Onmel

Onmel is a brand name for itraconazole in oral solution form, an azole antifungal medication used to treat a range of systemic fungal infections caused by susceptible organisms, as well as certain dermatologic infections. Itraconazole works by inhibiting fungal cytochrome P450 14α-demethylase, an enzyme required for ergosterol synthesis. Disruption of ergosterol production compromises the fungal cell membrane and inhibits fungal growth.

Pharmacokinetics and administration: The oral solution of itraconazole is readily absorbed and generally has good bioavailability, with absorption influenced by gastric pH and food intake. The drug is extensively metabolized in the liver, mainly by CYP3A4, and its metabolites are excreted in feces. Because itraconazole inhibits CYP3A4, it has the potential for many drug interactions with agents such as certain statins, antiarrhythmics, and other antifungals. Absorption and effect can be affected by concomitant antacids or acid-suppressing medications, so clinicians consider these factors when selecting a regimen.

Adverse effects and safety: Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, headache, and rash. Serious but less common risks include hepatotoxicity and congestive heart failure; liver function monitoring is advised during prolonged use, and itraconazole should be used with caution in patients with baseline cardiac dysfunction. Due to potential drug interactions, a comprehensive review of a patient’s medications is recommended before starting Onmel. Use in pregnancy is generally avoided unless clearly indicated.

Brand and regulatory status: Onmel has been marketed in various markets as a branded itraconazole oral solution. As with other itraconazole products, labeling emphasizes indications, interactions, hepatic monitoring, and cautions related to gastric acidity and concomitant medications.