#最小單位貼紙

黴菌感染 Treatment of susceptible fungal infections caused by Candida or Cryptococcus

Antifungal Agent
Penetrates fungal cells and is converted to fluorouracil which competes with uracil interfering with fungal RNA and protein synthesis

Absorption:
1. Rapid; serum concentrations tended to be higher in children <12 years of age
2. Bioavailability: 78% to 89%; decreased in neonates
3. Time to peak, serum: ~1 to 2 hours
Distribution:
1. Into CSF, aqueous humor, joints, peritoneal fluid
2. Vd: 0.6 L/kg
3. Protein binding: 3-4%
Metabolism:
Minimally hepatic; deaminated both in yeasts and possibly via gut bacteria to 5-fluorouracil
Excretion:
1. Urine (>90% as unchanged drug)
2. Half-life elimination:(Neonates) 4-34 hours; (Infants) 7.4 hours; (Adults) 2-5 hours; (Anuria) 85 hours; (ESRD) 75-200 hours

1. Hypersensitivity to flucytosine
2. Known complete dihydropyrimidine dehydrogenase enzyme deficiency <20220727>

C [FDA]

Excretion in breast milk unknown/ not recommended.

Nausea or vomiting in high dose, diarrhea, elevated LFTs, skin rashes, bone marrow suppression

Usual dosage range: 50-150 mg/kg/day in divided doses every 6 hours

1. CrCl >40 mL/minute: No dosage adjustment necessary
2. CrCl 21-40 mL/minute: 25 mg/kg/dose every 12 hours
3. CrCl 10-20 mL/minute: 25 mg/kg/dose every 24 hours
4. CrCl <10 mL/minute: 25 mg/kg/dose every 48 hours
5. End-stage renal disease on intermittent hemodialysis: 25 to 50 mg/kg/dose every 48 to 72 hours; administer dose after hemodialysis

There are no dosage adjustments provided in the manufacturer's labeling; use with caution.