Which oral antifungals require liver function monitoring?
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Manufacturers of oral antifungal agents recommend some level of liver function monitoring due to their potential hepatotoxicity (SOR: B, based on limited randomized controlled trials, cohort studies, and case studies). Itraconazole pulse therapy is safe and may not need liver function monitoring (SOR: A, based on a systematic review). Patients taking antifungal agents for >1 week should be informed about signs and symptoms of possible hepatotoxicity. (SOR: C, based on expert opinion.) Patients with underlying liver disease or taking other hepatotoxic drugs should avoid antifungal therapy or have close liver function monitoring before and during therapy (SOR: C, based on expert opinion).
Evidence Based Practice 13(8): 01-02.