When a child is found to have a disease caused by pathogenic fungi, drugs are used that can affect precisely such pathogens. One of the most popular among them is "Fluconazole". It has proven itself well in the fight against candida and other fungi, is common in pharmacies, and receives mostly good reviews from doctors and patients.
Release form
Fluconazole is produced by many Russian and foreign pharmaceutical companies and is presented in pharmacies in several dosage forms:
- Capsules. They are yellow, white-green, blue, white-blue, dark green, white or white-yellow. Inside the dense gelatin shell is a white powder. The most common are packs containing one, seven or ten capsules, but some manufacturers offer different quantities. The drug is sold in blisters or in jars.
- Pills. They usually have a round shape and a white shell. Depending on the dosage, one package of such "Fluconazole" includes 1, 2 or 10 tablets.
- Solution for injections. It is available in polyethylene or glass bottles of 50 and 100 ml and is a colorless (sometimes yellowish) transparent liquid. Depending on the doctor's prescription, you can buy one bottle separately or buy a pack containing 5, 10 or more bottles.
Sometimes the name of the drug includes a second word or prefix indicating the manufacturer, for example, "Fluconazole Sandoz" is produced in Slovenia by the company "Sandoz", the drug "Fluconazole-Teva" is a product of the famous Israeli company "Teva", and "Fluconazole Stada" is produced in Russia. by the company "Nizhpharm". However, the effect of these drugs is the same, since they are all antifungal agents based on the same substance.
Composition
The main component of the drug has the same name - fluconazole. In solid form (both capsules and tablets), it is presented in a dosage of 50, 100 or 150 mg. One milliliter of solution for injection contains such an ingredient in an amount of 2 mg. Additionally, depending on the manufacturer, the capsules contain corn starch, MCC, milk sugar, aerosil, calcium stearate and other substances.
The auxiliary components of the injection form are sterile water and sodium chloride, and some manufacturers add hydrochloric acid or sodium hydroxide to the solution (this is necessary for a suitable pH).
Operating principle
Fluconazole has a specific effect on pathogenic fungi. In particular, such a substance inhibits the activity of an enzyme called "cytochrome P450". This affects metabolic processes in fungal cells and increases the permeability of their membranes. The drug has a high activity against Candida. "Fluconazole" also affects other pathogens of mycoses, including cryptococci, coccidioides, trichophytos, and ringworm pathogens.
Indications
Capsules and tablets "Fluconazole" are prescribed for the defeat of the mucous membranes of the mouth, lungs, skin, genitals (with thrush), heart and other organs. The drug is also used for mycoses of different localization (trunk, feet, nails), with histoplasmosis, cryptococcosis and coccidioidomycosis. Capsules are also prescribed to prevent fungal damage after a course of radiotherapy, chemotherapy, HIV, malignant tumors, after transplantation and in other cases when immunity suffers.
Treatment with "Fluconazole" in the form of injections is used for generalized forms of candidiasis, endemic mycoses and cryptococcosis. The drug is also in demand as a prophylactic agent for a reduced immune response, for example, if a patient receives immunosuppressive drugs or undergoes an organ transplant.
At what age is it prescribed?
The use of "Fluconazole" in children is possible from birth, but solid forms are not used until 3-4 years of age, because it is quite difficult for small children to swallow them. Since the elimination of fluconazole in newborns is slower, infants in the first two weeks of life are given injections not every day, but with an interval of 72 hours.
Children of the third and fourth weeks of life are injected with medicine every 48 hours.
Contraindications
Fluconazole should not be used in children with hypersensitivity to any of the ingredients in the medicine. If milk sugar is present in the capsules, such a medicine is not prescribed to patients with its intolerance or lactase deficiency. Children with liver failure, heart disease, kidney pathologies and other serious diseases require medical supervision during treatment with such an antifungal agent.
Side effects
Due to the use of "Fluconazole", various negative reactions may appear, eg:
- rash on the skin;
- decreased appetite;
- headache;
- nausea;
- loose stools;
- changes in taste;
- itchy skin;
- flatulence.
