Candinil
Generic Name
Fluconazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| candinil 50 mg suspension | ৳ 78.00 | N/A |
Description
Overview of the medicine
Candinil 50 mg Suspension contains Fluconazole, an antifungal medication used to treat a variety of fungal infections, including candidiasis. It belongs to the triazole class of antifungals and works by inhibiting the growth of fungi.
Uses & Indications
Dosage
Adults
Dosage varies widely based on indication. For oropharyngeal candidiasis: 50 mg once daily for 7-14 days. For vaginal candidiasis: 150 mg single dose (usually not suspension). For prophylaxis: 50-400 mg daily. For 50 mg suspension, specific instructions will be provided by a doctor.
Elderly
Same as adults, but dose adjustment may be necessary in patients with renal impairment.
Renal_impairment
Dosage adjustment is required based on creatinine clearance. For CrCl 21-50 mL/min, reduce dose by 50%. For CrCl ≤20 mL/min, reduce dose by 75% (after initial loading dose).
How to Take
Administer orally, with or without food. Shake the bottle well before each use to ensure proper mixing. Use the provided measuring device for accurate dosing.
Mechanism of Action
Fluconazole inhibits fungal cytochrome P450-dependent 14-alpha-demethylase, an enzyme essential for the synthesis of ergosterol. Ergosterol is a vital component of the fungal cell membrane, and its inhibition leads to increased cell permeability and eventual cell lysis.
Pharmacokinetics
Onset
1-2 hours for peak plasma concentration, therapeutic effects may take longer depending on infection.
Excretion
Primarily renal excretion (approximately 80% as unchanged drug); a small amount is excreted in feces.
Half life
Approximately 30 hours, allowing for once-daily dosing.
Absorption
Well absorbed orally, with bioavailability typically exceeding 90%. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Minimal hepatic metabolism, about 11% is metabolized.
Side Effects
Contraindications
- Hypersensitivity to fluconazole, other azole antifungals, or any component of the formulation.
- Coadministration with drugs known to prolong the QT interval and metabolized by CYP3A4, such as terfenadine, astemizole, cisapride, pimozide, quinidine, or erythromycin.
Drug Interactions
Warfarin
Increased prothrombin time (INR) and risk of bleeding.
Phenytoin
Increased phenytoin levels; monitor and adjust dose.
Rifampicin
Decreased fluconazole levels; consider increasing fluconazole dose.
Cyclosporine, Tacrolimus
Increased levels of immunosuppressants, leading to potential toxicity.
Oral Hypoglycemics (e.g., Sulfonylureas)
Increased serum concentration and prolonged half-life of oral hypoglycemics, leading to hypoglycemia.
Statins (e.g., Atorvastatin, Simvastatin)
Increased risk of myopathy or rhabdomyolysis.
Storage
Store below 30°C. Protect from light and moisture. Keep the bottle tightly closed. Do not freeze.
Overdose
In case of overdose, symptomatic and supportive treatment should be initiated. Gastric lavage may be considered. Hemodialysis can significantly enhance the elimination of fluconazole from the body.
Pregnancy & Lactation
Pregnancy: Category D for prolonged or high-dose use (especially for invasive or life-threatening fungal infections); otherwise Category C. Use only if the potential benefit justifies the potential risk to the fetus. Lactation: Fluconazole is excreted in breast milk. Caution is advised, and a healthcare provider should be consulted.
Side Effects
Contraindications
- Hypersensitivity to fluconazole, other azole antifungals, or any component of the formulation.
- Coadministration with drugs known to prolong the QT interval and metabolized by CYP3A4, such as terfenadine, astemizole, cisapride, pimozide, quinidine, or erythromycin.
Drug Interactions
Warfarin
Increased prothrombin time (INR) and risk of bleeding.
Phenytoin
Increased phenytoin levels; monitor and adjust dose.
Rifampicin
Decreased fluconazole levels; consider increasing fluconazole dose.
Cyclosporine, Tacrolimus
Increased levels of immunosuppressants, leading to potential toxicity.
Oral Hypoglycemics (e.g., Sulfonylureas)
Increased serum concentration and prolonged half-life of oral hypoglycemics, leading to hypoglycemia.
Statins (e.g., Atorvastatin, Simvastatin)
Increased risk of myopathy or rhabdomyolysis.
Storage
Store below 30°C. Protect from light and moisture. Keep the bottle tightly closed. Do not freeze.
Overdose
In case of overdose, symptomatic and supportive treatment should be initiated. Gastric lavage may be considered. Hemodialysis can significantly enhance the elimination of fluconazole from the body.
Pregnancy & Lactation
Pregnancy: Category D for prolonged or high-dose use (especially for invasive or life-threatening fungal infections); otherwise Category C. Use only if the potential benefit justifies the potential risk to the fetus. Lactation: Fluconazole is excreted in breast milk. Caution is advised, and a healthcare provider should be consulted.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 months from the date of manufacture when stored as recommended. Refer to the product packaging for specific dates.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory authorities (e.g., DGDA, FDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Fluconazole has undergone extensive clinical trials demonstrating its efficacy and safety across a broad spectrum of fungal infections, including both superficial and systemic candidiasis, cryptococcal meningitis, and prophylaxis in vulnerable populations.
Lab Monitoring
- Liver function tests (baseline and periodically, especially in patients with pre-existing hepatic impairment or during prolonged therapy)
- Renal function tests (for dose adjustment in renal impairment)
- Complete blood count (CBC) in prolonged therapy
Doctor Notes
- Ensure proper diagnosis of fungal infection before initiating fluconazole therapy.
- Monitor liver function tests (LFTs) at baseline and periodically, especially in patients with pre-existing hepatic impairment or those on prolonged therapy. Discontinue if LFTs significantly elevate.
- Be aware of potential drug interactions, particularly with QT-prolonging agents and other CYP3A4 substrates/inhibitors. Review concomitant medications.
- Provide clear instructions for accurate dosing and administration of the suspension, especially for pediatric patients.
Patient Guidelines
- Complete the full course of treatment as prescribed by your doctor, even if your symptoms improve, to prevent recurrence of the infection.
- Shake the suspension bottle well before each use.
- Measure the dose accurately using the provided measuring device.
- Report any unusual or severe side effects to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double doses to make up for a missed one.
Driving Precautions
Candinil 50 mg Suspension may cause dizziness or seizures in some individuals. Patients should be advised to exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good personal hygiene to prevent the spread and recurrence of fungal infections.
- Avoid sharing personal items such as towels, combs, and clothing.
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