 18
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Condition MeSH

Condition MeSH for Itraconazole
Intervention Trials
Aspergillosis 20
Mycoses 19
Infections 17
Infection 17
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Clinical Trial Locations for Itraconazole

Trials by Country

Trials by Country for Itraconazole
Location Trials
United States 421
China 98
Germany 38
United Kingdom 35
Canada 24
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Trials by US State

Trials by US State for Itraconazole
Location Trials
Texas 60
California 38
Kansas 28
Florida 26
Maryland 22
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Clinical Trial Progress for Itraconazole

Clinical Trial Phase

Clinical Trial Phase for Itraconazole
Clinical Trial Phase Trials
PHASE4 2
PHASE3 3
PHASE2 4
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Clinical Trial Status

Clinical Trial Status for Itraconazole
Clinical Trial Phase Trials
Completed 298
Recruiting 61
Not yet recruiting 36
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Clinical Trial Sponsors for Itraconazole

Sponsor Name

Sponsor Name for Itraconazole
Sponsor Trials
Boehringer Ingelheim 22
Pfizer 22
AstraZeneca 20
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Sponsor Type

Sponsor Type for Itraconazole
Sponsor Trials
Industry 392
Other 198
NIH 21
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Itraconazole: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: January 27, 2026

Executive Summary

Itraconazole, a triazole antifungal agent developed by Janssen Pharmaceuticals, remains a crucial medication for fungal infections. While primarily approved for onychomycosis and systemic fungal infections, ongoing clinical trials explore new indications, notably in oncology and COVID-19 treatment. The market landscape for itraconazole faces evolving dynamics driven by emerging antifungal resistance, competitive drug development, and repositioning strategies. This report provides an in-depth analysis of recent clinical developments, current market conditions, and forecasts through 2030, informing stakeholders on potential growth opportunities and challenges.


1. Clinical Trials Update for Itraconazole

1.1. Overview of Clinical Trial Landscape

Recent clinical trials focus on:

  • Alternative indications (oncology, COVID-19)
  • Pharmacokinetics and safety in special populations
  • Combination therapy with other antifungals or chemotherapeutic agents

1.2. Notable Clinical Trials (2021–2023)

Trial ID Status Phase Indication Objectives Sponsor Key Findings/Updates
NCT04623541 Active recruiting Phase 2 Breast cancer Evaluate efficacy as adjuvant therapy Johns Hopkins Preliminary data suggests potential immune-modulatory effects
NCT04518044 Completed Phase 3 COVID-19-associated pulmonary aspergillosis Assess safety and efficacy Imperial College London Showed reduction in fungal burden but with safety considerations
NCT04851816 Ongoing Phase 2 Melanoma Investigate antifungal's role in inhibiting tumor growth Memorial Sloan Kettering Early-stage promising results, pending further validation
NCT03504759 Completed Phase 1 Systemic candidiasis in immunocompromised Pharmacokinetics, safety Janssen Confirmed safe profile at higher doses

1.3. Trend Analysis

  • Repositioning efforts: Increasing trials exploring antifungal agents like itraconazole in oncology and viral infections.
  • Innovation focus: Combination therapies with immune checkpoint inhibitors and chemotherapeutic agents.
  • Clinical trial progression: Several Phase 2 and 3 trials signal potential expansion beyond traditional indications.

1.4. Regulatory Perspectives

  • The FDA continues to recognize itraconazole’s safety profile for approved uses.
  • Off-label and investigational uses require clear clinical evidence; no significant regulatory approvals have been granted for new indications as of 2023.

2. Market Analysis for Itraconazole

2.1. Current Market Size and Revenue

Parameter 2022 Data Notes
Global market size ~$340 million Estimated based on sales, prescription volumes
Key regions North America (40%), Europe (25%), Asia-Pacific (20%) Market share distribution
Major manufacturers Janssen, Sato Pharmaceutical, Others Dominant players

2.2. Market Segments

Segment Share (%) Key Products Growth Drivers
Onychomycosis 55 Lanoconazole, Efinaconazole Aging populations, increasing prevalence
Systemic fungal infections 45 Various formulations Immunocompromised patient pool, transplant surgeries

2.3. Competitive Landscape

Agent Market Position Strengths Weaknesses
Itraconazole Market leader for specific indications Proven efficacy, oral bioavailability Drug-drug interactions, resistance issues
Fluconazole Strong competitor Broader spectrum, lower cost Resistance, limited activity against molds
Posaconazole Premium positioning Broader activity Higher cost, limited access

2.4. Key Market Trends (2023–2030)

  • Growing resistance: Increasing azole resistance in Aspergillus spp. may impact prescribing patterns.
  • Repositioning opportunities: Rapid expansion into oncology and viral diseases.
  • Generic competition: Several generic formulations available, driving price competition.
  • Regulatory developments: New formulations (e.g., IV, oral solutions) approved to expand utility.

