AnatomyOrganismsDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesDisciplines and Occupations
FlucytosineAntifungal AgentsMeningitis, CryptococcalAmphotericin BFluconazoleCandidaCryptococcus neoformansDrug Resistance, FungalMicrobial Sensitivity TestsItraconazoleCandidiasisCryptococcosisCryptococcus gattiiCandida albicansKetoconazoleFungemiaNucleobase Transport ProteinsTriazolesCandida tropicalisMycosesAzolesCytosineCandida glabrataMycologyCytosine DeaminaseMeningitis, FungalExophialaDrug Resistance, Multiple, FungalMycological Typing TechniquesDrug Therapy, CombinationCryptococcusEchinocandinsMeningoencephalitisCerebrospinal FluidAIDS-Related Opportunistic InfectionsFungiMitosporic FungiColorimetryDrug CombinationsLipopeptidesTrichosporonYeastsCulture MediaSerum Bactericidal Test
FluconazoleAmphotericinFluorouracilMade in 1957IntravenousCandidaConcentrationsMajor PharmaceuticalsCaspofunginAdverseCryptococcal MeningitisSynthesisOralCryptococcusCitationTreatmentInfectionsPatientsClassMainMakeCountriesPotentialAmphotericin B and FlucytosineItraconazoleCandidaAncobonCryptococcalCapsules USPDosesExcreted via the kidneysHydroxyureaSpeciesIsolatesSerumPyrimidineSystemicPharmacodynamicPneumoniaSevereResistanceVitroHepaticCandidalRenalIncidenceProtein boundEnzymeRarelyRapidlyEliminationToxicDrugsInjectionTherapyMechanism
Fluconazole3
  • Flucytosine must not be used as a sole agent in life-threatening fungal infections due to relatively weak antifungal effects and fast development of resistance, but rather in combination with amphotericin B and/or azole antifungals such as fluconazole or itraconazole. (wikipedia.org)
  • The trial, conducted in Botswana, Malawi, South Africa, Uganda, and Zimbabwe, assessed whether combining two oral antifungals - fluconazole and flucytosine - with a single high dose of liposomal amphotericin-B could be as effective at reducing deaths as the WHO-recommended seven-day treatment with amphotericin-B. (news-medical.net)
  • Single-dose liposomal amphotericin B combined with flucytosine and fluconazole was noninferior to the WHO-recommended treatment for HIV-associated cryptococcal meningitis and was associated with fewer adverse events,' says the study, published last month in the New England Journal of Medicine . (news-medical.net)
Amphotericin8
  • These people benefit from combination therapy including flucytosine, but the incidence of side-effects of a combination therapy, particular with amphotericin B, may be higher. (wikipedia.org)
  • Combination therapy with flucytosine results in more rapid CSF sterilization and improved mortality when compared to amphotericin alone. (hopkinsguides.com)
  • ABSTRACT In a randomized controlled trial of amphotericin B-based therapy for human immunodeficiency virus (HIV)-associated cryptococcal meningitis in Thailand, we also compared the mycological efficacy, toxicity, and pharmacokinetics of oral versus intravenous flucytosine at 100 mg/kg of body weight/day for the initial 2 weeks. (tropmedres.ac)
  • We compared amphotericin B therapy for cryptococcal meningitis with a newer regimen containing both amphotericin B and flucytosine. (johnshopkins.edu)
  • 4 In vitro 5 and in vivo 6 evidence that amphotericin B and flucytosine were at least additive in their effects against cryptococcosis prompted clinical trials of the combination. (johnshopkins.edu)
  • The only challenge with the implementation of these findings is that both flucytosine and liposomal amphotericin B are not readily available in the public sector in Kenya and many other Sub-Saharan countries which bear the brunt of cryptococcal meningitis,' she tells SciDev.Net . (news-medical.net)
  • Also, both flucytosine and liposomal amphotericin B are costly. (news-medical.net)
  • Flucytosine is usually used with amphotericin B for serious Candida and cryptococcal infections. (msdmanuals.com)
Fluorouracil3
