Flucostat: how it works and when it is prescribed

Composition of Flucostat

Composition of 1 ml solution for parenteral administration:

• fluconazole – 2 mg;
• sodium chloride;
• water for injections.

capsule has the following components:

• fluconazole – 50 mg (or 150 mg);
• colloidal silicon dioxide (aerosil);
• corn starch;
• magnesium stearate;
• sodium lauryl sulfate;
• lactose.

capsule shell contains:

• gelatin;
• red dye iron oxide (E 172);
• methyl parahydroxybenzoate;
• propyl parahydroxybenzoate;
• titanium dioxide (E 171);
• acetic acid.

Release form

• Film-coated capsules are light pink or pink-brown in color, opaque. Inside there is a white or close to white powder. Packaged in 7 pieces in contour cell blisters. Cardboard packaging holds 1 plate.
• Tablets of 50 or 150 mg are white, oval in shape, secured in a contour-cell blister of 1 or 2. A cardboard pack contains only 1 plate with the drug.
• Solution for intravenous administration in the form of a clear, colorless liquid in 50 ml bottles. One bottle of medicine is placed in a cardboard package.
• White oval-shaped vaginal suppositories

How to use Flucostat for thrush

The dosage regimen, as a rule, is selected individually, since it depends on the form of the fungal infection, the severity of the disease and the age of the patient. The drug is produced in the form of capsules. The package contains 1, 2 or 7 pieces. For thrush, it is recommended to purchase a package with 1 or 2 capsules, since this type of package implies the presence of 150 g of fluconazole in 1 capsule. In packages of 7 capsules, the single dose is significantly lower - 1 capsule contains 50 g of active ingredient.

For primary infection with thrush, at an early stage of the disease, take 1 capsule. In acute cases of the disease, a single dose of 1 capsule containing 150 mg of fluconazole is also sufficient. If a fungal infection re-spreads, take 1 capsule per day, two days in a row. It is recommended to take the second dose at the same time as the first. This will ensure there is no gap between the drug remaining in the blood and will also reduce the risk of overdose.

pharmachologic effect

Flucostat is a strong antifungal pharmaceutical drug that, according to its chemical structure, belongs to the class of triazole compounds. Active against the following families of microorganisms:

• Candida spp;
• Cryptococcus neoformans;
• Microsporum spp;
• Trichphuton spp;
• Blastomyces dermatidis;
• Coccidioides immits;
• Histoplasma capsulatum.

The mechanism of the therapeutic action of the drug lies in the ability of the biologically active component to selectively inhibit the synthesis of sterols in the cells of sensitive fungi, due to which the cell wall of harmful or opportunistic microorganisms becomes untenable , since sterol is one of its main components.

Pharmacodynamics and pharmacokinetics

After oral administration of tablets or capsules, the active ingredients are well absorbed from the gastrointestinal tract. After 0.5-1.5 hours on an empty stomach, the maximum plasma concentration is achieved. The constituent elements of the drug penetrate well into all biological fluids of the body . There are certain properties for cumulation - six months after completion of conservative therapy, Fluconazole can be detected in the nails. About 80% of pharmaceutical drug metabolites are eliminated by the kidneys.

With intravenous administration of a parenteral solution of Flucostat, the active components are evenly distributed throughout biological fluids (the concentration in pulmonary sputum and saliva in the oral cavity corresponds to the amount of Fluconazole in the blood plasma). After several injections of 1 dose per day, the level of equilibrium concentration is reached by 4-5 days of conservative treatment, and with the initial use of a double amount of the drug - by 2 days.

In the bloodstream, about 11-12% of the total amount of Fluconazole binds to plasma proteins, which is why the half-life corresponds to 30 hours. The vast majority (about 80%) of the pharmaceutical drug is excreted in the urine. The clearance of the active component is directly proportional to the clearance of Creatinine.

How quickly does Flucostat work for thrush?

Simultaneous ingestion of food with the use of the drug does not affect the speed and quality of absorption of the substance. The maximum concentration of the substance in the blood plasma is observed after 40 minutes. The drug leaves the body gradually over a long period of time. Half-life occurs within 30 hours. Once in the body, fluconazole begins an active fight against fungal cells within an hour. The patient can feel the first relief two hours after taking the first capsule. With widespread candidiasis, symptoms disappear the morning after administration.

Indications for use

• cryptococcosis (including cryptococcal meningitis);
• pityriasis versicolor;
• generalized or disseminated candidiasis, mainly affecting the skin and mucous membranes (for example, the oral cavity and esophagus);
• deep endemic mycoses (sporotrichosis, histoplasmosis, coccidioidomycosis);
• urogenital candidiasis in men (candidal balanitis) and women (vaginal candidiasis or thrush);
• prevention of fungal infections in patients with acquired immunodeficiency syndrome;
• mycoses of various etiologies;
• damage by pathogenic fungi during cytostatic, chemotherapy or radiation therapy;
• onychomycosis.

Contraindications

Strict contraindications include the following conditions:

• increased individual sensitivity to the active ingredient or excipients;
• glucose-galactose malabsorption syndrome;
• lactose intolerance (including lactase deficiency);
• hereditary or acquired intolerance to the components of a pharmaceutical drug;
• children under 3 years of age;
• galactosemia;
• combined use of Flucostat with drugs that prolong the QT interval on the electrocardiogram (in particular astemizole or terfenadine ).

