Active ingredient: Fluconazole. Indications: Systemic candidiasis - candidemia, disseminated candidiasis (endocardial lesion, abdominal, respiratory, eye and urinary tract).
Release form
Capsules
Indications
cryptococcosis
- cryptococcal meningitis cryptococcal infections of the lungs and skin
cryptococcal sepsis prevention of relapses of cryptococcosis in AIDS
patients with organ transplantation or other cases of
immunodeficiency,
generalized candidiasis, candidiasis, and candida infection respiratory
and urinary tract), incl. in patients receiving a course of cytostatic
or immunosuppressive therapy, as well as in the presence of other
factors predisposing to the development of candidiasis, treatment and
prevention of
candidiasis of the mucous membranes of the oral
cavity, including atrophic candidiasis of the oral cavity associated
with wearing dentures, pharynx, esophagus and non-invasive
bronchopulmonary infections, candiduria
genital candidiasis - vaginal (acute or chronic relapsing form) candida balanitis (capsules)
prevention
of fungal infections in patients with malignant neoplasms who are
predisposed to such infections as a result of chemotherapy with
cytostatics or radiation therapy prevention of recurrence of
oropharyngeal candidiasis in patients with oropharyngeal candidiasis
skin, including mycoses of the trunk, inguinal region
capsules: pityriasis versicolor, onychomycosis, foot mycoses
deep endemic mycoses, including coccidioidosis, paracoccidioidosis and histoplasmosis in patients with normal immunity.
Contraindications
hypersensitivity to fluconazole, other components of the drug, or other similar structured azole compounds
simultaneous
use of terfenadine (against the background of continuous administration
of fluconazole at a dose of 400 mg / day or higher) and cisapride,
because both drugs lengthen the QT interval and increase the risk of
severe cardiac arrhythmias
simultaneous use of astemizole
lactose intolerance, lactase deficiency, glucose-galactose malabsorption (capsules)
lactation period.
Caution:
hepatic and / or renal failure rash on the background of the use of
fluconazole in patients with superficial fungal infection and invasive /
systemic fungal infections, the simultaneous use of fluconazole with
rifabutin or other drugs metabolized by the P450 cytochrome system, the
simultaneous use of terfenadine and fluconazole in a dose of less than
400 mg / day proarrhythmogenic conditions in patients with multiple risk
factors (organic heart disease, electrolyte imbalance, one belt intake
of drugs causing arrhythmias) patients with intolerance to
acetylsalicylic acid pregnancy.
Use during pregnancy and lactation
Use of fluconazole during pregnancy is possible only if the potential benefit to the mother outweighs the risk to the fetus.
Fluconazole
is determined in breast milk at the same concentration as in plasma,
therefore, its appointment during lactation is contraindicated.
Composition
1 capsule contains:
Active ingredient:
fluconazole 150 mg
Excipients:
silicon dioxide colloidal
magnesium stearate
talc
povidone
anhydrous corn starch
lactose.
Side
effects of the digestive system: nausea, vomiting, diarrhea,
flatulence, abdominal pain, taste change, impaired liver function
(hyperbilirubinemia, increased activity of hepatic transaminases,
alkaline phosphatase, jaundice, hepatitis, hepatocellular necrosis,
incl. fatal).
From the nervous system: headache, dizziness, cramps.
From the hemopoietic organs: leukopenia, thrombocytopenia, neutropenia, agranulocytosis.
Allergic
reactions: skin rash, erythema multiforme exudative (including
Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell syndrome),
anaphylactoid reactions (including angioedema, swelling of the face,
urticaria, itching of the skin), bronchial asthma (more often with
intolerance to acetylsalicylic acid).
On the part of the CCC: an increase in the duration of the QT interval on the ECG, ventricular fibrillation / flutter.
Other: impaired renal function, alopecia, hypercholesterolemia, hypertriglyceridemia, hypokalemia.
Drug Interaction
Anticoagulants.
Patients receiving fluconazole and indirect coumarin anticoagulants
need careful control of PV as it may increase.
Sulfonylureas.
Fluconazole, when taken at the same time, may prolong the T1 / 2
derivatives of sulfonylureas, so when combined, consideration should be
given to the possibility of hypoglycemia.
Phenytoin. Concomitant
administration of fluconazole and phenytoin may be accompanied by a
clinically relevant increase in the concentration of phenytoin, which
requires a reduction in its dose.
Rifampicin. Co-administration
of rifampicin and fluconazole decreases Cmax and T1 / 2 of the latter,
therefore, a combination dose should increase the dose of fluconazole.
Rifabutin.
The combined use of fluconazole and rifabutin is accompanied by an
increase in serum concentration of the latter, the development of
uveitis is possible.
Cyclosporine. When fluconazole and
cyclosporine are co-administered, it is recommended to control the
concentration of the latter as it may increase.
Terfenadine.
Given the occurrence of serious, life-threatening, arrhythmias in
patients taking antifungal agents - azole derivatives in combination
with terfenadine, their co-administration is contraindicated.
Cisapride.
With concomitant administration of fluconazole and cisapride, adverse
events from the heart have been reported, including ventricular
tachycardia paroxysms. Simultaneous administration is contraindicated.
Zidovudine.
When combined with fluconazole, it is possible to increase the
concentration of zidovudine in the blood plasma. Patients taking this
combination should be observed to identify side effects of zidovudine.
Theophylline.
Fluconazole administration leads to a decrease in the average clearance
rate of theophylline from the blood plasma, therefore increasing the
risk of the toxic effect of theophylline and its overdose.
Midazolam.
Concomitant use of fluconazole and midazolam leads to a significant
increase in the latter's plasma concentration and the risk of
psychomotor reactions.
Hydrochlorothiazide. Concomitant
administration of fluconazole and hydrochlorothiazide increases the
concentration of fluconazole in blood plasma by 40%.
Tacrolimus.
Concomitant administration of fluconazole and tacrolimus increases the
concentration of the latter in the serum, leading to an increased risk
of nephrotoxicity.
Caution should be exercised when using fluconazole in patients receiving other drugs metabolised by the cytochrome P450 system.
Overdose
Symptoms: nausea, vomiting, diarrhea in severe cases, convulsions, hallucinations, paranoid behavior may occur.
Treatment:
symptomatic (gastric lavage, forced diuresis, hemodialysis). After a
3-hour hemodialysis session, the concentration of fluconazole in the
blood plasma decreases by about 50%.
Storage conditions
The drug should be stored at a temperature of 15 ° to 30 РC.
Deystvuyuschee substances
Fluconazole