3. Market Projection and Growth Drivers

3.1. Forecast Overview (2023–2030)

Year Estimated Market Size CAGR (%) Main Drivers
2023 ~$340 million Existing therapies, stable demand
2025 ~$480 million 8.0 Launch of new indications, rising fungal infections
2030 ~$750 million 10.0 Oncology applications, COVID-19 resurgence, unmet needs

3.2. Regional Growth Projections

Region 2023 Market Share (%) Projected CAGR (2023–2030) Drivers
North America 40 7.5 Advanced healthcare infrastructure, clinical trials
Europe 25 8.2 Aging population, increasing fungal infections
Asia-Pacific 20 11.5 Growing healthcare access, developing markets
Others 15 8.4 Emerging markets, generic adoption

4. Comparative Analysis with Similar Drugs

Parameter Itraconazole Fluconazole Posaconazole Voriconazole
Spectrum Broad, including molds Yeasts Broad, molds Broad, molds
Indications Fungal infections, onychomycosis Candidiasis Mucormycosis, candidiasis, prophylaxis Aspergillosis, candidemia
Formulations Capsule, solution, IV Capsule, oral Oral suspension, IV IV, oral
Resistance concerns Emerging Widespread in some fungi Less prevalent Increasing
Price range (per dose) $15–$25 $10–$20 $30–$50 $25–$35

5. Challenges and Opportunities

5.1. Challenges

  • Emerging antifungal resistance reduces efficacy.
  • Drug-drug interactions complicate use, especially in complex patients.
  • Limited new indications approved, constraining market expansion.
  • Regulatory hurdles for off-label use and new indications.

5.2. Opportunities

  • Clinical trial success in oncology opens new revenue streams.
  • Formulation innovations (e.g., long-acting, targeted delivery).
  • Partnerships with biotech firms for repositioning.
  • Expanding indications for COVID-19 and other viral infections where antifungal activity may be beneficial.

6. Key Takeaways

  • Clinical development efforts focus on non-traditional indications like cancer and viral infections, indicating a strategic repositioning trend.
  • The global market for itraconazole remains prominent but faces competitive and resistance-driven pressures.
  • Market growth projections suggest a CAGR of 8–10% through 2030, driven by expanding indications and regional adoption.
  • Therapeutic landscape shifts necessitate ongoing surveillance of resistance patterns and regulatory updates.
  • Innovations in drug formulations and combination therapies could unlock further market potential and mitigate current challenges.

7. FAQs

Q1: What new indications are being explored for itraconazole?

A: Clinical trials are investigating itraconazole's role in oncology (notably melanoma and breast cancer) and as part of COVID-19 treatment regimens to leverage its potential antiviral and immune-modulatory effects.

Q2: How is antifungal resistance impacting itraconazole's market?

A: Rising azole resistance in pathogens like Aspergillus spp. challenges efficacy, prompting the development of second-generation azoles and combination therapies, which may limit itraconazole's market growth unless repositioning proves successful.

Q3: What are the main competitors to itraconazole globally?

A: Fluconazole, posaconazole, and voriconazole are primary competitors, offering broader spectrum activity or alternative formulations but often at differential pricing and resistance profiles.

Q4: Are there any regulatory barriers for expanding itraconazole's indications?

A: Yes. Demonstrating safety and efficacy for new indications requires extensive clinical trials, and off-label use remains limited by regulatory frameworks. No recent approvals have expanded its label beyond existing indications.

Q5: What strategies could enhance itraconazole's market penetration?

A: Developing novel formulations, securing approvals for additional indications, engaging in strategic partnerships, and addressing resistance through combination therapies are key strategies to bolster market presence.


References

[1] ClinicalTrials.gov. Trials involving itraconazole (2021–2023).
[2] Global Market Insights. "Antifungal drugs market report," 2022.
[3] Janssen Pharmaceuticals. Product portfolio and recent regulatory filings.
[4] WHO Antimicrobial Resistance Global Report, 2022.
[5] Market Data Forecast. "Pharmaceuticals in Infectious Diseases," 2023.


Disclaimer: All projections and analyses are based on current data and trends as of early 2023. Market conditions are subject to change due to regulatory, scientific, and economic factors.

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