  • The issue has been raised because traces of 5-fluorouracil, which is a known carcinogen, are found in the colon resulting from the metabolization of flucytosine. (wikipedia.org)
  • Flucytosine and fluorouracil concentrations in plasma and CSF were measured by high-performance liquid chromatography. (tropmedres.ac)
  • Adverse events include dose-related bone marrow suppression and bloody diarrhea due to intestinal flora conversion of flucytosine to 5-fluorouracil. (unboundmedicine.com)
Made in 19571
Intravenous4
  • Half of 32 patients assigned to the two arms containing flucytosine were randomized to oral and half to intravenous flucytosine. (tropmedres.ac)
  • In patients receiving intravenous flucytosine, the median 24-h area under the concentration-time curve was significantly higher than in the oral group. (tropmedres.ac)
  • Despite this difference, there was no difference in early fungicidal activity between patients on intravenous compared with patients on oral flucytosine. (tropmedres.ac)
  • Concentrations of flucytosine with intravenous formulation at 100 mg/kg/day may be in excess of those required for maximal fungicidal activity. (tropmedres.ac)
Candida2
Concentrations1
  • Adjust dose to maintain flucytosine concentrations (2-hour post-dose) between 40-60 mcg/mL. (hopkinsguides.com)
Major Pharmaceuticals1
  • The NDC code 0904-6835 is assigned by the FDA to the product Flucytosine which is a human prescription drug product labeled by Major Pharmaceuticals. (ndclist.com)
Caspofungin1
  • Resistant to caspofungin,anidulafungin,5-flucytosine and itroconazole. (atcc.org)
Adverse2
  • Breast feeding during flucytosine therapy not recommended because of concern for potential adverse effects. (hopkinsguides.com)
  • Adverse reactions to flucytosine occurred in 11 of 34 patients but were not life threatening. (johnshopkins.edu)
Cryptococcal Meningitis1
  • We conclude that combined flucytosine-amphoericin B therapy is the regimen of choice in cryptococcal meningitis. (johnshopkins.edu)
Synthesis2
  • Flucytosine interferes with protein synthesis by incorporation into fungal RNA after being converted to 5-FU intracellularly. (hopkinsguides.com)
  • Flucytosine is a class of antifungal drugs that inhibit DNA synthesis and RNA transcription. (brainscape.com)
Oral1
  • It is often combined with an oral antifungal medicine called 5-flucytosine. (stlukes-stl.com)
Cryptococcus1
Citation2
  • citation needed] In animal models (rats), flucytosine has been found to be teratogenic. (wikipedia.org)
  • citation needed] It is not known if flucytosine is distributed in human breast milk. (wikipedia.org)
Treatment1
  • Given the potential risk to the child, the patient should not breastfeed during treatment with flucytosine. (wikipedia.org)
Infections2
  • Minor infections such as candidal cystitis may be treated with flucytosine alone. (wikipedia.org)
  • Flucytosine is used to treat serious fungal infections in the body. (ndclist.com)
Patients2
  • Patients with renal disease should receive flucytosine cautiously and in reduced doses. (wikipedia.org)
  • All patients receiving flucytosine should be under strict medical supervision. (wikipedia.org)
Class1
Main1
  • Founded in 2006, we are a specialized manufacturing and trading enterprise of fine chemicals, with 5-Fluoro-2-methoxy-4(1H)pyrimidinone, 2-Ethoxy-5-fluoro-4(3H)-pyrimidinone, 5-Flucytosine, Piperonal and Floramelon as main products. (decortkirknerlaw.com)
Make1
  • Flucytosine can also cure this infection, but secondary drug resistance and a low proportion of cures make this drug undesirable as a single agent. (johnshopkins.edu)
Countries1
  • Maritim adds that in some African countries such as Guinea, Mozambique, Niger, Sudan, and Tunisia, flucytosine is not registered with the regulatory authorities. (news-medical.net)
Potential1
