Flugard
Generic Name
Fluconazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| flugard 50 mg capsule | ৳ 8.00 | ৳ 80.00 |
| flugard 150 mg capsule | ৳ 22.00 | ৳ 220.00 |
Description
Overview of the medicine
Flugard (Fluconazole) is an antifungal medication used to treat a variety of fungal infections, including vaginal yeast infections, oral thrush, esophageal candidiasis, and systemic fungal infections.
Uses & Indications
Dosage
Adults
For vaginal candidiasis: 150 mg orally as a single dose. For oropharyngeal candidiasis: 50-100 mg orally once daily for 7-14 days. For systemic candidiasis: 400 mg on day 1, then 200-400 mg once daily. Dosage varies greatly by indication.
Elderly
Dosage adjustments may be necessary based on renal function.
Renal_impairment
Dose reduction is required for patients with creatinine clearance <50 ml/min. Typically, the initial loading dose is given, followed by 50% of the usual daily dose.
How to Take
Oral capsules can be taken with or without food. Oral suspension should be measured accurately. IV infusion should be administered slowly.
Mechanism of Action
Fluconazole works by inhibiting fungal cytochrome P450 enzyme 14-alpha-demethylase, which is essential for the synthesis of ergosterol, a vital component of the fungal cell membrane. This disruption leads to increased permeability and eventual cell lysis.
Pharmacokinetics
Onset
Onset of action varies depending on the type and severity of infection, typically within a few days for symptomatic relief.
Excretion
Primarily renal; about 80% of the administered dose is excreted unchanged in the urine, and about 11% as metabolites.
Half life
Approximately 30 hours, allowing for once-daily dosing for many indications.
Absorption
Well absorbed orally, with bioavailability typically exceeding 90%. Peak plasma concentrations are achieved within 1-2 hours after oral administration.
Metabolism
Minimally metabolized; approximately 11% of the dose is metabolized to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to fluconazole or other azole antifungals
- Co-administration with terfenadine, cisapride, astemizole, pimozide, or quinidine due to risk of QT prolongation and serious arrhythmias
Drug Interactions
Warfarin
Increased prothrombin time (INR), leading to bleeding risk.
Phenytoin
Increased phenytoin levels, requiring dose monitoring.
Rifampicin
Decreased fluconazole plasma concentrations, may require dose increase.
Hydrochlorothiazide
Increased fluconazole plasma concentrations.
Cyclosporine, Tacrolimus
Increased plasma concentrations of immunosuppressants.
Benzodiazepines (e.g., Midazolam)
Increased benzodiazepine levels, leading to prolonged sedation.
Oral hypoglycemics (sulfonylureas)
Increased plasma concentrations of sulfonylureas, leading to hypoglycemia.
Statins (e.g., Atorvastatin, Simvastatin)
Increased statin levels, leading to increased risk of myopathy/rhabdomyolysis.
Certain antihistamines (e.g., Terfenadine)
Increased risk of QT prolongation and serious arrhythmias (contraindicated).
Storage
Store below 30°C, in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In cases of overdose, supportive measures should be initiated. Gastric lavage may be considered if recent ingestion. Hemodialysis significantly reduces plasma concentrations of fluconazole.
Pregnancy & Lactation
Pregnancy: For single-dose vaginal candidiasis, Fluconazole is Category C. For high doses or prolonged use, it is Category D due to potential for birth defects. Lactation: Fluconazole is excreted in breast milk; caution is advised, and a healthcare provider should be consulted.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacturing date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Fluconazole has undergone extensive clinical trials demonstrating its efficacy and safety in treating various fungal infections across different patient populations.
Lab Monitoring
- Liver function tests (ALT, AST, ALP, bilirubin) especially during prolonged therapy or in patients with underlying liver disease.
- Renal function tests (serum creatinine, BUN) if renal impairment is suspected or present.
- Electrolyte monitoring if receiving high doses or concomitant medications that affect electrolytes.
Doctor Notes
- Counsel patients on completing the full course of therapy to prevent recurrence and resistance.
- Monitor liver function tests, especially in patients on prolonged therapy or with pre-existing liver conditions.
- Be aware of significant drug interactions, particularly with medications that prolong the QT interval.
Patient Guidelines
- Take the medication exactly as prescribed, even if symptoms improve.
- Do not stop taking the medication without consulting your doctor.
- Report any severe side effects, especially signs of liver problems (e.g., unusual fatigue, dark urine, yellowing of skin/eyes).
- For oral suspension, shake well before use and use a measuring device for accurate dosing.
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 continue your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Fluconazole may cause dizziness or seizures in some individuals. Patients should be advised to exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good personal hygiene to help prevent recurrent infections.
- Avoid wearing tight, non-breathable clothing if treating skin or vaginal fungal infections.
- For oral candidiasis, practice good oral hygiene.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.