ANTIFUNGAL THERAPY: PAST, PRESENT, AND FUTURE
ANDREW HANZLICEK, DVM, MS, DACVIM MiraVista Diagnostics, Indianapolis, Indiana
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TABLE 2. Recommended dosage of select antifungal drugs in dogs and cats
Route PO
Drug Itraconazole*
Species Dog
Formulation Capsule or
Dose 10 mg/kg/day for 3 days then 5 mg/kg/day
Solution Capsule Solution
Cat
10 mg/kg/day 5 mg/kg/day 20 mg/kg/day 20 mg/kg/day 5 mg/kg EOD 5 mg/kg BID 15 mg/kg once then 7.5 mg/kg/day 5 mg/kg BID 12.5 mg (total dose) q 72 h 1-2 mg/kg EOD Cumulative dose 24 mg/kg 0.5-1 mg/kg EOD Cumulative dose 12 mg/kg
PO
Fluconazole
Dog Cat Dog
Tablet or Solution Tablet or Solution Tablet ER Solution Solution Tablet or Solution
PO
Posaconazole
Cat Dog Cat Dog
PO
Voriconazole
Solution Solution
IV
Amphotericin B (lipid or liposomal)
Cat
Solution
*Starting dose only. Individualized dose should be determined based on itraconazole blood levels.
References 1. Legendre AM, Rohrbach BW, Toal RL, et al. Treatment of blastomycosis with itraconazole in 112 dogs. J Vet Intern Med 1996; 10: 365-371. DOI: 10.1111/j.1939-1676.1996.tb02082.x. 2. KuKanich K, KuKanich B, Lin Z, et al. Clinical pharmacokinetics and outcomes of oral fluconazole therapy in dogs and cats with naturally occurring fungal disease. J Vet Pharmacol Ther 2020. DOI: 10.1111/jvp.12888. 3. Renschler J, Albers A, Sinclair-Mackling H, et al. Comparison of Compounded, Generic, and Innovator- Formulated Itraconazole in Dogs and Cats. J Am Anim Hosp Assoc 2018; 54: 195-200. DOI: 10.5326/JAAHA- MS-6591. 4. Middleton SM, Kubier A, Dirikolu L, et al. Alternate-day dosing of itraconazole in healthy adult cats. J Vet Pharmacol Ther 2016; 39: 27-31. DOI: 10.1111/jvp.12231. 5. Mawby DI, Whittemore JC, Fowler LE, et al. Comparison of absorption characteristics of oral reference and compounded itraconazole formulations in healthy cats. J Am Vet Med Assoc 2018; 252: 195-200. DOI: 10.2460/javma.252.2.195. 6. Mawby DI, Whittemore JC, Genger S, et al. Bioequivalence of orally administered generic, compounded, and innovator-formulated itraconazole in healthy dogs. J Vet Intern Med 2014; 28: 72-77. DOI: 10.1111/ jvim.12219.
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