Generic drug of the therapeutic class: Infectiology - Parasitology
active ingredients: Flucytosine
laboratory: Meda Pharma
Box of 1 Tube of 100
Severe systemic mycosis with sensitive germs, as an alternative or as a relay for the parenteral route in particular: candidiasis, cryptococcosis, chromomycosis and certain forms of aspergillosis.
Association with another antifungal:
It is essential to use flucytosine in combination to avoid as much as possible the selection of resistant mutants, especially in the treatment of candidiasis and cryptococcosis.
The association with amphotericin B is often synergistic and never antagonistic.
Dosage ANCOTIL 500 mg Tablet Box of 1 Tube of 100
Dosages range from 100 to 200 mg / kg per day depending on the nature of the infection, its location and the sensitivity of the causative agent.
The daily dosage should be divided into 3 or 4 oral doses.
USE IN RENAL INSUFFICIENT:
The doses will be administered at longer intervals according to the following dosage schedule:
- creatinine clearance> = 40 ml / min: 25 to 50 mg / kg / dose every 6 hours.
- 20 ml / min <= creatinine clearance <40 ml / min: 25 to 50 mg / kg / dose every 12 hours.
- 10 ml / min <= clearance of creatinine <20 ml / min: 25 to 50 mg / kg / dose every 24 hours.
- creatinine clearance <10 ml / min: single dose of 25 mg / kg followed by plasma monitoring 12 hours after the initial dose, before repeating the dose.
Since flucytosine is dialysable, the dose of this drug should be repeated after each treatment session.
ASSOCIATIONS WITH OTHER ANTIFUNGALS:
The flucytosine-amphotericin B combination is synergistic: it sometimes makes it possible to reduce the dosage and to reduce the risk of occurrence of secondary resistance to flucytosine.
There does not seem to be any antagonism with the imidazole derivatives.
This drug is contraindicated in case of hypersensitivity to any of the constituents.
NOT RECOMMENDED :
Pregnancy: studies in animals have shown a teratogenic effect of flucytosine. There is currently no sufficient data to evaluate the possible malformative or foetotoxic effect of flucytosine when administered during pregnancy. As a result, the use of this drug is not recommended during pregnancy. This element does not constitute the systematic argument for counseling a termination of pregnancy but leads to an attitude of caution and oriented antenatal surveillance.
- Breast-feeding: There are no data on the passage into breast milk. However, when prescribing this medicine, breast-feeding should be avoided because of the important digestive absorption of flucytosine.
Ancotil side effects
- Digestive disorders such as nausea, diarrhea, more rarely vomiting.
- Hematological disorders: (leukopenia, thrombocytopenia), most often moderate and transient and more frequent in case of renal insufficiency or when the serum levels of flucytosine are higher than 100 μg / ml. More severe lesions (aplasia, agranulocytosis), which may be irreversible and may exceptionally lead to death, have sometimes been observed, most often in patients who, moreover, undergo treatment with spinal toxicity.
- Hepatic disorders: elevated transaminase levels (ASAT, ALT), alkaline phosphatase, regressive at discontinuation of treatment and rare acute hepatitis have sometimes been observed.
Exceptional cardiac disorders usually of ischemic pace.
- Allergic manifestations: rare cases of skin rash and exceptional cases of Lyell's syndrome.