You should also outline a list of non-absolute contraindications when the medicine must be used with caution (conservative therapy under the supervision of qualified medical personnel is recommended):

• renal or liver failure;
• alcoholism;
• treatment with potentially dangerous pharmaceuticals with a high percentage of hepatotoxicity ;
• proarrhythmogenic conditions (especially if the patient has multiple risk factors for arrhythmia).

Flucostat capsules 150 mg 2 pcs.

Single or multiple doses of fluconazole at a dose of 50 mg do not affect the metabolism of phenazone (Antipyrine) when taken once. The simultaneous use of fluconazole with the following drugs is contraindicated: Cisapride. With the simultaneous use of fluconazole and cisapride, adverse reactions from the heart are possible, including ventricular tachysystolic arrhythmia of the “pirouette” type (torsade de pointes). The use of fluconazole at a dose of 200 mg once a day and cisapride at a dose of 20 mg 4 times a day leads to a marked increase in plasma concentrations of cisapride and an increase in the QT interval on the ECG. The simultaneous use of cisapride and fluconazole is contraindicated. Terfenadine. With the simultaneous use of azole antifungals and terfenadine, serious arrhythmias may occur as a result of an increase in the QT interval. When taking fluconazole at a dose of 200 mg/day, an increase in the QT interval has not been established. However, the use of fluconazole in doses of 400 mg/day and above causes a significant increase in the concentration of terfenadine in the blood plasma. Concomitant use of fluconazole in doses of 400 mg/day or more with terfenadine is contraindicated (see section “Contraindications”). Treatment with fluconazole in doses less than 400 mg/day in combination with terfenadine should be carried out under close monitoring. Astemizole. The simultaneous use of fluconazole with astemizole or other drugs whose metabolism is carried out by the cytochrome P450 system may be accompanied by an increase in serum concentrations of these drugs. Elevated concentrations of astemizole in blood plasma can lead to prolongation of the QT interval and, in some cases, to the development of ventricular tachysystolic arrhythmia of the “pirouette” type (torsade de pointes). The simultaneous use of astemizole and fluconazole is contraindicated. Pimozide. Although appropriate in vitro or in vivo studies have not been conducted, the simultaneous use of fluconazole and pimozide may lead to inhibition of the metabolism of pimozide. In turn, an increase in plasma concentrations of pimozide can lead to a prolongation of the QT interval and, in some cases, the development of ventricular tachysystolic arrhythmia of the “pirouette” type (torsade de pointes). The simultaneous use of pimozide and fluconazole is contraindicated. Quinidine. Although adequate in vitro or in vivo studies have not been conducted, concomitant use of fluconazole and quinidine may also lead to inhibition of quinidine metabolism. The use of quinidine is associated with prolongation of the QT interval and, in some cases, with the development of ventricular tachysystolic arrhythmia of the “torsade de pointes” type. The simultaneous use of quinidine and fluconazole is contraindicated. Erythromycin. Concomitant use of fluconazole and erythromycin potentially leads to an increased risk of cardiotoxicity (QT prolongation, torsade de pointes) and, consequently, sudden cardiac death. The simultaneous use of fluconazole and erythromycin is contraindicated. Amiodarone. Concomitant use of fluconazole and amiodarone may result in inhibition of amiodarone metabolism. Amiodarone use has been associated with QT prolongation. The simultaneous use of fluconazole and amiodarone is contraindicated (see section "Contraindications"). Caution and possible dosage adjustments should be used when the following drugs are used concomitantly with fluconazole: Drugs affecting fluconazole: Hydrochlorothiazide. Simultaneous repeated use of fluconazole and hydrochlorothiazide can lead to an increase in the concentration of fluconazole in the blood plasma by 40%. An effect of this severity does not require a change in the fluconazole dosage regimen in patients receiving concomitant diuretics, but the doctor should take this into account. Rifampicin. The combination with rifampicin leads to a decrease in AUC (area under the concentration-time curve) by 25% and a shortening of the plasma half-life of fluconazole by 20%. Therefore, in patients receiving concomitant rifampicin, it is necessary to consider the advisability of increasing the dose of fluconazole. Drugs affected by fluconazole: Fluconazole is a potent inhibitor of the cytochrome P 450 isoenzyme CYP2C9 and CYP2C19 and a moderate inhibitor of the CYP3A4 isoenzyme. In addition to the effects listed below, there is a risk of increased plasma concentrations of other drugs metabolized by the isoenzymes CYP2C9, CYP2C19 and CYP3A4 when taken simultaneously with fluconazole. In this regard, caution should be exercised when using the following drugs simultaneously, and if such combinations are necessary, patients should be under close medical supervision. It should be taken into account that the inhibitory effect of fluconazole persists for 4-5 days after discontinuation of the drug due to the long half-life. Alfentanil. There is a decrease in clearance and volume of distribution, and an increase in the half-life of alfentanil. This may be due to inhibition of the CYP3A4 isoenzyme by fluconazole. Alfentanil dosage adjustment may be required. Amitriptyline, nortriptyline. Increase the effect. Concentrations of 5-nortriptyline and/or S-amitriptyline can be measured at the start of combination therapy with fluconazole and one week after the start of treatment. If necessary, the dose of amitriptyline/nortriptyline should be adjusted. Amphotericin B. In studies in mice (including immunosuppressed mice), the following results were observed: small additive antifungal effect in systemic infection with C. albicans, no interaction in intracranial infection with Cryptococcus neoformans, and antagonism in systemic infection with A .fumigatus. The clinical significance of