FLUCYTOSINE oral

Therapeutic action

• Antifungal

Indications

• Cryptococcocal meningitis (induction phase), in combination with amphotericin B or fluconazole

Forms and strengths

• 500 mg capsule

Also comes in 250 mg capsule and 500 mg tablet.

Dosage

• Child over 1 week and adult: 25 mg/kg 4 times daily

Duration

• One week if in combination with amphotericin B
• 2 weeks if in combination with fluconazole

Contra-indications, adverse effects, precautions

• Administer with caution and monitor use in patients > 60 years or with renal impairment or haematological disorders.
• Reduce the dose by half (25 mg/kg 2 times daily) in patients with renal impairment.
• May cause: gastrointestinal disturbances, haematological disorders (leukopenia, thrombocytopenia, less frequently, agranulocytosis), increase in transaminase levels, allergic reactions sometimes severe; sometimes, confusion and halucinations.
• Monitor blood count and liver and renal function until the end of treatment.
• Pregnancy and breast-feeding: flucytosine is generally not recommended. It is teratogenic in animals and its safety in pregnant or lactating women has not been established. However, taking into account the severity of the disease, the potential benefit of treatment for the mother and in the absence of a safer alternative, it may be used despite the potential risks for the child.

Remarks

• For children, tablets may be crushed.

Storage