Medicine Information

Flucostin

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

Tablet50 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
flucostin 50 mg tablet	৳ 8.00	৳ 80.00

Description

Overview of the medicine

Flucostin 50 mg Tablet contains Fluconazole, a triazole antifungal agent used to treat various fungal infections caused by Candida species and Cryptococcus neoformans.

Uses & Indications

Vaginal candidiasis (yeast infection)

Oropharyngeal and esophageal candidiasis

Systemic candidiasis (including candidemia, disseminated candidiasis)

Cryptococcal meningitis

Dermatophytosis (tinea infections) and onychomycosis

Dosage

Adults

Dosage varies with indication. For oropharyngeal candidiasis: 50-100 mg once daily for 7-14 days. For esophageal candidiasis: 100-200 mg once daily for 14-30 days. 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 vaginal candidiasis: 150 mg single oral dose.

Elderly

Dosage adjustment is generally not necessary unless there is evidence of renal impairment.

Renal_impairment

Dosage should be adjusted based on creatinine clearance. For CrCl <50 mL/min, reduce dose by 50% after initial loading dose.

How to Take

Take the tablet orally, with or without food. It can be taken at any time of the day.

Mechanism of Action

Fluconazole works by inhibiting fungal cytochrome P450-dependent 14-alpha-demethylase, an enzyme necessary for ergosterol synthesis. Ergosterol is a vital component of fungal cell membranes, and its inhibition disrupts membrane integrity and inhibits fungal growth.

Pharmacokinetics

Onset

Within 1-2 hours for significant antifungal activity.

Excretion

Primarily renal excretion, with approximately 80% of the dose eliminated unchanged in urine.

Half life

Approximately 30 hours (range 20-50 hours).

Absorption

Well absorbed orally, with bioavailability >90%. Peak plasma concentrations achieved within 1-2 hours.

Metabolism

Minimally metabolized; approximately 11% of the dose is metabolized to inactive metabolites.

Side Effects

Contraindications

Hypersensitivity to fluconazole or any of its excipients.
Concomitant administration of terfenadine or cisapride (due to risk of QT prolongation).
Concomitant administration of drugs known to prolong the QT interval and metabolized by CYP3A4.

Drug Interactions

Rifampin

Decreased fluconazole levels; consider increasing fluconazole dose.

Warfarin

Increased prothrombin time; monitor INR.

Phenytoin

Increased phenytoin levels; monitor levels.

Cyclosporine

Increased cyclosporine levels; monitor levels.

Hydrochlorothiazide

Increased fluconazole plasma concentrations.

Oral Hypoglycemics (sulfonylureas)

Increased plasma concentrations of sulfonylureas; monitor blood glucose.

QT-prolonging drugs (e.g., amiodarone, quinidine)

Increased risk of QT prolongation; avoid co-administration.

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 measures and symptomatic treatment should be instituted. Gastric lavage may be performed. Fluconazole is largely excreted in the urine, and a 3-hour hemodialysis session decreases plasma levels by approximately 50%.

Pregnancy & Lactation

Pregnancy Category C/D (depending on dose/duration). High doses or chronic use during pregnancy may cause birth defects. Use only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding, as fluconazole is excreted in breast milk.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per box

Shelf Life

2-3 years from manufacturing date

Availability

Available in pharmacies and hospitals

Approval Status

Approved by FDA/DGDA

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Fluconazole has undergone extensive clinical trials demonstrating its efficacy and safety in various fungal infections. 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 those on prolonged therapy.
Renal function should be monitored, particularly in patients with kidney impairment.

Doctor Notes

Counsel patients on completing the full course of therapy to prevent relapse and resistance.
Monitor liver function tests periodically, especially in patients on prolonged therapy or with pre-existing hepatic conditions.
Be aware of potential drug interactions, particularly with warfarin, phenytoin, and QT-prolonging agents.

Patient Guidelines

Complete the full course of medication as prescribed by your doctor, even if symptoms improve.
Report any severe skin reactions, yellowing of skin/eyes, dark urine, or unusual bruising/bleeding to your doctor immediately.
Avoid alcohol during treatment as it may increase the risk of liver side effects.

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 take a double dose to make up for a missed one.