these results is unclear. Anticoagulants. When using fluconazole, like other antifungal agents (azole derivatives), with warfarin, the prothrombin time increases (on average by 12%). Bleeding may develop (hematomas, bleeding from the nose and gastrointestinal tract, hematuria, melena). In patients receiving coumarin anticoagulants, prothrombin time must be constantly monitored during therapy and for 8 days after simultaneous use. The advisability of adjusting the warfarin dose should also be assessed. Azithromycin. With simultaneous oral use of fluconazole in a single dose of 800 mg with azithromycin in a single dose of 1200 mg, no pronounced pharmacokinetic interaction has been established between both drugs. Benzodiazepines (short-acting). After oral administration of midazolam, fluconazole significantly increases midazolam concentrations and psychomotor effects, and this effect is more pronounced after fluconazole is administered orally than when administered intravenously. If concomitant therapy with benzodiazepines is necessary, patients taking fluconazole should be monitored to assess the appropriateness of an appropriate reduction in the benzodiazepine dose. When coadministered with a single dose of triazolam, fluconazole increases the AUC of triazolam by approximately 50%, Cmax by 25-50% and half-life by 25-50% due to inhibition of triazolam metabolism. Triazolam dose adjustment may be necessary. Carbamazepine. Fluconazole inhibits the metabolism of carbamazepine and increases its serum concentration by 30%. The risk of carbamazepine toxicity must be taken into account. The need for carbamazepine dose adjustment based on concentration/effect should be assessed. Nevirapine. Coadministration of fluconazole and nevirapine increased nevirapine exposure by approximately 100% compared with control data for nevirapine alone. Due to the risk of increased excretion of nevirapine during concomitant use of drugs, some precautions and careful monitoring of patients are necessary. Calcium channel blockers. Some calcium channel antagonists (nifedipine, isradipine, amlodipine, verapamil and felodipine) are metabolized by the CYP3A4 isoenzyme. Fluconazole increases the systemic exposure of calcium channel antagonists. Monitoring for side effects is recommended. Cyclosporine. It is recommended to monitor the concentration of cyclosporine in the blood in patients receiving fluconazole, since in patients with a kidney transplant, taking fluconazole at a dose of 200 mg/day leads to a slow increase in the concentration of cyclosporine in plasma. However, with repeated doses of fluconazole at a dose of 100 mg/day, no changes in cyclosporine concentrations were observed in bone marrow recipients. Cyclophosphamide. With the simultaneous use of cyclophosphamide and fluconazole, an increase in serum concentrations of bilirubin and creatinine is observed. A combination of drugs is possible taking into account the risk of these disorders. Fentanyl. There has been a report of one death possibly related to the concomitant use of fentanyl and fluconazole. The disturbances are believed to be related to fentanyl intoxication. Fluconazole has been shown to significantly prolong the clearance time of fentanyl. It should be borne in mind that an increase in the concentration of fentanyl can lead to depression of respiratory function. Halofantrine. Fluconazole may increase plasma concentrations of halofantine due to inhibition of the CYP3A4 isoenzyme. When used simultaneously with fluconazole, as well as with other azole antifungal drugs, the development of ventricular tachysystolic arrhythmia of the “pirouette” type is possible, so their combined use is not recommended. HMC-CoA reductase inhibitors. When fluconazole is used concomitantly with HMC-CoA reductase inhibitors metabolized by the CYP3A4 isoenzyme (such as atorvastatin and simvastatin) or the CYP2D6 isoenzyme (fluvastatin), the risk of developing myopathy and rhabdomyolysis increases. If simultaneous therapy with these drugs is necessary, patients should be monitored to identify symptoms of myopathy and rhabdomyolysis. It is necessary to monitor the concentration of creatinine kinase. If there is a significant increase in creatinine kinase concentrations or if myopathy or rhabdomyolysis is diagnosed or suspected, therapy with HMC-CoA reductase inhibitors should be discontinued. Losartan. Fluconazole inhibits the metabolism of losartan to its active metabolite (E-31 74), which is responsible for most of the effects associated with angiotensin II receptor antagonism. Regular monitoring of blood pressure is necessary. Methadone. Fluconazole may increase plasma concentrations of methadone. Methadone dose adjustment may be necessary. Non-steroidal anti-inflammatory drugs (NSAIDs). Cmax and AUC of flurbiprofen increased by 23% and 81%, respectively. Similarly, the Cmax and AUC of the pharmacologically active isomer [S-(+)-ibuprofen] increased by 15% and 82%, respectively, when fluconazole was co-administered with racemic ibuprofen (400 mg). With simultaneous use of fluconazole at a dose of 200 mg/day and celecoxib at a dose of 200 mg, the Cmax and AUC of celecoxib increased by 68% and 134%, respectively. In this combination, it is possible to reduce the dose of celecoxib by half. Despite the lack of targeted studies, fluconazole may increase the systemic exposure of other NSAIDs metabolized by the CYP2C9 isoenzyme (naproxen, lornoxicam, meloxicam, diclofenac). NSAID dose adjustment may be necessary. When NSAIDs and fluconazole are used concomitantly, patients should be closely monitored medically to identify and monitor NSAID-related adverse events and toxicities. Oral contraceptives. With simultaneous use of a combined oral contraceptive with fluconazole at a dose of 50 mg, no significant effect on hormone levels has been established. With a daily dose of 200 mg fluconazole, the AUCs of ethinyl estradiol and levonorgestrel increased by 40% and 24%, respectively. When fluconazole 300 mg was administered once weekly, the AUCs of ethinyl estradiol and norethindrone increased by 24% and 13%, respectively. Thus, repeated use of fluconazole at the indicated doses is unlikely to affect the effectiveness