Hydroxy-itraconazole pharmacokinetics is similar to that of itraconazole in immunocompromised patients receiving oral solution of itraconazole

► We enrolled 46 immunocompromised patients taking an oral solution of ITZ. ► Pharmacokinetics of ITZ, OH-ITZ, and keto-ITZ were evaluated. ► The plasma concentration of OH-ITZ was strongly correlated with that of ITZ. ► Metabolism of OH-ITZ to keto-ITZ was saturable and variable in clinical settings. ► Plasma concentrations of ITZ and OH-ITZ were associated with Alb, TB, and eGFR.