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Flucoral
(capsules)

Composition:Flucoral capsules
Each capsule contains:
Fluconazole ........................150 mg.
Or
Fluconazole...........................50 mg.

Properties:
Fluconazole is a diflurophenyl bis triazole tertiary alcohol which has a broad spectrum antifungal activity than ketoconazole.
Flucoral is water soluble; very well absorbed from the GIT even in the presence of food, antacids or H2 receptor antagonist pretreatment.
After oral administration plasma levels are nearly as high as intravenous administration.
Flucoral is widely distributed in tissues & body fluids.
Concentrations in C.S.F., saliva, sputum, vaginal fluid approximate those attained in the plasma.
Oral bioavailability exceeds 90% in contrast to other azoles antifungal which are highly protein bound.
Flucoral is only 11% protein bound.
The drug is excreted mainly in the urine.
Elimination half-life is approximately 30 hours.

Indications:
Oropharyngeal, esophageal & vaginal Candidiasis.
Fungal infections of the skin & nail due to Candida or dermatophytes.
Serious systemic candidal infections including, urinary tract infections, peritonitis, pneumonia
Cryptococcal meningitis.
For the prophylaxis of fungal infections in immuno-compromised patients.


Flucoral and C.albicans:

Contraindications:
Is contraindicated in patients who have shown hypersensitivity to Fluconazole or in case of acute impaired liver functions.

Warning:
In patients who develop liver function abnormalities or skin rash treatment should be discontinued.

Precautions:
Flucoral may be used in pregnancy only in life threatening infections and if the potential benefit justifies the possible risk to the fetus. The use of Flucoral in nursing mothers is not recommended

Pregnancy & lactation:
Fluconazole should not be used during pregnancy and lactation.

Drug interactions:
Fluconazole increases levels of coumarine type anticoagulant, oral hypoglycemics, cyclosporin, phenytoin, theophyllin rifabutin, hydrocholothiazide & zidovudin.
Rifampin increases the metabolism of fluconazole.
Concomitant use of tacrolimus with fluconazole may lead to nephrotoxicity as it increases tacrolimus serum levels.

Dosage and administration:
Vaginal Candidacies : single oral dose of 150 mg ( one capsule) is given.
Orophargeal candidiasis: 200 mg on the first day, followed by 100 mg once daily. Treatment should be continued for at least 2 weeks.
Oesophageal candidisasis: 200 mg on the first day then 100 mg once daily. Doses up to 400 mg may be used based on the response to the therapy.
Coetaneous fungal infections :  single oral dose of 150 mg, & treatment is repeated after one week. A third or fourth dose on the third or fourth week may be needed in very few cases.
Pharyngeal & Esophageal Candidacies : A daily dose of 150 mg (one capsule) is given.
Systemic Candidacies : Initially 400 mg followed by 200-400 mg daily.
Candida urinary tract infection: 50-200 mg daily.
Cryptococcus meningitis: 400 mg on the first day, followed by 200 mg once daily up to 400 mg daily based on response to the therapy.

N.B
In patients with impaired renal functions : full dosage of creatinine clearance exceeds 0.8 ml/sec is recommended.

Side effects::
Flucoral is very well tolerated, nausea, headache, abdominal discomfort may occur. Occasionally abnormalities of liver enzymes. As with other anoles anaphylaxis has been rarely reported.

Overdosage:
In the event of overdosage, supportive measure and symptomatic treatment with gastric lavage if necessary may be adequate.
Forced volume diuresis would probably increase the elimination rate, as Fluconazole is largely excreted in

Storage:
Keep at temperature not exceeding 30°C

Packing:
Box of 2 or 100 capsules.(150 mg Fluconazole)
Box of 7 or 10 capsules. (50 mg Fluconazole)

Related Links
Fungal diseases & Flucoral

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