Drug Index

Flucytosine

 
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Synonym :

5- Fluorocytosine

Mechanism :

Flucytosine is taken up by fungal organisms via the enzyme cytosine permease. In the fungal cell, flucytosine is rapidly converted to fluorouracil by the enzyme cytosine deaminase. Fluorouracil is converted into several active metabolites, which inhibit protein synthesis by being incorporated into fungal RNA or interfere with the biosynthesis of fungal DNA through the inhibition of the enzyme thymidylate synthetase.


Indication :

• Candidiasis

• Cryptococcus infection


Contraindications :

Flucytosine should not be used in patients with a known hypersensitivity to the drug. Blood count and liver enzymes should be monitored before and during therapy. Caution should be exercised in patients with pre-existing bone marrow depression.


Dosing :

Neonates: 80-160 mg/kg/day orally in 4 divided doses.

Children: 50-150 mg/kg/day orally in 4 divided doses.


Adverse Effect :

Myocardial toxicity, cardiac arrest, ventricular dysfunction, rash, urticaria, pruritus, photosensitivity, respiratory arrest, chest pain, dyspnea, azotemia, crystalluria, creatinine and BUN elevation, renal failure, nausea, emesis, abdominal pain, diarrhea, dry mouth, anorexia, gastrointestinal hemorrhage, duodenal ulcer, hepatic dysfunction, ulcerative colitis.


Interaction :

Cytosine arabinoside: Has been reported to inactivate the antifungal activity of flucytosine by competitive inhibition.
Drugs which impair glomerular filtration may prolong the biological half-life of flucytosine.


07/19/2019 03:11:05 Flucytosine
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