Category:

• Antifungal

Description:

• Systemic antifungal

Indications:

• Fungal infections of the skin, hair, and nails caused by susceptible organisms.

• Antifungal spectrum usually includes: Trichophyton rubrum, T. tonsurans, T. mentagropytes, T. interdigitalis, T. verrucosum, T. megninii, T. gallinae, T. crateriform, T. sulphureum, T. schoenleinii, Microsporum audouinii, M. canis, M. gypseum, Epidermophyton floccosum

Contraindications:

• Porphyria

• Hepatocellular failure

Precautions:

• Pregnancy category C; avoid use during pregnancy; use caution in nursing mothers

• Penicillin allergy (possible cross-sensitivity)

• Lupus erythematosus

Adverse Reactions (Side Effects):

• CNS: dizziness, fatigue, headache, insomnia, mental confusion, paresthesias

• GI: diarrhea, epigastric distress, BI bleeding, hepatic toxicity, nausea, oral thrush, vomiting

• GU: menstrual irregularities, proteinuria

• HEME: granulocytopenia, leukopenia

• SKIN: angioneurotic edema, photosensitivity, rash, urticaria  

Dosage:

Administered orally (microsize tablets, ultramicrosize tablets, suspension)

• Adult: (microsize) PO 500-1000mg daily in single or divided doses; (ultramicrosize) 330-375mg daily in single or divided doses, max 750mg daily

• Child: > or = 2 years: PO (microsize) 10-15 mg/kg/day in single or divided doses; (ultramicrosize) 5.5-7.3 mg/kg/day in single or divided dose

Duration of Treatment:

Drug interactions:

• Reduces the response of : Aspirin, Cyclosporine, Oral Contraceptives, Tacrolimus, and Warfarin

• Phenobarbital: reduces plasma griseofulvin level

Special considerations:

• Prior to therapy, the type of fungus responsible for infection should be identified

• Response to therapy may not be apparent for some time; complete entire course of therapy

• Avoid prolonged exposure to sunlight

• Clinician should be notified if sore throat or skin rash occurs

• Store suspension at room temperature in light-resistant container