of the combined oral contraceptive. Phenytoin. Concomitant use of fluconazole and phenytoin may lead to an increase in plasma phenytoin concentrations to a clinically significant extent. Therefore, if it is necessary to use these drugs together, it is necessary to monitor phenytoin concentrations with dose adjustment in order to maintain drug levels within the therapeutic interval. Prednisone. There is a report of the development of acute adrenal insufficiency in a patient after liver transplantation when fluconazole was discontinued after a three-month course of therapy. Presumably, discontinuation of fluconazole therapy caused an increase in the activity of the CYP3A4 isoenzyme, which led to increased metabolism of prednisone. Patients receiving combination therapy with prednisone and fluconazole should be under close medical supervision when discontinuing fluconazole to assess the condition of the adrenal cortex. Rifabutin. The simultaneous use of fluconazole and rifabutin can lead to an increase in serum concentrations of the latter by up to 80%. Cases of uveitis have been described with the simultaneous use of fluconazole and rifabutin. Patients receiving rifabutin and fluconazole simultaneously should be carefully monitored. Saquinavir. AUC increases by approximately 50%, Cmax by 55%. The clearance of saquinavir is reduced by approximately 50% due to inhibition of the hepatic metabolism of CYP3A4 and P-glycoprotein. Dose adjustment of saquinavir may be necessary. Sirolimus. An increase in the concentration of sirolimus in the blood plasma is presumably due to inhibition of the metabolism of sirolimus through inhibition of the CYP3A4 isoenzyme and P-glycoprotein. This combination can be used with appropriate dose adjustment of sirolimus depending on the effect/concentration. Sulfonylureas. Fluconazole increases the plasma half-life of oral hypoglycemic agents - sulfonylurea derivatives (chlorpropamide, glibenclamide, glipizide, tolbutamide). The combined use of fluconazole and oral hypoglycemic agents is allowed, but the doctor must keep in mind the possibility of developing hypoglycemia. Regular monitoring of blood glucose and, if necessary, dose adjustment of sulfonylurea drugs are necessary. Tacrolimus. The use of fluconazole and tacrolimus (orally) leads to an increase in serum concentrations of the latter by 5 times due to inhibition of the metabolism of tacrolimus occurring in the intestine through the CYP3A4 isoenzyme. No significant changes in the pharmacokinetics of the drugs were observed when tacrolimus was administered intravenously. Cases of nephrotoxicity have been described. Patients receiving oral tacrolimus and fluconazole concomitantly should be monitored closely. The dose of tacrolimus should be adjusted depending on the degree of increase in its concentration in the blood. Theophylline. When used simultaneously with fluconazole at a dose of 200 mg for 14 days, the average rate of plasma clearance of theophylline is reduced by 18%. When prescribing fluconazole to patients taking high doses of theophylline or to patients at increased risk of developing theophylline toxicity, monitor for symptoms of theophylline overdose and, if necessary, adjust therapy accordingly. Vinca alkaloid. Although targeted studies are lacking, it is suspected that fluconazole may increase plasma concentrations of vinca alkaloids (eg, vincristine and vinblastine) and thus lead to neurotoxicity, which may be due to inhibition of CYP3A4. Vitamin A. There is a report of one case of the development of adverse reactions from the central nervous system (CNS) in the form of pseudotumor cerebri with the simultaneous use of all-trans retinoic acid and fluconazole, which disappeared after discontinuation of fluconazole. The use of this combination is possible, but one should remember the possibility of adverse reactions from the central nervous system. Zidovudine. In patients receiving a combination of fluconazole and zidovudine, there is an increase in the Cmax and AUC of zidovudine by 84% and 74%, respectively, which is caused by a decrease in the metabolism of the latter to its main metabolite. Before and after therapy with fluconazole at a dose of 200 mg/day for 15 days in patients with AIDS and ARC (AIDS-related complex), a significant increase in the AUC of zidovudine (20%) was found. Patients receiving this combination should be monitored for side effects of zidovudine. Voriconazole (inhibitor of the isoenzyme CYP2C9, CYP2C19 and CYP3A4). Concomitant use of voriconazole (400 mg twice daily on the first day, then 200 mg twice daily for 2.5 days) and fluconazole (400 mg on the first day, then 200 mg daily for 4 days) leads to an increase in voriconazole concentration and AUC by 57% and 79%, respectively. It has been shown that this effect persists when the dose and/or frequency of administration of any of the drugs is reduced. Concomitant use of voriconazole and fluconazole is not recommended. Tofacitinib. The exposure of tofacitinib is increased when it is co-administered with drugs that are both moderate inhibitors of the CYP3A4 isoenzyme and strong inhibitors of the CYP2C19 isoenzyme (for example, fluconazole). Dose adjustment of tofacitinib may be necessary. Ivacaftor. When coadministered with ivacaftor, a cystic fibrosis transmembrane conductance regulator (CFTR) stimulator, there was a 3-fold increase in ivacaftor exposure and a 1.9-fold increase in hydroxymethyl-ivacaftor (M1) exposure. Patients who simultaneously take CYP3A inhibitors, such as fluconazole and erythromycin, are recommended to reduce the dose of Ivacafator to 150 mg once a day. Studies of the interaction of oral forms of fluconazole with its simultaneous intake with food, cimetidin, antacids, as well as after total irradiation of the body to prepare for bone marrow transplantation, showed that these factors do not have a clinically significant effect on the absorption of fluconazole. The listed interactions are established with multiple use of fluconazole; Interactions with drugs as a result of a single use of fluconazole are not known. Doctors should take into account that interaction with other drugs has not been specially studied, but it is possible.

