Two medicines, side by side
Itraconazole vs voriconazole
Itraconazole and voriconazole are both labeled for fungal infections. Drugs@FDA records approvals of itraconazole since 1992 and of voriconazole since 2002. Pharmacies paid $0.910 per itraconazole 100 mg capsule and $1.88 per voriconazole 200 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Itraconazole, “Mechanism of Action In vitro studies have demonstrated that itraconazole inhibits the cytochrome P450-dependent synthesis of ergosterol, which is a vital component of fungal cell membranes.”; Voriconazole, “Voriconazole is an antifungal drug [see Microbiology (12.4) ].”
Check it at the source: the itraconazole FDA label on DailyMed (effective July 13, 2026); the voriconazole FDA label on DailyMed (effective February 26, 2026).
Highlights of the itraconazole record
Itraconazole (Sporanox) · label of July 13, 2026
Congestive Heart Failure, Cardiac Effects and Drug Interactions Congestive Heart Failure and Cardiac Effects SPORANOX ® (itraconazole) Capsules should not be administered for the treatment of onychomycosis in patients with evidence of ventricular dysfunction such as congestive heart failure (CHF) or a history of CHF. If signs or symptoms of congestive heart failure occur during administration of SPORANOX ® Capsules, discontinue administration.
Used for
From the label: indicationsSPORANOX ® (itraconazole) Capsules are indicated for the treatment of the following fungal infections in immunocompromised and non-immunocompromised patients: Blastomycosis, pulmonary and extrapulmonary Histoplasmosis, including chronic cavitary pulmonary disease and disseminated, non-meningeal histoplasmosis, and Aspergillosis, pulmonary and extrapulmonary, in patients who are intolerant of or who are refractory to amphotericin B therapy. […]
On the market
- Earliest approval on file
- September 11, 1992
- Generic labelers
- 11 labelers
- Pharmacy cost
- $0.910 per capsule
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 1
Highlights of the voriconazole record
Voriconazole (Vfend) · label of February 26, 2026
Used for
From the label: indicationsVFEND is an azole antifungal indicated for the treatment of adults and pediatric patients 2 years of age and older with: • Invasive aspergillosis ( 1.1 ) • Candidemia in non-neutropenics and other deep tissue Candida infections ( 1.2 ) • Esophageal candidiasis ( 1.3 ) • Serious fungal infections caused by Scedosporium apiospermum and Fusarium species including Fusarium solani, in patients intolerant of, or […]
On the market
- Earliest approval on file
- May 24, 2002
- Generic labelers
- 31 labelers
- Pharmacy cost
- $1.88 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 4
Source: FDA drug labels via openFDA (Itraconazole label of July 13, 2026, Voriconazole label of February 26, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do itraconazole and voriconazole differ on the record?
How each works, in its label's words: Itraconazole, “Mechanism of Action In vitro studies have demonstrated that itraconazole inhibits the cytochrome P450-dependent synthesis of ergosterol, which is a vital component of fungal cell membranes.”; Voriconazole, “Voriconazole is an antifungal drug [see Microbiology (12.4) ].”
Only the itraconazole label carries a boxed warning.
Both are in FDA's class azole antifungals.
Generics: itraconazole since 2004; voriconazole since 2010 (Drugs@FDA).
| Itraconazole | Voriconazole | |
|---|---|---|
| Labeled for | Fungal infections | Fungal infections |
| Pharmacologic class | Azole Antifungal | Azole Antifungal |
| How it works (label) | Mechanism of Action In vitro studies have demonstrated that itraconazole inhibits the cytochrome P450-dependent synthesis of ergosterol, which is a vital component of fungal cell membranes. | Voriconazole is an antifungal drug [see Microbiology (12.4) ]. |
| Half-life (label) | The terminal half-life of itraconazole generally ranges from 16 to 28 hours after single dose and increases to 34 to 42 hours with repeated dosing. | n/a |
| Earliest approval on file (Drugs@FDA) | September 11, 1992 | May 24, 2002 |
| First generic approved | May 28, 2004 | April 22, 2010 |
| Generic labelers (NDC) | 11 labelers | 31 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.910 per capsule (Itraconazole 100 mg capsule) | $1.88 per tablet (Voriconazole 200 mg tablet) |
| 12-month price change | -4% | -2% |
| Boxed warning | Yes | No |
| Shortage now | A presentation being discontinued | A presentation being discontinued |
| Recalls recorded | 1 | 4 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 11,610 | 30,201 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to itraconazole
- every medicine labeled for the same conditions