  • Pregnant women should be given flucytosine only if the potential benefits exceed the potential harm to the fetus. (wikipedia.org)
Amphotericin B and Flucytosine2
  • Ourin vitrostudies showed that with the combination of amphotericin B and flucytosine against these species, the median fractional inhibitory concentration (FIC) indices for strains ranged from 0.25 to 0.38, indicating synergy. (ru.nl)
  • 5 However, access to the preferred drugs, amphotericin B and flucytosine, is a challenge, as highlighted by a rapid survey of MSF HIV/AIDS programmes in 9 countries. (samj.org.za)
Itraconazole1
Candida5
Ancobon1
  • Flucytosine is available as tablets of 250 and 500 mg in generic forms and under the brand name of Ancobon. (nih.gov)
Cryptococcal2
  • Flucytosine is active against several Candidal and Cryptococcal species. (nih.gov)
  • When treating cryptococcal meningitis and severe systemic candidiasis, flucytosine should be given in combination with amphotericin B. Where amphotericin B is not suitable for the treatment of cryptococcal meningitis, flucytosine may be given with fluconazole (although rate of cure may be slower). (medscape.co.uk)
Capsules USP4
  • These instructions should be thoroughly reviewed before administration of Flucytosine Capsules USP. (nih.gov)
  • Flucytosine Capsules USP, an antifungal agent, is available as 250 mg and 500 mg capsules for oral administration. (nih.gov)
  • Flucytosine Capsules USP is not metabolized significantly when given orally to man. (nih.gov)
  • Limited data are available regarding the pharmacokinetics of Flucytosine Capsules USP administered to neonatal patients being treated for systemic candidiasis. (nih.gov)
Doses4
  • Patients with renal disease should receive flucytosine cautiously and in reduced doses. (wikipedia.org)
  • [ 56 ] The recommended oral dose of flucytosine is 50-150 mg/kg in four divided doses. (medscape.com)
  • Other studies revealed mean serum concentrations of approximately 70 to 80 mcg/mL 1 to 2 hours after a dose in patients with normal renal function receiving a 6-week regimen of flucytosine (150 mg/kg/day given in divided doses every 6 hours) in combination with amphotericin B. The half-life in the majority of healthy subjects ranged between 2.4 and 4.8 hours. (nih.gov)
  • Median serum flucytosine concentrations at steady state were calculated to be 57 ± 10 mcg/mL (doses of 50 to 125 mg/kg/day, normalized to 25 mg/kg per dose for comparison). (nih.gov)
Excreted via the kidneys1
  • Flucytosine is excreted via the kidneys by means of glomerular filtration without significant tubular reabsorption. (nih.gov)
Hydroxyurea1
Species1
  • Resistance to flucytosine is rarely described for this species but was observed for 45 (35%) of 130 C. tropicalis isolates recovered from blood cultures in the Paris area in a 4-year survey. (cdc.gov)
Isolates2
  • The aims of this study were to test the hypothesis that the flucytosine-resistant isolates could represent a subgroup and to determine the relationship between epidemiologic and genomic data. (cdc.gov)
  • Our results suggest that a clone of flucytosine-resistant isolates, associated with malignancies and a lower mortality than that for other C. tropicalis isolates, is widespread in the Paris area. (cdc.gov)
Serum6
  • Flucytosine therapy can cause transient mild-to-moderate serum aminotransferase elevations and has been mentioned as a very rare cause of clinically apparent acute drug induced liver injury. (nih.gov)
  • Transient mild-to-moderate elevations in serum aminotransferase or alkaline phosphatase levels occur in up to 41% of patients treated with flucytosine. (nih.gov)
  • The cause of serum aminotransferase elevations from flucytosine is unknown. (nih.gov)
  • mentions that transient serum enzyme elevations occur in 5-10% of patients treated with flucytosine, and a single case report of severe hepatitis attributed to flucytosine has been published). (nih.gov)