Side effects

When using capsules or tablets orally:

• From the digestive system: nausea, diarrhea, bloating and flatulence .
• Nervous system: headache and dizziness .
• From the hematopoietic system: thrombocytopenia, leukopenia, agranulocytosis .
• Allergic manifestations: anaphylactic reactions, skin rash .

Intravenous use of a pharmaceutical drug may cause the following side effects:

• From the gastrointestinal tract: nausea followed by vomiting, flatulence, abdominal pain, functional liver failure (increased levels of alkaline phosphatase, serum aminotransferases or bilirubin).
• Nervous system: headache, seizures .
• From the cardiovascular system: increased duration of the QT interval , ventricular fibrillation or even flutter .
• Allergic reactions: skin rash, Stevens-Jonas syndrome , toxic epidermal necrosis or Lyell's syndrome (an extreme manifestation of toxicoderma ), anaphylactic reactions.
• Metabolic processes: hypercholesterolemia, hypokalemia, hypertriglyceridemia.
• From other systems: alopecia, renal failure .

Adverse reactions after taking Flucostat

Most often, headaches and dizziness occur while taking the drug. Less common are convulsions and changes in taste, as well as insomnia and tremors of the limbs.

From the digestive system, abdominal pain, diarrhea, and vomiting are often observed. Dry mouth and constipation may occur.

Skin disorders include a rash, which appears more often than other negative reactions. Less common are increased sweating, hives, and even facial swelling.

Flucostat, instructions for use (Method and dosage)

Flucostat tablets, instructions for use

Film-coated capsules and tablets are used enterally , that is, orally. They should be swallowed whole without breaking the integrity, this may affect the therapeutic effectiveness of the treatment. How to take it - before or after a meal - does not matter, since the absorption of the active components of Flucostat does not depend on filling the lumen of the digestive tube. The duration of treatment is selected individually; as a rule, conservative therapy is carried out until the results of microbiological studies of the pathological focus are completely negative.

The dosage of the pharmaceutical drug and the treatment regimen depend on the clinical diagnosis:

• atrophic oral candidiasis and similar infections of the mucous membranes – 50-100 mg/day for 14-30 days;
• cryptococcal infections , disseminated candidiasis and fungi entering the blood - 1st day 400 mg, and then 200-400 mg once a day for a long period;
• vaginal candidiasis and balanitis - 150 mg once, and then to prevent relapse 150 mg once a month for 4-12 months;
• skin mycoses - 150 mg once a week or 50 mg once a day for 2-6 weeks, depending on the sensitivity of the pathogen to therapy;
• pityriasis versicolor – 50 mg once a day for 2-4 weeks;
• deep endemic mycoses - 200-400 mg per day (duration depends on the pathogenic fungus that caused the disease);
• onychomycosis - 150 mg once a week until the unaffected nail plate is completely restored (nails on the hands grow in 3-6 months, and on the feet in 6-12 months).

antibiotics are often added to the treatment regimen . Solutab , a beta-lactam penicillin , which is used to prevent the development of generalized infectious diseases with local or general decrease in immunity due to toxins of pathogenic fungal colonies, has received especially widespread use in this vein You should find out from your doctor how to take antibiotics, because their incorrect use can lead to such adverse consequences as dysbacteriosis or the development of microflora resistance to the penicillin group of drugs.

Antifungal medicine for children

The tablet form of Flucostat can also be used in pediatric practice, since fungal infections in children develop and occur even more often than in adults. The dosage is selected individually for each child, based on his anthropometric indicators (in particular weight) and clinical diagnosis, which should be confirmed by microscopic examination. treatment regimens for pediatricians exist

• candidiasis of the mucous membranes - 6 mg per 1 kg of patient weight on day 1, and then 3 mg per kg until the results of microbiological studies are negative;
• cryptococcosis and systemic candidiasis – 6-12 mg/kg, depending on the severity of the disease;
• for preventive purposes against the background of reduced immune abilities of the body - 3-12 mg per 1 kg of weight per day (the exact amount of the pharmaceutical drug should be calculated based on the level of leukopenia in a blood test).

