Medicine Information

Candiver

Name: Candiver
Brand: Candiver
Rating: 4.5 (117 reviews)

Capsule50 mgAntifungalATC: J02AC01

Generic Name

Fluconazole

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
candiver 50 mg capsule	৳ 9.00	৳ 90.00

Description

Overview of the medicine

Candiver 50 mg Capsule contains Fluconazole, an antifungal drug belonging to the triazole class. It is used to treat various fungal infections, including candidiasis (vaginal, oral, esophageal, systemic), cryptococcal meningitis, and dermatophytosis.

Uses & Indications

Vaginal candidiasis (thrush)

Oropharyngeal and esophageal candidiasis

Systemic candidiasis (including candidemia, disseminated candidiasis, and other invasive Candida infections)

Cryptococcal meningitis (treatment and prophylaxis in immunocompromised patients)

Dermatophytosis (e.g., tinea pedis, tinea corporis, tinea cruris, tinea versicolor)

Dosage

Adults

Depends on the indication. For vaginal candidiasis, typically 150 mg as a single oral dose. For oropharyngeal candidiasis, 50 mg once daily for 7-14 days. For systemic infections, initial dose 400 mg, then 200-400 mg daily.

Elderly

Dosage adjustment may be necessary based on renal function, similar to adult patients with renal impairment. No dosage adjustment is needed for elderly patients with normal renal function.

Renal_impairment

For creatinine clearance (CrCl) 21-50 mL/min, reduce dose by 50%. For CrCl < 20 mL/min (not on dialysis), reduce dose by 75%. Patients on regular dialysis should receive 100% of the recommended dose after each dialysis session.

How to Take

Candiver capsules can be taken orally with or without food. Swallow the capsule whole with a glass of water. It is important to complete the full course of treatment as prescribed by your doctor.

Mechanism of Action

Fluconazole works by inhibiting fungal cytochrome P450 enzyme 14α-demethylase, which is essential for ergosterol synthesis. Ergosterol is a key component of the fungal cell membrane. By inhibiting its synthesis, fluconazole disrupts the fungal cell membrane integrity, leading to fungal cell death.

Pharmacokinetics

Onset

Peak plasma concentrations are usually reached within 1-2 hours after oral administration.

Excretion

Primarily renal; approximately 80% of the dose is excreted unchanged in urine.

Half life

Approximately 30 hours (range 20-50 hours).

Absorption

Well absorbed orally (>90%). Bioavailability is not significantly affected by food.

Metabolism

Minimally metabolized; primarily hepatic oxidative metabolism (approximately 11% of the dose is metabolized).

Side Effects

Contraindications

Hypersensitivity to fluconazole or other azole antifungals.
Concomitant administration with terfenadine (with multiple doses of fluconazole 400 mg/day or more).
Concomitant administration with other drugs known to prolong the QT interval and are metabolized by CYP3A4 (e.g., cisapride, astemizole, pimozide, quinidine, erythromycin).

Drug Interactions

Warfarin

Increased prothrombin time, monitor INR.

Phenytoin

Increased phenytoin levels, monitor phenytoin levels.

Rifampicin

Decreased fluconazole concentrations, consider increased fluconazole dose.

Cyclosporine/Tacrolimus

Increased levels of immunosuppressants, monitor levels.

Oral Hypoglycemics (sulfonylureas)

Potentiates hypoglycemic effect, monitor blood glucose.

Statins (e.g., simvastatin, atorvastatin)

Increased risk of myopathy/rhabdomyolysis, monitor for muscle pain.

Storage

Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.

Overdose

In case of overdose, symptomatic treatment and supportive measures are recommended. Gastric lavage may be appropriate, and hemodialysis significantly reduces plasma concentrations of fluconazole.

Pregnancy & Lactation

Pregnancy Category C for single doses, Category D for multiple or high doses. Avoid in pregnancy unless the potential benefit outweighs the risk. Fluconazole is excreted in breast milk; use with caution during lactation, especially with repeated or high doses.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

1 x 7 capsules (blister pack)1 x 10 capsules (blister pack)

Shelf Life

Typically 24 to 36 months from the date of manufacture when stored under recommended conditions.

Availability

Pharmacies, hospitals

Approval Status

Approved (DGDA, FDA)

Patent Status

Generic available, original patent expired

WHO Essential Medicine

Yes

Clinical Trials

Fluconazole has been extensively studied in numerous clinical trials demonstrating its efficacy and safety for various fungal infections, leading to its widespread approval and use globally.

Lab Monitoring

Liver function tests (ALT, AST, alkaline phosphatase, bilirubin) before and during prolonged therapy, especially in patients with pre-existing hepatic impairment.
Renal function monitoring (creatinine clearance) in patients with impaired renal function.
Complete blood count (CBC) during prolonged therapy.

Doctor Notes

Monitor liver function tests (LFTs) at baseline and periodically during prolonged treatment, especially in patients with pre-existing hepatic impairment.
Be mindful of potential drug-drug interactions, particularly with CYP3A4 substrates, QT-prolonging agents, and medications with a narrow therapeutic index.
Emphasize the importance of completing the full prescribed course of treatment to prevent relapse and development of resistance.

Patient Guidelines

Take Candiver exactly as prescribed by your doctor. Do not stop taking it early, even if you feel better, as the infection may return.
Inform your doctor about all other medications, herbal products, and supplements you are taking to avoid potential drug interactions.
Report any severe side effects such as severe rash, yellowing of skin/eyes, or unusual fatigue immediately to your doctor.
Do not share this medicine with others, even if they have similar symptoms.

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 take your next dose at the regularly scheduled time. Do not take two doses at once to make up for a missed dose.

Driving Precautions

Candiver may cause dizziness or, rarely, seizures. Patients should be cautious when driving or operating machinery until they know how the medication affects them.

Lifestyle Advice

Practice good personal hygiene to prevent fungal infections.
For skin infections, keep the affected area clean and dry, and wear loose, breathable clothing.
If treating vaginal candidiasis, avoid douching and tight-fitting synthetic underwear. Also, avoid excessive sugar intake if prone to candidiasis.