Flucytosine oral

Therapeutic action

Antifungal.

Indications

Cryptococcal meningitis, induction phase, in combination with amphotericin B or fluconazole.

Forms and strengths

• 500 mg capsule and tablet.

Dose

• Child over 1 week and adult: 25 mg/kg 4 times daily.

Duration

• One week if in combination with amphotericin B.
• 2 weeks if in combination with fluconazole.

Contra-indications, adverse effects, precautions

• Administer with caution and monitor use in patients over 60 years, with renal impairment, or with haematological disorders.
• Reduce the dose by half, 25 mg/kg 2 times daily, in patients with renal impairment.
• May cause gastrointestinal disturbances, leukopenia, thrombocytopenia, less frequently agranulocytosis, increased transaminases, severe allergic reactions, and sometimes confusion and hallucinations.
• Monitor blood count and liver and renal function until the end of treatment.
• Pregnancy and breast-feeding: generally not recommended, but may be used despite potential risks when disease severity and lack of safer alternatives justify treatment.