Canazole 150: Antifungal Treatment for a Range of Infections

Canazole 150 is a prescription antifungal medication used to treat a wide array of fungal infections. It is effective against various candidal infections (affecting the vagina, mouth, esophagus, and systemically), cryptococcal infections (including meningitis), and different types of Tinea infections (such as ringworm, jock itch, athlete's foot), as well as pityriasis versicolor and onychomycosis. Canazole also serves as a prophylactic agent to prevent fungal infections in immunocompromised patients and cryptococcal meningitis.

How Canazole Works (Pharmacology)

Canazole contains Fluconazole, a triazole antifungal agent. Its mechanism of action involves potent inhibition of fungal cytochrome P-450 dependent enzymes. The cytochrome P-450 enzyme system is a crucial component of the fungal cell membrane, responsible for the synthesis of ergosterol. Ergosterol is vital for maintaining the structural integrity and proper function of the fungal cell membrane. By inhibiting its synthesis, Fluconazole disrupts the fungal cell membrane, leading to fungal cell death and thus effectively treating the infection.

Key Indications & Benefits

• Vaginal Candidiasis: Effective for yeast infections.
• Oropharyngeal Candidiasis (Thrush): Treats fungal infections in the mouth and throat.
• Esophageal Candidiasis: Addresses fungal infections of the esophagus.
• Dermatophyte Infections: Treats various Tinea infections (Tinea corporis/cruris/pedis/other Tinea), Kerion, and Pityriasis versicolor.
• Onychomycosis: Treats fungal nail infections.
• Invasive Candidal Infections & Cryptococcal Infections (including Meningitis): Used for serious systemic fungal infections.
• Prevention of Cryptococcal Meningitis: Reduces the risk of recurrence.
• Prevention of Fungal Infections in Immunocompromised Patients: Prophylaxis for patients at high risk, such as those with AIDS or cancer undergoing chemotherapy.
• Fungal Urinary Tract Infections: Treats fungal infections in the urinary system.
• Disseminated Candidiasis: Manages widespread candidal infections.
• Acute treatment of other systemic fungal infections: Such as coccidioidomycosis and histoplasmosis.

Always consult a registered physician for medication use.

Dosage & Administration

Canazole can be administered orally or by IV infusion, with dosages varying based on the type and severity of the infection.

Adults:

• Vaginal Candidiasis: 150 mg as a single dose.
• Oropharyngeal Candidiasis: 200 mg on the first day, followed by 100 mg daily for 14 days.
• Esophageal Candidiasis: 200 mg on the first day, followed by 100 mg daily for 14-30 days.
• Tinea corporis/Tinea cruris/Tinea pedis/Other Tinea: 150 mg weekly for 4-6 weeks.
• Kerion: 50 mg daily for 20 days.
• Pityriasis versicolor: 400 mg as a single dose.
• Onychomycosis: 150 mg weekly for 12 months.
• Invasive candidal infections and cryptococcal infections (including meningitis): Orally or by IV infusion, 400 mg on the first day, then 200-400 mg daily.
• Prevention of cryptococcal meningitis: Orally or by IV infusion, 200 mg daily.
• Prevention of fungal infections in immunocompromised patients: Orally or by IV infusion, 50-400 mg daily.

Children (over 1 year):

• Superficial Candidiasis: 1-2 mg/kg daily.
• Systemic Candidiasis & Cryptococcal Infection: 3-6 mg/kg daily.
• In serious life-threatening infections, up to 12 mg/kg daily has been given to children aged 5-13 years (Maximum 400 mg daily).
• Typical Dosing by Age/Weight (for syrup/drops):
  • 1 year (approx. 9 kg): ½ measuring spoonful
  • 1-2 years (approx. 12 kg): 1 measuring spoonful
  • 2-3 years (approx. 14 kg): 1½ measuring spoonful
  • 3-4 years (approx. 16 kg): 2 measuring spoonful
  • 4-6 years (approx. 20 kg): 2½ measuring spoonful

Use in Specific Populations:

• Elderly Patients: The normal dose should be used if there is no evidence of renal impairment.
• Renal Impairment:
  • No adjustment is required for single-dose therapy.
  • For multiple-dose therapy, normal doses should be given on days 1 and 2. Thereafter, dosage intervals should be modified based on creatinine clearance:
    • CrCl >40 ml/min: 24-hour interval (normal dosage regimen).
    • CrCl 21-40 ml/min: 48-hour interval or half normal daily dose.
    • CrCl 10-20 ml/min: 72-hour interval or one-third normal daily dose.
    • Patients receiving regular dialysis: One dose after every dialysis session.
  • Children with Renal Impairment: Renal clearance in children may be proportionately more rapid than in adults, and doses up to 12 mg/kg are recommended.

