AZOLES AND FOOD

Some foods increase the absorption of itraconazole capsules or tablets, but appears to decrease the bioavailability of itraconazole solution. Studies with ketoconazole have shown little effect of food on absorption although one found a decrease. Food increases the bioavailability of posaconazole suspension. The bioavailability of voriconazole is modestly reduced by food.
Itraconazole capsules are best taken with or after food, whereas the acidic solution should be taken at least 1 hour before food. Similarly, posaconazole should be taken with food. A confusing and conflicting picture is presented by the studies with ketoconazole; however, one manufacturer of ketoconazole says that it should always be taken with meals. The manufacturers of voriconazole recommend that it should be taken at least one hour before or at least one to two hours after a meal. Food does not appear to affect fluconazole capsules. Cola drinks may increase itraconazole and ketoconazole bioavailability, see H2-receptor antagonists, below, and proton pump inhibitors.
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