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 50 mg capsule | ৳ 8.10 | ৳ 81.00 |
Description
Overview of the medicine
Flucoder 50 mg capsule contains Fluconazole, an antifungal medication used to treat a variety of fungal infections, including vaginal, oral, esophageal, and systemic candidiasis, as well as cryptococcal meningitis.
Uses & Indications
Dosage
Adults
Dosage varies by indication. For oropharyngeal candidiasis: 50 mg once daily for 7-14 days. For esophageal candidiasis: 50 mg once daily for 14-30 days. For vaginal candidiasis, a single 150 mg dose is typical (Flucoder 50 mg is not typically used for this single dose, but for prolonged courses or specific prophylactic regimens). Consult a physician for specific dosing.
Elderly
Similar to adult dosage, but dose adjustment may be necessary in elderly patients with renal impairment. Monitor renal function.
Renal_impairment
Dose adjustment required based on creatinine clearance. For CrCl 21-50 mL/min, reduce dose by 50%. For CrCl <20 mL/min, reduce dose by 75% or administer a standard loading dose followed by 50% of the recommended dose.
How to Take
Flucoder capsules can be taken orally with or without food. Swallow the capsule whole with water.
Mechanism of Action
Fluconazole inhibits fungal cytochrome P450 enzyme 14 alpha-demethylase, which is essential for the synthesis of ergosterol, a vital component of the fungal cell membrane. This inhibition leads to the disruption of the fungal cell membrane and ultimately cell death.
Pharmacokinetics
Onset
Onset of action varies depending on the type and severity of infection, typically within days.
Excretion
Primarily excreted unchanged in the urine (approximately 80% of the administered dose). Renal clearance is proportional to creatinine clearance.
Half life
Approximately 30 hours, allowing for once-daily dosing for many indications.
Absorption
Well absorbed orally, with bioavailability >90% that is not affected by food.
Metabolism
Undergoes very little hepatic metabolism (approximately 11% is metabolized).
Peak plasma concentration
Achieved within 1-2 hours after oral administration.
Side Effects
Contraindications
- Hypersensitivity to fluconazole, other azole antifungals, or any component of the formulation.
- Co-administration with terfenadine in patients receiving multiple doses of fluconazole 400 mg/day or more.
- Co-administration with cisapride, astemizole, pimozide, quinidine, or erythromycin due to the risk of QT prolongation and potential for serious cardiac events.
Drug Interactions
Warfarin
Increased prothrombin time; monitor INR.
Phenytoin
Increased phenytoin levels; monitor levels.
Rifampicin
Decreased fluconazole levels; consider increasing fluconazole dose.
Cyclosporine
Increased cyclosporine levels; monitor levels.
Hydrochlorothiazide
Increased fluconazole levels.
Benzodiazepines (e.g., Midazolam)
Increased benzodiazepine levels; monitor for sedation.
Oral Hypoglycemics (sulfonylureas)
Increased hypoglycemic effect; monitor blood glucose.
Statins (e.g., Atorvastatin, Simvastatin)
Increased statin levels, risk of myopathy/rhabdomyolysis.
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, supportive treatment should be initiated. Gastric lavage may be considered if appropriate. Hemodialysis significantly reduces plasma levels of fluconazole.
Pregnancy & Lactation
Pregnancy Category C (single dose for vaginal candidiasis) to D (high doses or prolonged use) due to potential for fetal harm. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Fluconazole is excreted into breast milk; caution should be exercised when administered to a nursing mother. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to fluconazole, other azole antifungals, or any component of the formulation.
- Co-administration with terfenadine in patients receiving multiple doses of fluconazole 400 mg/day or more.
- Co-administration with cisapride, astemizole, pimozide, quinidine, or erythromycin due to the risk of QT prolongation and potential for serious cardiac events.
Drug Interactions
Warfarin
Increased prothrombin time; monitor INR.
Phenytoin
Increased phenytoin levels; monitor levels.
Rifampicin
Decreased fluconazole levels; consider increasing fluconazole dose.
Cyclosporine
Increased cyclosporine levels; monitor levels.
Hydrochlorothiazide
Increased fluconazole levels.
Benzodiazepines (e.g., Midazolam)
Increased benzodiazepine levels; monitor for sedation.
Oral Hypoglycemics (sulfonylureas)
Increased hypoglycemic effect; monitor blood glucose.
Statins (e.g., Atorvastatin, Simvastatin)
Increased statin levels, risk of myopathy/rhabdomyolysis.
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, supportive treatment should be initiated. Gastric lavage may be considered if appropriate. Hemodialysis significantly reduces plasma levels of fluconazole.
Pregnancy & Lactation
Pregnancy Category C (single dose for vaginal candidiasis) to D (high doses or prolonged use) due to potential for fetal harm. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Fluconazole is excreted into breast milk; caution should be exercised when administered to a nursing mother. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the manufacturing date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Fluconazole has undergone extensive clinical trials since its development, demonstrating efficacy and safety for various fungal infections. Ongoing post-marketing surveillance and studies continue to refine its use.
Lab Monitoring
- Liver function tests (ALT, AST, ALP, bilirubin) at baseline and periodically during prolonged therapy.
- Renal function tests (serum creatinine, BUN) in patients with renal impairment.
Doctor Notes
- Always inquire about concurrent medications due to significant drug interaction potential, especially with CYP2C9/3A4 substrates.
- Educate patients on the importance of completing the full course and recognizing signs of hepatotoxicity or severe skin reactions.
- Consider dose adjustment in renal impairment; monitor renal function parameters.
Patient Guidelines
- Take the medicine for the full prescribed duration, even if symptoms improve, to prevent recurrence.
- Report any unusual side effects, especially severe rash, yellowing of skin/eyes, or severe abdominal pain, to your doctor immediately.
- Do not share your medicine with others.
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 the dose to catch up.
Driving Precautions
This medicine may cause dizziness or seizures in some individuals. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain good personal hygiene to help prevent fungal infections.
- Avoid sharing personal items like towels or clothing.
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