Always consult a registered physician for medication use.

Important Considerations & Warnings

It is crucial to discuss your full medical history with your doctor before taking Canazole, as it has specific contraindications and precautions.

Contraindications:

• Known hypersensitivity to Fluconazole or to related triazole compounds.

Side Effects: Canazole is generally well tolerated. The most common side effects are gastrointestinal, including:

• Nausea
• Abdominal discomfort
• Diarrhea
• Flatulence Other adverse events, such as rash, are rarely encountered (incidence less than 1%). In rare cases, as with other azoles, anaphylaxis (severe allergic reaction) has been reported.

Interactions:

• Warfarin: Fluconazole can increase prothrombin time. Careful monitoring of prothrombin time is recommended if co-administered.
• Oral Sulphonylureas (e.g., chlorpropamide, glibenclamide, glipizide, tolbutamide): Fluconazole prolongs their serum half-life, increasing the risk of hypoglycemia. Monitor blood sugar levels.
• Hydrochlorothiazide: Increases plasma concentrations of fluconazole by 40%. This typically doesn't necessitate a dose change, but prescribers should be aware.
• Phenytoin: Concomitant administration may increase phenytoin levels to a clinically significant degree.
• Rifampicin: Results in a 25% decrease in AUC and 20% shorter half-life of fluconazole. An increase in fluconazole dose may be considered.
• Oral Contraceptives: Unlikely to significantly affect the efficacy of combined oral contraceptives at typical doses (50 mg, 200 mg).
• Cyclosporin: Fluconazole may slowly increase cyclosporin concentrations, especially at 200 mg daily. Cyclosporin plasma concentration monitoring is recommended.
• Theophylline: Fluconazole may decrease the plasma clearance of theophylline. Patients at increased risk for theophylline toxicity should be observed for signs of toxicity and therapy modified if necessary.
• Food, Cimetidine, Antacids, Total Body Irradiation: Do not clinically impair fluconazole absorption.

Precautions & Warnings:

• Hepatic & Renal Function Abnormalities: In some patients, particularly those with serious underlying diseases (AIDS, cancer), abnormalities in liver, kidney, and blood tests have been observed. The clinical significance and relationship to fluconazole are uncertain. Very rarely, severe underlying disease and multiple concomitant medications have been associated with hepatic necrosis post-mortem; a causal relationship with fluconazole cannot be excluded. The risk-benefit ratio should be assessed if liver enzymes significantly rise.
• Severe Cutaneous Reactions: Patients have rarely developed exfoliative cutaneous reactions like Stevens-Johnson Syndrome and toxic epidermal necrolysis. AIDS patients are more prone to severe cutaneous reactions. If a rash develops in patients treated for superficial fungal infection, and it's attributable to fluconazole, discontinue therapy. For patients with invasive/systemic fungal infections who develop rashes, monitor closely and discontinue if bullous lesions or erythema multiforme develop.
• Lactation: Fluconazole is found in human breast milk at concentrations similar to plasma; therefore, its use in nursing mothers is not recommended.
• Driving/Machinery Use: Therapy is unlikely to impair ability to drive or use machinery.

Pregnancy:

• Adverse fetal effects have been seen in animals only at dose levels associated with maternal toxicity, many times higher than therapeutic doses. There has been limited use during human pregnancy. Accordingly, fluconazole should not be used in pregnancy or in women of child-bearing potential unless adequate contraception is employed.

Overdose Effects: In case of overdosage, supportive measures and symptomatic treatment with gastric lavage may be adequate. As fluconazole is primarily excreted in urine, forced volume diuresis would likely increase the elimination rate. Hemodialysis can decrease plasma levels by approximately 50% in a three-hour session.

Storage Conditions

Keep in a dry place away from light and heat. Keep out of the reach of children.