Flucytosine

Brand names of flucytosine

  • Ancobon
  • Ancotil
  • Novo-Triphyl

Flucytosine is an anti-fungal medicament; these properties were discovered in 1964, though the drug was first synthesized in 1957. It helps to slow the growth of fungus in the body especially any serious fungal infections of the blood, urinary tract, central nervous system, heart and lungs. It is used with other medications and works just like an antibiotic.

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Flucytosine is structured like cytostatic fluorouracil and also resembles floxuridine. It is more commonly known by its brand name Ancobon. It is available as a capsule as well as an injection. The available strength of the capsules is 250mg and 500mg. If flucytosine is taken as an injection then it is diluted in 250mL saline solution to make it equivalent to 2.5 g (10mg/mL). Amphotericin B is one of the many drugs that are physically incompatible with this solution.

Things you need to tell your physician before taking flucytosine

Before you begin to take flucytosine your doctor or pharmacist must know if you are allergic to flucytosine or any other medication. Before the doctor prescribes this medication for you he must have your full medical history especially if you have ever suffered from kidney or liver problems. If there has been a decreased bone marrow function or decreased number of either red or white blood platelets or if you have received radiation these facts must also be communicated to the doctor. Mineral imbalance of any kind like low potassium levels in the blood must also be reported to the doctor.

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There are some precautions that should be taken by people suffering from fungal infections. Hands must be washed to prevent any spread of infection. Avoid contact with people who have been infected with chicken pox, measles, flu or any other communicable disease. If you have been exposed to any infectious disease consult the doctor and take medication according to his advice.

Consult your doctor if there is a requirement for immunization or vaccinations. Any contact with people who have just received live vaccinations such as inhalation of live vaccine through the nose must be avoided. Avoid contact sports and also injuries, cuts and bruises. Take precautions in using sharp objects like knives, razors and nail-cutters.

Since the kidneys work to remove this medication older patients may be more sensitive to the side-effects of flucytosine as kidney functions decline with age.

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During pregnancy the medication must be used only when absolutely essential and should be avoided fully in the first three months of pregnancy as it could harm the foetus. It is advisable to discuss the risks with the doctor about this and also if you are breast feeding the baby. Though it is not known if the medicament is passed into the breast milk, still consult the doctor so that undesirable effects and harm to the baby can be avoided.

Usage

Flucytosine helps to treat serious fungal infections known as osteomyelitis which affects the bone and bone marrow and meningitis, a condition when tissues that surround the brain get infected. Other conditions when this medication is used is for pneumonia that affects the respiratory tract, blood septicaemia and also infections of the genitourinary tract especially infections that have AIDS association.

How to use flucytosine

The medicine is taken orally 4 times a day with six hourly intervals unless the doctor directs you differently. As the medication has the side effect of causing an upset stomach it is best not to swallow all the capsules meant for a single dose together. Take the dose over a fifteen minute period till all the capsules are swallowed one by one.

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The drug works best when the level of flucytosine levels in the blood remain constant and to achieve that it is best to split the duration (six hourly gaps) between one dose and the next equally, till all four doses are completed for the day. Fix a time for the entire period the medication is to be taken and take it at the same time each day.

Do not stop in between but finish the full prescribed amount of the medication even if symptoms disappear half way through. If the entire course of the medication is not complete it is possible that the infection might return as the fungus will grow again when the medication is discontinued before time.

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If your condition does not change or if it becomes worse consult the doctor.

How flucytosine works

Flucytosine prevents microorganisms from synthesizing RNA and DNA (genetic material) and so the cells cannot reproduce and so the infection is killed.

Side effects

Serious
Common
Less common

Possible interactions

Herbal medicines and minerals should be taken with caution particularly Echinacea which is taken to enhance the immune system. However, Echinacea is not advisable for patients whose immune system is damaged. If the remedy is taken too often or for too long a period, it can actually weaken the immune system. Extreme reactions like added photosensitivity to the sun could be caused with St. John wort. It is better to avoid exposure to the sun while on flucytosine.

Discontinuation

The medication may be required for a longer period and so the doctor will decide for how long it is required and when to stop taking it.

Storage instructions

Flucytosine must be stored at room temperature and away form pets and children. Store it away from light and moisture and not in bathroom but at room temperature 77°F or 25°C. For brief periods of time it can be stored between 59-86 degrees Fahrenheit (i.e. 15° - 30°Celsius).

The pharmacist and the waste disposal squad in your area could advice you to understand how to dispose the medicine safely. Do not simply flush it or pour into the drain without consultation with them.

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