How to take medicine for thrush

How to take Flucostat for thrush , each patient can decide independently or find out in consultation with a qualified specialist, since there are different treatment regimens for fungal infections of the urogenital area in women. The quantity and frequency of application depends on the manifestations of the pathological process, the form of the disease and associated complications:

• An uncomplicated form of candidiasis that occurs for the first time with mild or moderate symptoms - 1 capsule (150 mg of Flucostat) once.
• Complicated form of thrush with severe symptoms or against the background of concomitant chronic diseases - 150 mg of the drug on days 1 and 4 of conservative therapy.
• A recurrent form of candidiasis in women, which manifests itself at least 4 times during the year - 150 mg in three doses, on the 1st, 4th and 7th day of sanitation. It is also necessary to treat the sexual partner - 150 mg once. This form of fungal pathology requires maintenance therapy to prevent repeated episodes of the disease. For this purpose, 150 mg tablets are used once a week for 6 months.

How long does it take for a pharmaceutical drug to help?

Whether the medicine for thrush helps and how long to wait for the therapeutic effect can be found out after two weeks in case of a severe form of the disease or in a week if the nosological unit manifests itself with mild symptoms without adverse consequences, because this is how long the course of conservative treatment usually lasts, after which the following symptoms disappear without a trace:

• annoying itching and burning in the external genitalia and vagina;
• copious curdled discharge ;
• pain during intercourse or urination.

Flucostat suppositories

It should be noted that the instructions for using Flucostat for thrush may also include suppositories as a local means of combating harmful fungi, which from the point of view of the medical community is much more favorable for a number of reasons:

• the use of vaginal suppositories is not accompanied by unpleasant sensations or inconvenience;
• a course of conservative therapy can be started immediately from the moment the characteristic symptoms of a given nosological unit are detected, without even waiting for the end of the menstrual cycle;
• side effects from pharmaceutical treatment are less ;
• the therapeutic effectiveness of suppositories does not depend on food intake, time of day and in no way affects the usual routine of things.

To make sure how to take Flucostat for thrush in the form of suppositories, the exact dosages of this pharmaceutical form of the drug, the duration of the course of therapy, you should contact the antenatal clinic or the gynecological department, however, as a rule, the treatment regimen does not differ from that when using the enteral form of the antifungal drug facilities.

Instructions for Flucostat for men

Thrush is a disease that affects predominantly the female half of the population, but the widespread belief is that genital candidiasis is their exclusive lot. is erroneous. Of course, yeast-like fungi of the genus Candida do not take root well in the urethra of most of our planet, since they are regularly washed out with urine , but with a local weakening of immune mechanisms, favorable conditions are created for the development of urogenital candidiasis , and therefore the question is increasingly being asked whether men can take Flucostat to eliminate thrush.

antifungal pharmaceutical drug is absorbed into the main bloodstream and is evenly distributed in the biological fluids and environments of the male body in the same way as in women. But biologically active components have no effect on hormonal levels and are not capable of changing it in any way, so can men Flucostat to get rid of an unpleasant pathology - of course, yes. Such therapeutic measures will be regarded as etiological therapy aimed at eradicating the causative agent of thrush.

Flucostat

FLUKOSTAT® is a systemic antifungal drug for the treatment of thrush.

Advantages of the brand

• long history of use, supported by positive experience of use and the trust of millions of women in Russia
• proven and confirmed equivalence to the original Western drug1
• production in a plant standardized according to European quality standards EU GMP2
• affordable price for a wide range of consumers3

Advantages of the molecule

• wide spectrum of antifungal activity
• the ability to inhibit the growth and reproduction of fungi of the genus Candida, especially Candia albicans - the main causative agents of genital candidiasis (“thrush”)
• favorable pharmacokinetic characteristics:
• bioavailability when taken orally is comparable to intravenous administration;
• high degree of distribution in tissues and environments of the body (including the ability to create and maintain high therapeutic concentrations in vaginal tissues and vaginal secretions)4;
• prolonged therapeutic effect and long-term protective effect.

• achieving maximum concentrations in the vaginal mucosa and vaginal secretions within 2 hours after administration7*
• onset of reduction in clinical symptoms on average within 24 hours after taking one capsule at a dosage of 150 mg8
• the average time for symptom regression is 2 days8
• just one capsule at a dosage of 150 mg is sufficient to eliminate the symptoms of “thrush” in most women with an uncomplicated form of acute vulvovaginal candidiasis
• a single oral dose of a 150 mg capsule is comparable to a weekly course of therapy with some intravaginal anti-thrush agents9**

Advantages of the release form (capsules for oral administration)

Systemic distribution into most tissues, organs and biological fluids of the body creates high concentrations in them, which contributes to:

• elimination of fungal cells not only from the surface of the vaginal mucosa, including microfolds, but also throughout its entire thickness7
• eliminating the pathogens of “thrush” not only in the genital tract, but also in other possible places of their habitat - the oral mucosa and intestines, thereby minimizing the risk of re-exacerbation of the disease after treatment8

convenience and comfort during the treatment process:

• possibility of starting treatment on any day of the menstrual cycle, including menstruation
• the ability to take the capsule at any time of the day - day or night
• the possibility of taking the drug regardless of the diet - on an empty stomach, during or after meals (simultaneous food intake and increased acidity do not have a significant effect on the absorption and therapeutic effect of the drug)
• the possibility of taking the drug regardless of the method of contraception used - fluconazole does not violate the integrity of latex contraceptives when it comes to using a condom or diaphragm, and also does not reduce the level of estradiol, which is the main component of oral contraceptives

• simplicity and ease of the process of taking the drug - all that is required is to take the capsule out of the blister and swallow it with the required amount of water
• in most cases, it is enough to take just 1 capsule of the drug per course

Indications for use

• treatment of acute vaginal candidiasis, when local therapy is not applicable.

