Description
Description
Capsules are opaque, white, No. 0 capsule contents are white or almost white powder.
Latin name
Flucostat
Release form
Capsules
Packing
2 capsules.
Pharmacological action
Flucostat – antifungal.
Selectively inhibits the synthesis of sterols in the cell wall of fungi.
Pharmacodynamics
Active against Candida spp., Cryptococcus neoformans, Microsporum spp., Trichoptyton spp., Blastomyces dermatitidis, Coccidioides immitis and Histoplasma capsulatum.
Pharmacokinetics
When taken orally, it is well absorbed in the digestive tract. Cmax is achieved 0.5 ² 1.5 hours after fasting. It penetrates well into all body fluids, 6 months after completion of therapy it is determined in the nails. It is excreted by the kidneys up to 80%.
After iv administration, fluconazole penetrates well into tissues and body fluids. Concentrations of the drug in saliva and sputum correspond to plasma concentrations.
In patients with fungal meningitis, the content of fluconazole in the cerebrospinal fluid reaches 80% of the corresponding plasma levels.
After several injections of 1 dose per day, 90% the level of equilibrium concentration is reached by the 4th ² 5th day, with the introduction of the dose on the 1st day, 2 times the usual daily dose, by the 2nd day.
The apparent volume of distribution approaches the total volume of water in the body. 11 ² 12% of fluconazole binds to plasma proteins. T1 / 2 – 30 hours.
Excreted by the kidneys 80% unchanged. Fluconazole clearance is directly proportional to creatinine clearance. No metabolites found in peripheral blood.
Indications of
cryptococcosis, including cryptococcal meningitis and other localizations of this infection (including lungs, skin), both in patients with a normal immune response and in patients with various forms of immunosuppression (including in AIDS patients , for organ transplantation) the drug can be used to prevent cryptococcal infection in AIDS patients
generalized candidiasis, including candidaemia, disseminated candidiasis and other forms of invasive candida infections (infections of the peritoneum, endocardium, eyes, respiratory and urinary tract). Treatment can be carried out in patients with malignant neoplasms, patients in intensive care units, patients undergoing a course of cytostatic or immunosuppressive therapy, as well as in the presence of other factors, predisposing to the development of candidiasis
candidiasis of the mucous membranes, including the oral cavity and pharynx (including atrophic candidiasis of the oral cavity associated with the wearing of dentures), the esophagus, non-invasive bronchopulmonary candidiasis, candiduria, skin candidiasis prevention of relapse of oropharyngeal candidiasis in AIDS patients
genital candidiasis: treatment of vaginal candidiasis, prophylactic use with to reduce the recurrence rate of vaginal candidiasis, candidiasis balanitis
prevention of fungal infections in patients with malignant neoplasms who are predisposed to such infection m as a result of chemotherapy with cytostatics or radiation therapy
mycosis of the skin, including mycosis of the feet, body, inguinal lichen, onychomycosis candidiasis of the skin
deep endemic mycoses, including coccidiomycosis, paracoccidiomycosis, sporotrichosis and histoplasmosis in patients with normal immunity.
Contraindications
Hypersensitivity (including to similar azole compounds in structure), simultaneous use of terfenadine, astemizole, cisapride.
Composition
1 capsule contains:
Active ingredient:
fluconazole 150 mg.
Excipients:
silicon dioxide colloidal (aerosil),
corn starch,
magnesium stearate,
sodium lauryl sulfate,
lactose.
Capsule shell composition:
gelatin,
methyl parahydroxybenzoate,
propyl parahydroxybenzoate,
titanium dioxide (E171),
acetic acid.
Dosage and Administration
Inside.
For cryptococcal infections, candidaemia, disseminated candidiasis and other invasive candidiasis infections: on the 1st day – 400 mg, then – 200-400 mg once a day.
For the prevention of relapse of cryptococcal meningitis in AIDS patients after a full course of primary treatment: 200 mg / day for a long period.
For atrophic oral candidiasis associated with wearing dentures: 50 mg once a day for 10-14 days.
For other candidal infections of the mucous membranes: 50-100 mg / day for 14-30 days.
For the prevention of recurrence of oropharyngeal candidiasis in AIDS patients after completing the full course of primary treatment: 150 mg once a week.
For vaginal candidiasis and balanitis: once 150 mg. For the prevention of relapse – 150 mg once a month, for 4-12 months.
For the prevention of candidiasis in cancer patients during cytostatic chemo- or radiation therapy: 50-400 mg once a day. If there is a high risk of developing a generalized infection: 400 mg once a day several days before the expected occurrence of neutropenia after increasing the number of neutrophils by more than 1000 / mm3, treatment is continued for another 7 days.
With skin mycoses (feet, inguinal region, etc.), including candida infections: 150 mg once a week or 50 mg once a day. The duration of therapy is 2-4 weeks, with foot mycoses – up to 6 weeks.
With pityriasis versicolor: 50 mg 1 time per day for 2 4 weeks.
For onychomycosis: 150 mg once a week until the growth of an uninfected nail (3 6 and 6 12 months for fingernails and toes, respectively).
For deep endemic mycoses: 200 400 mg / day for 11 24 months (coccidioidomycosis), 2 17 months (paracoccidiomycosis), 1 16 months (sporotrichosis), 3 17 months (histoplasmosis).
Children with candidiasis of the mucous membranes on the 1st day – 6 mg / kg / day, then 3 mg / kg / day, with systemic candidiasis or cryptococcosis – 6-12 mg / kg, depending on the severity of the disease. For prophylaxis against a background of reduced immunity (depending on the severity of neutropenia) – 3-12 mg / kg / day.
Side effects
From the digestive tract: nausea, diarrhea, flatulence.
From the nervous system and sensory organs: headache, dizziness.
Allergic reactions: skin rash, anaphylactic reactions.
Drug Interaction
When combined with coumarin anticoagulants, prothrombin time may be increased (it should be monitored), with terfenadine – the risk of arrhythmia may develop, cisapride – an increase in adverse reactions from the cardiovascular system, including paroxysmal ventricular tachycardia.
Extends T1 / 2 serum sulfonylurea preparations (increased risk of hypoglycemia).
Increases the concentration of phenytoin, cyclosporine, zidovudine in the blood. Rifampicin shortens T1 / 2 Flucostat.
Overdose
In case of overdose, gastric lavage and symptomatic therapy, forced diuresis, or hemodialysis are required (hemodialysis reduces fluconazole concentration by 50% for 3 h).
Storage conditions
In a place inaccessible to children at a temperature not exceeding 25 ° C.
Expiration
2 years.
Deystvuyuschee substances
Fluconazole
pharmacy leave terms without prescription
dosage form
dosage form
capsules
