Indications

Canazole (Fluconazole) is a triazole antifungal agent indicated for a variety of fungal infections, including:

• Candidiasis: Vaginal, oropharyngeal, esophageal, invasive, and disseminated candidiasis.
• Tinea Infections: Tinea corporis, tinea cruris, tinea pedis, and pityriasis versicolor.
• Other Fungal Infections: Kerion, onychomycosis, cryptococcal infections (including meningitis), coccidioidomycosis, and histoplasmosis. It is also used for the prevention of fungal infections in immunocompromised patients and cryptococcal meningitis.

Pharmacology

Fluconazole is a potent inhibitor of fungal cytochrome P-450 dependent enzymes, which are essential for the synthesis of ergosterol, a key component of the fungal cell membrane. By disrupting this process, it effectively kills fungi.

Dosage & Administration

• Adults:
  • Vaginal Candidiasis: 150 mg as a single dose.
  • Oropharyngeal Candidiasis: 200 mg on day 1, then 100 mg daily for 14 days.
  • Tinea Infections: 150 mg weekly for 4-6 weeks.
  • Invasive Candidal & Cryptococcal Infections: 400 mg on day 1, then 200-400 mg daily.
• Children over 1 year:
  • Superficial Candidiasis: 1-2 mg/kg daily.
  • Systemic/Cryptococcal Infections: 3-6 mg/kg daily.
• Elderly: The normal adult dose can be used if there is no renal impairment.
• Renal Impairment: Dosage adjustments are necessary. For multiple-dose therapy, the dose interval should be increased or the daily dose reduced based on creatinine clearance.

Interaction

• Warfarin: Increases prothrombin time; careful monitoring is recommended.
• Oral Sulphonylureas (for diabetes): May prolong their half-life, increasing the risk of hypoglycemia.
• Hydrochlorothiazide: Increases plasma concentrations of Fluconazole.
• Phenytoin: May increase phenytoin levels.
• Rifampicin: Decreases Fluconazole levels, so a dose increase may be needed.
• Oral Contraceptives: Unlikely to affect their efficacy at common doses.
• Cyclosporin: Fluconazole may increase cyclosporin concentrations; monitoring is recommended.

Contraindications

Do not use in patients with a known hypersensitivity to Fluconazole or other triazole compounds.

Side Effects

Canazole is generally well tolerated. The most common side effects are gastrointestinal, including nausea, abdominal discomfort, and diarrhea. Skin rash is rare. In rare cases, anaphylaxis has been reported.

Pregnancy & Lactation

Fluconazole should not be used during pregnancy unless clearly needed, as animal studies have shown adverse fetal effects at high doses. It is found in breast milk at concentrations similar to plasma, so its use is not recommended for nursing mothers.

Precautions & Warnings

• Use with caution in patients with hepatic or renal dysfunction.
• Monitor patients for liver enzyme increases. If a significant rise occurs, the risk-benefit ratio should be assessed.
• Discontinue treatment if an allergic rash develops, especially if it progresses to severe skin reactions like Stevens-Johnson Syndrome.

Overdose Effects

In case of overdose, supportive and symptomatic treatment is recommended. Hemodialysis can reduce plasma levels by approximately 50%.

Therapeutic Class

Fluconazole belongs to the class of drugs for subcutaneous and mycoses.

Storage Conditions

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