Contraindications

• Hypersensitivity to fluconazole and other components of the drug
• Children under 18 years old
• Lactation period (see the instructions section “Use during pregnancy and breastfeeding”

For more details, see the instructions for medical use of the drug.

Overdose

Symptoms that are observed with a drug overdose:

• hallucinations;
• maximum manifestation of side effects (see list above);
• paranoid behavior.

There is no specific pharmaceutical antidote for reversing an overdose of Flucostat. Gastric lavage and symptomatic treatment of individual manifestations should be performed. Forced diuresis is also indicated , since the main route of excretion of metabolites of the active ingredient is in the urine. Hemodialysis works well, since within three hours of manipulation the plasma concentration of Fluconazole is reduced by half.

special instructions

Flucostat has the property of somewhat lowering local immunity , acting in a specific way on the microflora of the urogenital area. As a result of this side effect, additional gates are opened for the invasion of infectious pathogens of a non-fungal nature, and accordingly, conditions are created for the development of unpleasant diseases of the genitourinary system. In order to eliminate possible adverse effects of conservative therapy, antibiotics .

Qualified specialists agree that no ordinary pharmaceutical drug should be used, so as not to develop resistance to the main chemical components of drugs that affect harmful microflora. In this vein, Solutab 30 , a reserve antibiotic, is often used, which reduces the risk of the above-mentioned complications of treating fungal pathology.

Flucostat's analogs

Level 4 ATC code matches:
Medoflucon

Vfend

Itracon

Mikosist

Irunin

Mikomax

Orungal

Mycoflucan

Fluconazole

Sporagal

Orungamin

Difluzol

Rumicosis

Futsis

Vero-Fluconazole

Kandizol

Kanditral

Itraconazole

Diflazon

Contraindications to the use of Flucostat are common metabolic disorders, therefore there is a whole group of foreign pharmaceuticals that, under certain conditions, can be used as an analogue of Flucostat for thrush or other nosological units of fungal origin. Mikosist, Mikomax, Microflucan have received wide recognition among patients, but Diflucan as a high-quality substitute for an antifungal drug.

Diflucan and Flucostat: the difference between antifungal agents

• Diflucan is an imported drug that is produced in such advanced countries as the United States of America and France, in contrast to the domestic Flucostat;
• Flucostat is an original drug that appeared on the pharmaceutical market at the end of the last century;
• Flucostat contains some chemical components that are not found in Diflucan.

Based on the differences between these pharmaceuticals, it is difficult to definitively answer which is better—Flucostat or Diflucan. Of course, the credibility of an imported drug is greater, especially since production in such large countries allows you to be confident in the high quality of medicinal products. On the other hand, the price of Flucostat is 10, and sometimes more, times less than the cost of Diflucan, which in our mentality is also valued very highly, so the choice: what to use - Flucostat or Diflucan - should be made independently.

Domestic analogues

Since the price of analogues produced abroad is significantly higher than the cost of domestic drugs, patients try to avoid purchasing them and are increasingly seeking to find cheap Russian analogues of Flucostat. But this group of pharmaceuticals is presented extremely poorly on pharmacy shelves; moreover, we can say that there is only one analogue of Flucostat that is not inferior in therapeutic effectiveness, but cheaper - Fluconazole, the capsules of which use an identical active substance in the same dosages (50 and 150 mg), as in Flucostat, but the price of cardboard packages is sometimes 10 times lower, which, undoubtedly, makes the choice to the domestic analogue.

Is it possible to take Flucostat during pregnancy?

A pregnant woman must discuss taking any medications with her doctor, especially in the first trimester, when the child’s physical characteristics are just developing. There have been no special studies of the use of the drug in pregnant women on the basis of which it would be possible to draw a conclusion about the effects of fluconazole. However, statistics have shown that a single dose of Flucostat capsule at a dosage of 150 mg did not lead to undesirable consequences for the child.

At the same time, there is evidence indicating that the use of high doses of Flucostat (from 400 mg) several times throughout pregnancy led to the development of deformities in the fetus.

Flucostat and alcohol

Exposure to any pharmaceutical drug while drinking alcohol leads, as a rule, to the development of adverse consequences of conservative therapy. Flucostat, in turn, is not just an ordinary drug, but its active components have antibiotic properties, therefore combining alcohol with a course of conservative sanitation with an antifungal drug is strictly prohibited in order to avoid the development of the following pathological conditions:

• toxic and necrotic liver damage;
• inadequate functioning of the central nervous system with the development of increased sensitivity of various structures to afferent and efferent impulses;
• increased load on the heart muscle;
• high risk of developing arterial hypertension , up to rapid hypertensive crisis;
• a significant decrease in the therapeutic effectiveness of the drug.

