Diflu
Generic Name
Fluconazole 150 mg capsule
Manufacturer
Square Pharmaceuticals PLC.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| diflu 150 mg capsule | ৳ 22.00 | ৳ 132.00 |
Description
Overview of the medicine
Diflu 150 mg capsule contains Fluconazole, an antifungal medication belonging to the azole class. It is primarily used to treat various fungal infections, including vaginal candidiasis, oral thrush, esophageal candidiasis, and systemic fungal infections.
Uses & Indications
Dosage
Adults
Vaginal Candidiasis: 150 mg as a single oral dose. Oropharyngeal Candidiasis: 50-100 mg once daily for 7-14 days. Esophageal Candidiasis: 100-200 mg once daily for 14-30 days. Cryptococcal Meningitis: 400 mg on day 1, then 200-400 mg once daily for 6-8 weeks, followed by suppressive therapy if needed.
Elderly
No dosage adjustment is generally required for elderly patients with normal renal function. For elderly patients with renal impairment, dose adjustment based on creatinine clearance is necessary.
Renal_impairment
For creatinine clearance (CrCl) 21-50 mL/min, administer 50% of the recommended dose. For CrCl <20 mL/min, administer 25% of the recommended dose. Patients on regular hemodialysis should receive 100% of the recommended dose after each dialysis session.
How to Take
Diflu capsule can be taken 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, even if your symptoms improve.
Mechanism of Action
Fluconazole selectively inhibits fungal cytochrome P450-dependent 14-alpha-demethylase, an enzyme essential for the synthesis of ergosterol, a vital component of the fungal cell membrane. This inhibition leads to the accumulation of 14-alpha-methyl sterols and a consequent decrease in ergosterol, disrupting the fungal cell membrane and leading to fungal cell death.
Pharmacokinetics
Onset
Clinical effects typically observed within 24-48 hours, though a single dose for vaginal candidiasis may show improvement within 1-2 days.
Excretion
Primarily renal, with approximately 80% of the unchanged drug excreted in urine. Renal clearance is proportional to creatinine clearance.
Half life
Approximately 30 hours, allowing for once-daily dosing.
Absorption
Well absorbed orally, with bioavailability greater than 90% (similar to intravenous administration). Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Minimally metabolized; about 11% is metabolized by the liver into inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to fluconazole, other azole antifungals, or any excipients of the product.
- Co-administration with drugs known to prolong the QT interval and metabolized by CYP3A4, such as terfenadine, astemizole, cisapride, pimozide, and quinidine.
Drug Interactions
Warfarin
Increased prothrombin time; monitor INR closely.
Phenytoin
Increased phenytoin levels; monitor for toxicity.
Rifampicin
Decreased fluconazole plasma concentrations; consider increasing fluconazole dose.
Erythromycin
Increased risk of cardiotoxicity (QT prolongation).
Hydrochlorothiazide
Increased fluconazole plasma concentrations.
Midazolam/Triazolam
Increased plasma concentrations of benzodiazepines; monitor for increased sedation.
Cyclosporine/Tacrolimus
Increased plasma concentrations of these immunosuppressants; monitor drug levels.
Oral Hypoglycemics (e.g., sulfonylureas)
Increased risk of hypoglycemia; monitor blood glucose levels.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include hallucinations and paranoid behavior. Management involves symptomatic and supportive treatment. Hemodialysis significantly reduces plasma levels of fluconazole, with a 3-hour dialysis session decreasing plasma levels by approximately 50%.
Pregnancy & Lactation
Pregnancy: Category C for single doses, Category D for repeated high doses or prolonged use during the first trimester due to potential teratogenic effects. Use only if potential benefit justifies the potential risk to the fetus. Lactation: Fluconazole is excreted in breast milk at concentrations similar to plasma. Generally not recommended during breastfeeding unless the benefits outweigh the risks.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific expiry date is printed on the packaging.
Availability
Pharmacies and Hospitals
Approval Status
Approved by FDA and DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Fluconazole has undergone extensive clinical trials demonstrating its efficacy and safety across various fungal infections. Ongoing research explores its role in new indications and resistant strains.
Lab Monitoring
- Liver function tests (ALT, AST, alkaline phosphatase, bilirubin) should be monitored, especially in patients with pre-existing hepatic dysfunction or those on long-term therapy.
- Renal function (creatinine, BUN) should be monitored in patients with renal impairment.
Doctor Notes
- Emphasize patient compliance with the full course of therapy, particularly for systemic infections, to prevent recurrence and resistance.
- Be vigilant for signs of hepatotoxicity and discontinue fluconazole if symptoms suggestive of liver injury occur. Monitor LFTs in patients on chronic therapy.
- Review concomitant medications for potential drug interactions, especially those affecting CYP3A4 and CYP2C9, and drugs known to prolong the QT interval.
Patient Guidelines
- Take the medication exactly as prescribed by your doctor; do not stop treatment early even if symptoms improve.
- Inform your doctor about all other medications, herbal supplements, and over-the-counter drugs you are taking to avoid potential drug interactions.
- Seek immediate medical attention if you experience severe allergic reactions (e.g., difficulty breathing, swelling of face/throat), severe skin rash, or signs of liver problems (e.g., unusual fatigue, dark urine, yellowing of skin/eyes).
Missed Dose Advice
If you miss a dose of Diflu, take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Diflu may cause dizziness or seizures in some individuals. If you experience these side effects, avoid driving or operating machinery.
Lifestyle Advice
- Maintain good personal hygiene to help prevent recurrence of fungal infections.
- For vaginal yeast infections, wear loose-fitting, cotton underwear to promote air circulation and reduce moisture.
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