Flugal
Generic Name
Fluconazole
Manufacturer
XYZ Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| flugal 200 mg capsule | ৳ 25.17 | ৳ 151.02 |
Description
Overview of the medicine
Flugal 200 mg Capsule contains Fluconazole, a potent antifungal agent used to treat a variety of fungal infections, including candidiasis, cryptococcosis, and dermatophytosis.
Uses & Indications
Dosage
Adults
Vaginal candidiasis: 150 mg single oral dose. Oropharyngeal candidiasis: 50-100 mg once daily for 7-14 days. Systemic candidiasis/Cryptococcal meningitis: 400 mg on day 1, then 200-400 mg once daily. Dosage varies greatly based on indication and severity.
Elderly
No dosage adjustment is generally required unless renal function is impaired.
Renal_impairment
Dosage adjustment needed. 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 usual dose.
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 essential for the conversion of lanosterol to ergosterol. This leads to a disruption in fungal cell membrane synthesis, ultimately causing fungal cell death.
Pharmacokinetics
Onset
Within 24-48 hours for clinical improvement.
Excretion
Primarily excreted unchanged in urine (about 80% of the dose).
Half life
Approximately 30 hours (range 20-50 hours).
Absorption
Well absorbed orally; bioavailability >90%. Peak plasma concentrations within 1-2 hours.
Metabolism
Minimal hepatic metabolism (approximately 11% of the dose is metabolized).
Side Effects
Contraindications
- Hypersensitivity to fluconazole or any of the excipients, or to other azole antifungals.
- Co-administration with terfenadine or cisapride if fluconazole dose is ≥400 mg/day.
- Co-administration with drugs known to prolong the QT interval and are metabolized by CYP3A4 (e.g., astemizole, pimozide, quinidine, erythromycin).
Drug Interactions
Statins
Increased statin levels, increased risk of myopathy/rhabdomyolysis.
Warfarin
Increased prothrombin time; monitor INR.
Phenytoin
Increased phenytoin levels; monitor phenytoin levels.
Rifampicin
Decreased fluconazole levels; consider increasing fluconazole dose.
Hydrochlorothiazide
Increased fluconazole plasma concentrations.
SSRIs (e.g., Sertraline)
Increased SSRI levels, potential for serotonin syndrome.
Benzodiazepines (e.g., Midazolam)
Increased benzodiazepine levels.
Cyclosporine, Tacrolimus, Sirolimus
Increased levels of immunosuppressants; monitor drug levels.
Oral Hypoglycemics (e.g., sulfonylureas)
Increased plasma concentrations of sulfonylureas; monitor blood glucose.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms of overdose may include hallucinations and paranoid behavior. Management is symptomatic and supportive, with gastric lavage if indicated. Hemodialysis can reduce fluconazole plasma concentrations.
Pregnancy & Lactation
Pregnancy Category D. Avoid during pregnancy, especially in the first trimester, due to potential for fetal harm. Should only be used if the potential benefit justifies the potential risk to the fetus. Fluconazole is excreted in breast milk; caution is advised during lactation.
Side Effects
Contraindications
- Hypersensitivity to fluconazole or any of the excipients, or to other azole antifungals.
- Co-administration with terfenadine or cisapride if fluconazole dose is ≥400 mg/day.
- Co-administration with drugs known to prolong the QT interval and are metabolized by CYP3A4 (e.g., astemizole, pimozide, quinidine, erythromycin).
Drug Interactions
Statins
Increased statin levels, increased risk of myopathy/rhabdomyolysis.
Warfarin
Increased prothrombin time; monitor INR.
Phenytoin
Increased phenytoin levels; monitor phenytoin levels.
Rifampicin
Decreased fluconazole levels; consider increasing fluconazole dose.
Hydrochlorothiazide
Increased fluconazole plasma concentrations.
SSRIs (e.g., Sertraline)
Increased SSRI levels, potential for serotonin syndrome.
Benzodiazepines (e.g., Midazolam)
Increased benzodiazepine levels.
Cyclosporine, Tacrolimus, Sirolimus
Increased levels of immunosuppressants; monitor drug levels.
Oral Hypoglycemics (e.g., sulfonylureas)
Increased plasma concentrations of sulfonylureas; monitor blood glucose.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms of overdose may include hallucinations and paranoid behavior. Management is symptomatic and supportive, with gastric lavage if indicated. Hemodialysis can reduce fluconazole plasma concentrations.
Pregnancy & Lactation
Pregnancy Category D. Avoid during pregnancy, especially in the first trimester, due to potential for fetal harm. Should only be used if the potential benefit justifies the potential risk to the fetus. Fluconazole is excreted in breast milk; caution is advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Available in pharmacies and hospitals
Approval Status
Approved
Patent Status
Patent Expired
WHO Essential Medicine
YesClinical Trials
Fluconazole has undergone extensive clinical trials demonstrating its efficacy and safety across a broad range of fungal infections. Ongoing research explores its role in novel drug combinations and resistance management.
Lab Monitoring
- Liver function tests (LFTs) should be monitored periodically, especially in patients with underlying liver disease or those receiving prolonged therapy. Renal function should also be monitored.
Doctor Notes
- Monitor LFTs and renal function, especially with prolonged therapy or in high-risk patients.
- Be aware of significant drug interactions, particularly with CYP3A4 substrates and drugs that prolong the QT interval.
- Educate patients on the importance of completing the full course and recognizing signs of adverse effects.
Patient Guidelines
- Complete the full course of medication, even if symptoms improve, to prevent recurrence.
- Inform your doctor about all other medications you are taking.
- Report any unusual side effects, especially severe skin rashes or signs of liver problems (e.g., yellowing of skin/eyes, dark urine, severe fatigue).
- Avoid alcohol while taking this medicine as it may increase the risk of liver damage.
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 prevent fungal infections. Avoid sharing personal items like towels or clothing.
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