Flucoder
Generic Name
Fluconazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| flucoder 200 mg capsule | ৳ 25.00 | ৳ 250.00 |
Description
Overview of the medicine
Fluconazole is an antifungal medication used to treat various fungal infections, including candidiasis (vaginal, oral, esophageal, systemic), cryptococcal meningitis, and dermatophytosis.
Uses & Indications
Dosage
Adults
For systemic candidiasis: 400 mg on day 1, then 200-400 mg once daily. For cryptococcal meningitis: 400 mg on day 1, then 200-400 mg once daily for 6-8 weeks. For oropharyngeal candidiasis: 50-100 mg once daily for 7-14 days. For vaginal candidiasis, a single 150 mg dose is typical; 200 mg may be used for other specific fungal infections as per doctor's advice.
Elderly
Dosage adjustments usually not necessary unless renal function is impaired. If renal impairment is present, refer to renal impairment dosage.
Renal_impairment
Dosage adjustment required based on creatinine clearance (CrCl). If CrCl > 50 mL/min, use usual dose. If CrCl ≤ 50 mL/min, administer 50% of the recommended daily dose after the initial loading dose (if applicable).
How to Take
Take orally, with or without food. Swallow the capsule whole with a glass of water.
Mechanism of Action
Fluconazole inhibits fungal cytochrome P450-dependent 14-alpha-demethylase, which is an essential step in fungal ergosterol biosynthesis. This leads to disruption of fungal cell membrane integrity.
Pharmacokinetics
Onset
Varies by infection type, generally symptomatic improvement within days for superficial infections.
Excretion
Primarily renal, approximately 80% of the dose excreted unchanged in urine.
Half life
Approximately 30 hours, allowing for once-daily dosing.
Absorption
Well absorbed orally (>90% bioavailability), peak plasma concentrations reached within 0.5-1.5 hours.
Metabolism
Minimal hepatic metabolism, primarily excreted as unchanged drug.
Side Effects
Contraindications
- Hypersensitivity to Fluconazole or other azole antifungals.
- Co-administration with terfenadine, astemizole, cisapride, pimozide, quinidine, or erythromycin in patients receiving multiple doses of Fluconazole due to risk of QT prolongation and serious cardiac arrhythmias.
Drug Interactions
Warfarin
Increased prothrombin time (PT/INR), monitor for bleeding.
Phenytoin
Increased phenytoin levels, monitor for toxicity.
Rifampicin
Decreased Fluconazole plasma levels, consider increasing Fluconazole dose.
Hydrochlorothiazide
Increased Fluconazole plasma levels.
Oral contraceptives
May increase or decrease levels of some components of oral contraceptives, though generally not clinically significant.
Cyclosporine/Tacrolimus
Increased levels of these immunosuppressants, monitor renal function and drug levels.
Oral Hypoglycemics (e.g., sulfonylureas)
Increased plasma concentration of sulfonylureas, leading to a risk of hypoglycemia.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive treatment should be initiated. Hemodialysis significantly reduces plasma levels of Fluconazole.
Pregnancy & Lactation
Pregnancy Category D (for prolonged high-dose use); for single dose vaginal candidiasis, it's Category C. Should be avoided unless potential benefits outweigh potential risks. Fluconazole is excreted in breast milk; caution is advised or breastfeeding may need to be discontinued depending on the dose and duration of treatment.
Side Effects
Contraindications
- Hypersensitivity to Fluconazole or other azole antifungals.
- Co-administration with terfenadine, astemizole, cisapride, pimozide, quinidine, or erythromycin in patients receiving multiple doses of Fluconazole due to risk of QT prolongation and serious cardiac arrhythmias.
Drug Interactions
Warfarin
Increased prothrombin time (PT/INR), monitor for bleeding.
Phenytoin
Increased phenytoin levels, monitor for toxicity.
Rifampicin
Decreased Fluconazole plasma levels, consider increasing Fluconazole dose.
Hydrochlorothiazide
Increased Fluconazole plasma levels.
Oral contraceptives
May increase or decrease levels of some components of oral contraceptives, though generally not clinically significant.
Cyclosporine/Tacrolimus
Increased levels of these immunosuppressants, monitor renal function and drug levels.
Oral Hypoglycemics (e.g., sulfonylureas)
Increased plasma concentration of sulfonylureas, leading to a risk of hypoglycemia.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive treatment should be initiated. Hemodialysis significantly reduces plasma levels of Fluconazole.
Pregnancy & Lactation
Pregnancy Category D (for prolonged high-dose use); for single dose vaginal candidiasis, it's Category C. Should be avoided unless potential benefits outweigh potential risks. Fluconazole is excreted in breast milk; caution is advised or breastfeeding may need to be discontinued depending on the dose and duration of treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date. Check the expiration date on the package.
Availability
Pharmacies and Hospitals
Approval Status
Approved by major regulatory bodies globally
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Fluconazole has undergone extensive clinical trials demonstrating its efficacy and safety across various fungal infections, leading to its widespread approval and use globally. Post-marketing surveillance continues to monitor its effects.
Lab Monitoring
- Liver function tests (LFTs) should be monitored, especially in patients with pre-existing hepatic impairment or during prolonged therapy.
- Renal function tests should be monitored in patients with impaired renal function.
- Electrolytes (e.g., potassium) may be monitored with concomitant diuretics or in at-risk patients.
Doctor Notes
- Emphasize the importance of completing the full course of therapy to prevent resistance and recurrence.
- Educate patients on potential drug-drug interactions, especially with narrow therapeutic index drugs like warfarin and phenytoin.
- Advise immediate reporting of any signs of liver toxicity (e.g., jaundice, dark urine) or severe skin reactions.
Patient Guidelines
- Complete the full course of medication as prescribed by your doctor, even if your symptoms improve, to prevent recurrence of the infection.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Report any unusual side effects, especially severe skin reactions, yellowing of skin/eyes (jaundice), dark urine, or persistent nausea/vomiting, to your doctor immediately.
Missed Dose Advice
Take the missed dose 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 take a double dose to make up for a missed one.
Driving Precautions
Fluconazole may cause dizziness or seizures in some patients. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Maintain good personal hygiene to help prevent fungal infections.
- For skin infections, keep the affected area clean and dry. Avoid tight-fitting clothing made of synthetic materials that can trap moisture.
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