Medicine Information

Flugal

Name: Flugal
Brand: Flugal

Capsule150 mgAntifungalATC: J02AC01

Generic Name

Flugal

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
flugal 50 mg capsule	৳ 8.07	৳ 80.70
flugal 150 mg capsule	৳ 22.14	৳ 221.40
flugal 200 mg capsule	৳ 25.17	৳ 151.02
flugal 200 mg injection	৳ 200.00	N/A
flugal 50 mg suspension	৳ 78.53	N/A

Description

Overview of the medicine

Flugal is an antifungal medication primarily used to treat various fungal infections, including vaginal yeast infections, oral thrush, esophageal candidiasis, and systemic candidiasis. It works by stopping the growth of fungi.

Uses & Indications

Vaginal candidiasis

Oropharyngeal and Esophageal candidiasis

Systemic candidiasis

Cryptococcal meningitis

Dermatophytosis

Dosage

Adults

Vaginal candidiasis: 150 mg as a single oral dose. Oropharyngeal candidiasis: 50-100 mg once daily for 7-14 days. Systemic candidiasis: 400 mg on day 1, then 200-400 mg once daily.

Elderly

No dosage adjustment needed unless renal impairment is present. Adjust dosage based on creatinine clearance.

Renal_impairment

Dose reduction recommended for creatinine clearance <50 mL/min. For CrCl 21-50 mL/min, administer 50% of the recommended dose.

How to Take

Oral capsules can be taken with or without food. For systemic infections or patients unable to take oral medication, intravenous administration is also available.

Mechanism of Action

Flugal inhibits fungal cytochrome P450-dependent 14α-demethylation of lanosterol, an essential step in fungal ergosterol biosynthesis. This action disrupts the fungal cell membrane, leading to its death.

Pharmacokinetics

Onset

Onset of antifungal effects varies based on the type and severity of infection, typically observed within 24-48 hours.

Excretion

Primarily excreted unchanged in the urine, accounting for about 80% of the administered dose.

Half life

The plasma elimination half-life is approximately 30 hours.

Absorption

Well absorbed orally, with bioavailability exceeding 90%. Peak plasma concentrations are typically reached within 0.5-1.5 hours after oral administration.

Metabolism

Flugal undergoes minimal hepatic metabolism; approximately 11% of the drug is metabolized in the liver.

Side Effects

Contraindications

Hypersensitivity to Flugal or other azole antifungals
Co-administration with terfenadine, cisapride, or other drugs known to prolong the QT interval and metabolized by CYP3A4

Drug Interactions

Rifampin

Decreases Flugal plasma concentrations; consider increasing Flugal dose if co-administered.

Warfarin

Increased prothrombin time (INR); monitor INR closely.

Phenytoin

Increased serum phenytoin concentrations; monitor levels and adjust phenytoin dose if necessary.

Oral Hypoglycemics

May increase serum concentrations 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 the event of an overdose, supportive measures and symptomatic treatment should be initiated. Hemodialysis may enhance the elimination of Flugal.

Pregnancy & Lactation

Pregnancy Category C. Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Flugal is excreted in human breast milk; caution should be exercised when administered to a nursing woman.

Side Effects

Contraindications

Hypersensitivity to Flugal or other azole antifungals
Co-administration with terfenadine, cisapride, or other drugs known to prolong the QT interval and metabolized by CYP3A4

Drug Interactions

Rifampin

Decreases Flugal plasma concentrations; consider increasing Flugal dose if co-administered.

Warfarin

Increased prothrombin time (INR); monitor INR closely.

Phenytoin

Increased serum phenytoin concentrations; monitor levels and adjust phenytoin dose if necessary.

Oral Hypoglycemics

May increase serum concentrations 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 the event of an overdose, supportive measures and symptomatic treatment should be initiated. Hemodialysis may enhance the elimination of Flugal.

Pregnancy & Lactation

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

1 x 1 capsule1 x 5 capsules

Shelf Life

24 to 36 months from the manufacturing date when stored properly.

Availability

Available in pharmacies nationwide

Approval Status

Approved by DGDA

Patent Status

Patent expired; generic available

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have established the efficacy and safety of Flugal (referring to Fluconazole) for various fungal infections across diverse patient populations.

Lab Monitoring

Liver function tests (ALT, AST, alkaline phosphatase)
Renal function (creatinine, BUN)
INR for patients on warfarin

Doctor Notes

Monitor liver function tests, especially in patients on prolonged therapy or with pre-existing hepatic impairment.
Be aware of significant drug interactions, particularly with QT-prolonging agents and drugs primarily metabolized by CYP3A4, CYP2C9, and CYP2C19.

Patient Guidelines

Take the medication exactly as prescribed and complete the full course of treatment, even if symptoms improve.
Report any severe or persistent side effects to your doctor immediately.
Inform your doctor or pharmacist about all other medications you are taking, including over-the-counter drugs and herbal supplements.

Missed Dose Advice

If you miss a dose, 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 double dose to make up for a missed one.

Driving Precautions

Flugal may cause dizziness or visual disturbances in some individuals; exercise caution when driving or operating machinery until you know how the medication affects you.

Lifestyle Advice

Maintain good hygiene practices to prevent recurrent fungal infections.
Avoid sharing personal items like towels and clothing, especially in cases of superficial fungal infections.