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DIFLUCAN
(generic name: fluconazole) |
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Reviews |
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Diflucan |
Bone Marrow Transplant. 2005 Mar;35(6):583-6.
Caspofungin as second-line therapy for fever of unknown
origin or invasive fungal infection following allogeneic stem cell transplantation.
Trenschel R, Ditschkowski M, Elmaagacli AH, Koldehoff
M, Ottinger H, Steckel N, Hlinka M, Peceny R, Rath PM, Dermoumi H, Beelen
DW.
1Department of Bone Marrow Transplantation, University Hospital Essen,
Essen, Germany.
Summary:Caspofungin (CAS) is the first of a new class of antifungal agents,
the echinocandins, that interfere with fungal cell wall synthesis by inhibition
of glucan synthesis. Here, we report the results of 31 patients treated
with CAS following allogeneic SCT. CAS was administered as a second-line
agent to patients with invasive fungal infection (IFI) (n=15) or fever of
unknown origin (n=16) who were recalcitrant to or intolerant of prior antifungal
therapy. Unsuccessful first-line regimes included amphotericin B (n=17),
liposomal amphotericin B (n=5), fluconazole (n=3), itraconazole (n=1), and
voriconazole (n=2). All patients received concomitant immunosuppressive
therapy for graft-versus-host disease. In 23 patients, cyclosporin A (CSA)
and CAS were administered concurrently without any major side effects detected.
Observed increases in GPT were not clinically significant. Normalization
of serum creatinine and significant reductions in C-reactive protein were
observed in response to CAS. Favorable outcome to CAS were documented in
eight of 15 patients with IFI and in 15 of 16 patients with fever of unknown
origin. CAS is a promising alternative in patients with IFI and fever of
unknown origin in the setting of allogeneic SCT.Bone Marrow Transplantation
(2005) 35, 583-586. doi:10.1038/sj.bmt.1704859 Published online 31 January
2005.
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Mycoses. 2005 Mar;48(2):126-31.
Molecular epidemiology of Candida species isolated from
urine at an intensive care unit.
Ergon MC, Gulay Z.
Department of Microbiology and Clinical Microbiology, School of Medicine,
Dokuz Eylul University, Izmir, Turkey.
Summary Candida spp. has been the leading microorganism isolated from the
urine specimens of patients hospitalized at the Anesthesiology and Reanimation
intensive care unit (ICU) of Dokuz Eylul University Hospital, Izmir, since
1998. This study was undertaken to investigate the clonal relationship of
Candida urine isolates in order to find the mode of spread among the patients.
Epidemiological surveillance of 38 Candida albicans, 15 Candida tropicalis
and 12 Candida glabrata recovered from the urine specimens of patients who
were hospitalized in the ICU between June 11, 2000 and October 15, 2001
was carried out by antifungal susceptibility testing and randomly amplified
polymorphic DNA (RAPD) analysis. Two short primers [Cnd3 (5'-CCAGATGCAC-3')
and Cnd4 (5'-ACGGTACACT-3')] were used for RAPD. None of the isolates had
high minimal inhibitory concentration (MIC) values (>1 mug ml(-1)) against
amphotericin B with MIC(50)values of 0.5 mug ml(-1), 0.5 mug ml(-1) and
0.125 mug ml(-1) for C. albicans, C. tropicalis and C. glabrata isolates,
respectively. However, three C. glabrata isolates were resistant and one
C. albicans and five C. glabrata isolates were dose-dependent susceptible
(D-DS) to fluconazole. Among C. albicans isolates 19 and 20 patterns were
detected with primers Cnd3 and Cnd4, respectively. When primers Cnd3 and
Cnd4 were evaluated together, three and four genotypes were identified for
C. tropicalis and C. glabrata isolates, respectively. Our results suggest
that the source of C. albicans isolates was mostly endogenous. It is difficult
to interpret the mode of spread of C. tropicalis and C. glabrata urine isolates
as we obtained insufficient banding patterns for these species.
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| Br J Clin Pharmacol.
2005 Feb;59(2):160-6.
The effects of hepatic impairment on the pharmacokinetics
of fosfluconazole and fluconazole following a single intravenous bolus
injection of fosfluconazole.
Sobue S, Tan K, Haug-Pihale G.
Clinical Pharmacology, Pfizer Global R&D, Tokyo Laboratories, Pfizer
Japan Inc., Tokyo, Japan. satoshi.sobue@japan.pfizer.com.
