CANSTA Capsule

Adult patients: Oral or vaginal candidiasis unresponsive to nystatin or clotrimazole; nonlife-threatening Candida infections (e.g. cystitis, esophagitis); treatment of hepatosplenic candidiasis and other Candida infections in persons unable to tolerate amphotericin B; treatment of cryptococcal infections; secondary prophylaxis for cryptococcal meningitis in persons with AIDS; antifungal prophylaxis in allogeneic bone marrow transplant recipients.

Dosage and administration

Oropharygeal or Oesophageal candidiasis: 200mg on the first day followed by 100mg once daily. Max 400mg/day.

Vaginal Candidiasis: 150mg once oral dose.

Deep seated candidiasis: 400mg on first day then 200mg once daily for 4 weeks & for at least 2 weeks after resolution of symptoms.

Cryptococcal meningitis: 400mg on first day followed by 200mg once daily. Max. 400mg/day for 10-12 weeks. Thereafter 200mg once daily.

Neutropenic Cancer: 50-100mg daily.

Known hypersensitivity to fluconazole or other azoles; concomitant administration with terfenadine.

1%25-10%: Central nervous system: Headache, Dermatologic: Rash, Gastrointestinal: Nausea, vomiting, abdominal pain, diarrhea

<1%: Pallor, dizziness, hypokalemia, increased AST/ALT, or alkaline phosphatase

CYP2C9 enzyme inducer; CYP2C9, 2C18, and 2C19 enzyme inhibitor and CYP3A3/4 enzyme inhibitor (weak)

Increased effect/toxicity:

Coadministration with terfenadine or cisapride is contraindicated; use with caution with astemizole due to increased risk of significant cardiotoxicity

Hydrochlorothiazide may decrease fluconazole clearance

Fluconazole may also inhibit warfarin, phenytoin, cyclosporine, and theophylline, zidovudine, sulfonylureas, rifabutin, and warfarin clearance

Nephrotoxicity of tacrolimus may be increased

Modify dosage in patients with severe renal impairment; prolonged use may result in superinfection; use with caution in patients with a history of penicillin allergy especially IgE-mediated reactions (e.g. anaphylaxis, urticaria); may cause antibiotic-associated colitis or colitis secondary to C.difficile.

Interferes with CYP450 activity, decreasing ergosterol synthesis (principal sterol in fungal cell membrane) and inhibiting cell membrane formation.