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(for veterinary information only)
AVAILABLE IN
50 mg, 100 mg, 150 mg, 200 mg
TABLETS
AND ORAL SUSPENSION
The development of oral medications to be used in the treatment of invasive fungal infections has represented an immense medical breakthrough. With oral treatment available, human patients no longer require hospitalization several days per week for intravenous treatment of their disease; a more normal and productive lifestyle is now possible. Further, the toxicity profiles of the newer oral drugs represents vast improvement over those of the injectables.
Ketoconazole was the first such oral antifungal drug but it had room for improvement regarding its side effect potential. There were problems with nausea, liver toxicity, and feminization of male patients. Fluconazole was developed in answer to these concerns. Its potential for side effects is far lower and, recently, generic medications have made fluconazole readily affordable. Fluconazole represents yet another generation allowing excellent penetration of the blood/brain barrier, allowing neurologic fungal diseases to be treated.
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Molecular structure of Ergosterol
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HOW THIS MEDICATION WORKS
Fluconazole works by inhibiting the fungal enzymes that produce “ergosterol,” an important component of the fungal cell wall. Without adequate ergosterol, the fungal cell becomes weak, leaky and ultimately dies.
Fungal infections for which fluconazole can be used include:
- Dermatophytosis (“ringworm”) though it is usually reserved for more serious fungal diseases.
- Blastomycosis
- Cryptococcosis (“window washer’s disease)
- Histoplasmosis
- Aspergillosis (conflicting agreement as to whether it is effective or not against this fungal infection.)
- Candidiasis
- Coccidiodomycosis (“Valley Fever”)
There are two reasons for choosing fluconazole over other antifungal agents. One reason is to avoid side effects, especially with long term use. The other is to penetrate the blood-brain barrier in order to address a neurologic infection. While fluconazole users do not commonly experience side effects, it is important to be aware of what to watch for.
Side effects of concern are appetite loss, vomiting, and/or diarrhea. If they occur, medication should be discontinued and liver enzymes should be checked.
If an adverse side effect occurs, it is expected to resolve with discontinuation of the medication. After recovery, fluconazole can usually be restarted at a lower dose.
IF YOU THINK YOUR PET MAY BE HAVING AN ADVERSE DRUG REACTION,
YOU SHOULD NOTIFY YOUR VETERINARIAN’S OFFICE RIGHT AWAY.
The following heart medicines will be stronger in the presence of fluconazole and dosage may need to be reduced: rifampin, digoxin, warfarin, or glipizide. A similar problem occurs with cyclosporine, an immune suppressant used in immune mediated disease or after an organ transplant.
- Fluconazole can be given with or without food.
- One to two weeks are needed to get a stable blood level of fluconazole. Do not expect rapid results.
- Fluconazole is removed from the body via the kidneys. If a patient requiring this medication has poor kidney function, dose adjustments will be necessary.
Fluconazole is able to penetrate most body tissues and thus fight fungal infections in most organs.
FUNGAL INFECTIONS AS A GENERAL RULE ARE VERY RESISTANT
TO TREATMENT AND OFTEN MONTHS OF THERAPY ARE NEEDED.
Fluconazole is dangerous if given in pregnancy. If a pet is pregnant, Fluconazole should be avoided unless the fungal infection in question is potentially life-threatening.
Fluconazole should also be avoided in lactation as it will be delivered via milk to any nursing young.
Page last updated: 1/3/2012
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