  • dichlorphenamide and flucytosine both decrease serum potassium. (medscape.com)
  • In another study, serum concentrations were determined during flucytosine therapy in two patients (total assays performed =10). (nih.gov)
Pyrimidine2
  • Flucytosine is in the fluorinated pyrimidine analogue family of medications. (wikipedia.org)
  • Flucytosine (floo sye' toe zeen) is a fluorinated pyrimidine analogue which has potent fungicidal activity. (nih.gov)
Systemic1
  • 14. Invasive pulmonary aspergillosis in a non-immunosuppressed patient: successful management with systemic amphotericin and flucytosine and inhaled amphotericin. (nih.gov)
Pharmacodynamic4
  • In vitro pharmacodynamic characteristics of flucytosine determined by time-kill methods. (nih.gov)
  • flucytosine increases effects of amphotericin B deoxycholate by pharmacodynamic synergism. (medscape.com)
  • ganciclovir increases toxicity of flucytosine by pharmacodynamic synergism. (medscape.com)
  • valganciclovir increases toxicity of flucytosine by pharmacodynamic synergism. (medscape.com)
Pneumonia1
  • 18. Combined amphotericin B-flucytosine therapy in Aspergillus pneumonia. (nih.gov)
Severe1
  • Amphotericin B may also be given in combination with flucytosine when treating severe or long-standing infections due to other organisms. (medscape.co.uk)
Resistance1
Vitro1
  • In vitro studies have shown that 2.9% to 4% of flucytosine is protein-bound over the range of therapeutic concentrations found in the blood. (nih.gov)
Hepatic1
  • Instances of acute liver injury and hepatic failure have been mentioned in clinical trials of flucytosine therapy, but few details were provided and no convincing case reports of acute hepatic injury with jaundice have been published. (nih.gov)
Candidal1
  • Minor infections such as candidal cystitis may be treated with flucytosine alone. (wikipedia.org)
Renal2
  • flucytosine increases levels of peramivir by decreasing renal clearance. (medscape.com)
  • flucytosine increases levels of tenofovir DF by decreasing renal clearance. (medscape.com)
Incidence1
  • These people benefit from combination therapy including flucytosine, but the incidence of side-effects of a combination therapy, particular with amphotericin B, may be higher. (wikipedia.org)
Protein bound1
  • [ 55 ] Flucytosine is not highly protein bound, and ocular penetration appears to be very good. (medscape.com)
Enzyme1
  • The enzyme abnormalities are usually asymptomatic and resolve with stopping flucytosine, and sometimes even with its continuation. (nih.gov)
Rarely1
  • Duration of treatment should be determined on an individual basis but flucytosine should rarely be required for longer than one week. (medscape.co.uk)
Rapidly1
  • Flucytosine is rapidly and virtually completely absorbed following oral administration. (nih.gov)
Elimination2
  • amphotericin B deoxycholate increases levels of flucytosine by decreasing elimination. (medscape.com)
  • A linear correlation was found between the elimination rate constant of flucytosine and creatinine clearance. (nih.gov)
Toxic1
  • Human cells do not possess the enzymes to convert flucytosine to these toxic metabolites. (nih.gov)
Drugs1
  • The urgent challenge ahe---ad for all involved in translating these guidelines into practice is to accelerate access to affordable treatment by supporting the registration and procurement of flucytosine and amphotericin B at affordable prices in all the countries where these drugs are needed. (samj.org.za)
Injection1
  • Flucytosine is used by mouth and by injection into a vein. (wikipedia.org)
Therapy1
  • Hormone replacement therapy may be given at 30-60% cialis sale online bioavailability of atherogenesis Flucytosine is absorbed. (diarimaresme.com)
Mechanism1
  • flucytosine decreases effects of Saccharomyces boulardii by unspecified interaction mechanism. (medscape.com)