How to take antibiotics and Flucostat

Taking fluconazole simultaneously with antibacterial therapy should be discussed with your doctor, because some forms of antibiotics are not compatible with fluconazole:

• Concomitant use with erythromycin leads to the development of cardiotoxicity and, as a consequence, cardiac death. Therefore, the prescription of one of the drugs is a contraindication for the other.
• Rifampicin accelerates the elimination half-life of fluconazole from the blood. In this connection, the doctor must decide to increase the dose of Flucostat if simultaneous use with rifampicin is intended.
• Azithromycin does not have a significant effect on fluconazole, nor does the antifungal agent interfere with the action of the antibiotic.

Self-administration of Flucostat is possible only in cases where the patient does not take any other medications. Otherwise, before using Flucostat, you should consult your doctor about drug compatibility.

Flucostat during pregnancy (and lactation)

During the use of the drug, the active ingredients are absorbed into the main bloodstream and distributed throughout the woman’s body, evenly deposited in biological fluids. That is why the use of the antifungal drug Flucostat during pregnancy is allowed only for health reasons (for example, in the case of severe, generalized infections that threaten the life of the expectant mother and fetus).

If there is a need to undergo a course of conservative therapy during breastfeeding, then the child should be weaned from the breast and mother’s milk, because even in such a specific secretion traces of biologically active substances that are part of the enteral and parneteral forms of Flucostat are found.

Reviews of Flucostat

Reviews about Flucostat on the Internet are full of positive emotions and grateful words, because the drug in a short time allows you to eliminate very unpleasant pathological conditions associated not only with adverse consequences in the physical sense, but also with special psycho-emotional factors. Reviews from women vying with each other insist that diseases of the urogenital area, as a rule, are associated with stress, and this entails a deterioration in the functioning of all organs and systems in the body. Flucostat, in turn, not only eliminates the main cause of the unpleasant disease, but also allows you to “take a deep breath” when starting a new day.

Therefore, reviews of Flucostat for thrush recommend the use of the pharmaceutical drug everywhere, even only if a nosological entity caused by fungal invasion in the genitourinary system is suspected. Patients who have undergone a course of conservative therapy note that the drug allows for effective eradication of the pathogen even in the complicated form of thrush and with a recurrent course, which is not feasible for every antifungal drug.

Flucostat for men is no less useful a drug than for women, since, contrary to popular belief, the causative agent of thrush, the yeast-like fungus Candida albicans, can also infect the genitourinary system of the stronger sex. In this case, the therapeutic effect of the pharmaceutical drug makes it possible to eliminate unpleasant manifestations within a short period of sanitation. Also, film-coated capsules or a solution for parenteral administration of Flucostat are used to prevent asymptomatic carriage of fungi in men, because during sexual intercourse women are infected, in whose vagina the optimal environment for the development of a pathological focus is constantly maintained.

How to use

Capsules are swallowed with water, regardless of meals. For fungal infections of the oral mucosa, take fifty to one hundred milligrams once a day for two weeks. The capsule is not opened so as not to disrupt the dosage.

For vaginal thrush, take 150 milligrams once. For the prevention of intestinal and vaginal candidiasis during antibiotic treatment, the drug is prescribed on the seventh, fourteenth day.

For cryptococcal diseases, take 400 milligrams one day, then exactly half the dose for two weeks every day. For pityriasis versicolor, drink fifty milligrams once a month.

For onychomycosis, take 150 milligrams once a week.

Sometimes antibacterial drugs are added to increase the effectiveness of therapy.

For candidiasis in children, the dose is calculated to be 6 milligrams per kilogram of weight. This dose is taken one day, then half until the symptoms disappear.

For prevention, a dose is prescribed at the rate of 3 milligrams per kilogram of the child’s weight once.

• When treating thrush in women, the sexual partner is also treated. He is given 150 milligrams of the drug once.
• For vaginal candidiasis, suppositories are used along with capsules. They eliminate such unpleasant phenomena as: pain when urinating, itching of the genitals, discomfort during sexual intercourse.

Suppositories are placed in the vagina and can be used during menstruation. The duration of treatment is prescribed by the doctor. Side effects when using suppositories are observed much less frequently.

During an overdose caused by a violation of proper use, there are paranoid manifestations and hallucinations. In such cases, the stomach is washed and hemodialysis is prescribed.

Flucostat price, where to buy

The price of Flucostat largely depends on the form of release of the pharmaceutical drug and the country where you want to buy the antifungal agent. For example, Ukraine offers the most optimal price for pharmaceutical products, Kharkov is especially pleasing, because in the first capital the price of Flucostat tablets is 27 hryvnia, and the price of candles is less - 10-15 hryvnia.

In Russia, how much Flucostat costs in the pharmacy located closest to you must be found out taking into account the prescribed dosage of the drug, since the price of Flucostat 150 mg is 350 rubles, and capsules containing 50 mg of antifungal powder can be purchased for 270 rubles.

The price of Flucostat for thrush in other nearby countries can be calculated at the local exchange rate, because competition for the import of pharmaceutical products extends far beyond the borders of the CIS countries. For example, in Belarus, 150 mg tablets can be bought for between 10-40 thousand rubles, which reflects the exact cost of the drug in Kharkov, and the price of ointment in Kazakhstan is equivalent to its cost in Omsk.

• Online pharmacies in RussiaRussia

ZdravCity

• Flucostat capsules 50 mg 7 pcs. Pharmstandard-Leksredstva OJSC
  357 rub. order