AIMS: Fosfluconazole is a phosphate pro-drug of fluconazole (FLCZ). This
study was conducted to determine the pharmacokinetics of fosfluconazole
and FLCZ following a single intravenous injection of fosfluconazole in
subjects with hepatic impairment and to compare them with healthy subjects.
METHODS: Twenty-four subjects (12 with normal hepatic function and 12
with chronic stable mild to moderate impaired hepatic function) received
a single 1000-mg bolus intravenous injection of fosfluconazole. Concentrations
of fosfluconazole and FLCZ were determined in plasma and urine samples
taken up to 192 h and 48 h postdose, respectively. RESULTS: The total
clearance of fosfluconazole was higher and the t(1/2,Z) and mean residence
time were shorter in hepatically impaired subjects than in normal subjects.
This may reflect more rapid conversion to FLCZ. The degree of protein
binding of fosfluconazole (> 90%) and the amount of fosfluconazole
excreted in the urine were similar in both groups. Slightly higher mean
plasma concentrations of FLCZ were observed in the impaired group than
in the normal group; however, hepatic impairment had no statistically
significant effect on the FLCZ pharmacokinetic parameters apart from t(max).
The t(max) values were 4.8 h and 3.1 h in the normal and impaired subjects,
respectively. The shorter t(max) for FLCZ is also consistent with the
more rapid conversion in the impaired subjects. The ratios (95% confidence
intervals) for C(max) and AUC of FLCZ (impaired/normal) were 106.0% (92.8,
121.2) and 115.6% (86.4, 154.7), respectively. There were no serious adverse
events, and no discontinuations due to adverse events or laboratory test
abnormalities. The adverse events reported were mostly mild in severity
and no trend could be discerned between the groups. CONCLUSIONS: Fosfluconazole
was more rapidly converted to FLCZ in the hepatically impaired subjects
but the FLCZ pharmacokinetic parameters (except t(max)) were not statistically
significantly affected by hepatic impairment. Fosfluconazole was well
tolerated by both groups. These results suggest that there is no requirement
to adjust the dose of fosfluconazole when administered to subjects with
mild to moderate hepatic impairment. |
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Drug information |
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| GENERIC NAME: fluconazole
BRAND NAME: Diflucan
DRUG CLASS AND MECHANISM: Antifungal (treatment of certain
fungus infections).
PREPARATIONS: Suspension content per bottle is 350mg
(when diluted 10mg per ml) and 1400mg (when diluted 40mg per ml). Tablets
are available in 50mg, 100mg, and 200mg from Roerig Labs. Intravenous
solutions are available.
STORAGE: Store tablets in a dry place at 20-25 degrees
C (68-77 F), oral suspensions after dilution at 5-30 degrees C (41-86
F) the oral suspension should be discarded in 2 weeks after reconstituted.
PRESCRIBED FOR: Oral, esophageal, urinary, vaginal and
possibly other organ infections caused by the fungus Candida. Fluconazole
has also been used in the fungal infection Cryptococcus.
DOSING: Fluconazole is taken orally or by intravenous
injection. Modified dosing is needed if the patient has impaired renal
function or if taking certain other medications at the same time. Please
consult your pharmacist or physician if taking other medications with
fluconazole. This drug can be used in children and has been effective
down to the age of 6 months of age. Fluconazole can cause liver damage
in rare cases and the liver should be monitored if taken for several days.
DRUG INTERACTIONS: Caution if taking certain other medications
with fluconazole such as phenytoin, cyclosporin, theophylline and coumadin.
If a rash occurs while taking this medication notify your doctor.
PREGNANCY: Use of fluconazole in pregnancy is not usually
recommended.
NURSING MOTHERS: Use of fluconazole in nursing mothers
is not usually recommended.
SIDE EFFECTS: The incidence of side effects from this
medication is relatively high (up to 25%) Many (13%) may get headaches.
Some patients develop nausea, abdominal pain, diarrhea or dizziness. Severe
skin rash may occur but is uncommon.
Caution! Before starting
to take this medicine, it is vital that you should consult your doctor!
Do not use it on your own initiative, without medical advice.
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Order now ! |
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DIFLUCAN
Substance: Fluconazole
Manufacturer: Pfizer
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Dosage |
Packing |
Price |
Pay now |
50 mg |
28 caps |
USD 166.00 |
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100 mg |
28 tab |
USD 314.00 |
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150 mg |
4 caps |
USD 101.00 |
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150 mg |
16 caps |
USD 395.00 |
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