If these or other symptoms occur, it is recommended to consult a doctor to choose another drug.
Instructions for use
Capsules or tablets
The drug in this form must be swallowed and washed down with water. It is not recommended to bite, chew or open it in any other way. Such "Fluconazole" is given to the child once a day in a daily dose, which is calculated by weight and taking into account the diagnosis. For example, for candidal stomatitis, the drug is prescribed at 3 mg / kg per day.
On the first day, sometimes the doctor recommends taking the capsules at a double dosage (6 mg / kg). The same dose is used for prophylactic purposes, but can be increased up to 12 mg / kg. In more serious forms of candidiasis, the dosage also increases to 6-12 mg / kg.
In childhood, the permissible daily dose, which is considered 12 mg / kg, should not be exceeded. For example, the drug was prescribed to a 7-year-old patient weighing 25 kg. Such a child should not be given more than 300 mg of fluconazole per day, which corresponds to six 50 mg capsules, three 100 mg capsules, or two 150 mg capsules.
Injections
The drug is administered intravenously once a day and before use can be diluted with saline, dextrose solution and other solutions that are used for drip infusion. The introduction should be slow.
The dosage is determined individually, because it is influenced by the nature of the disease and the weight of the small patient... For example, if a child has generalized candidiasis or cryptococcal meningitis, then 1 kg of his body weight requires from 6 to 12 mg of fluconazole. The duration of such treatment is up to 12 weeks.
If a small patient has a lesion of the mucous membranes with candida, then the daily dosage of the drug will be 3 mg / kg. Many regimens include a loading dose on the first day (6 mg / kg) so that the concentration of fluconazole reaches effective levels faster. The duration of treatment is at least 2-3 weeks.
To reduce the risk of a fungal infection in a child if he has low immunity (for example, after radiation therapy), from 3 to 12 mg of fluconazole is injected intravenously per 1 kg of the patient's weight. How long to do such injections is determined by the indicators of a blood test.
Overdose
Accidental excess of the dose of "Fluconazole" in injection or in solid form can cause changes in behavior and hallucinations. To eliminate signs of an overdose, forced diuresis and symptomatic treatment are used. If the child's condition is serious, they resort to hemodialysis.
Interaction with other drugs
Fluconazole cannot be combined with terfenadine, rifabutin, warfarin, astemizole, phenytoin, acetylsalicylic acid and many others.
If the child is already receiving any treatment, the question of the admissibility of using "Fluconazole" should be decided by the doctor.
Terms of sale
Solid forms of the drug are classified as non-prescription drugs, and vials of "Fluconazole" for intravenous injections are sold only by prescription. The price of a medicine is influenced by the manufacturing company, the dosage of the medicine, and the number of capsules / tablets / vials in one box. For example, 7 capsules of "Fluconazole-Teva" 50 mg each cost about 260 rubles, and the same package of medicine from a Russian manufacturer can be purchased for 20-60 rubles.
Storage conditions
Store the capsule packaging at temperatures up to +25 degrees. It is important to keep such "Fluconazole" at home in a place where a small child cannot find it. The shelf life of an encapsulated medicine is usually 2 or 3 years.
Reviews
In most cases, the use of "Fluconazole" responds positively. According to the parents, this is an effective and affordable drug that quickly helps to eliminate the manifestations of candidiasis. However, in some patients, it provoked adverse reactions. There are also cases when the action of the drug was insufficient, because of which "Fluconazole" had to be replaced with other drugs.
Analogs
If you can't use "Fluconazole", they are primarily interested in drugs that have the same active substance. These tools include:
- Diflucan;
- "Mikosist";
- "Flucostat";
- Mikomax;
- Diflazon;
- Forkan;
- "Flucorus";
- "Flukorem";
- "Fangiflu" and other medicines.
All of them are available in capsules and tablets, as well as in injectable form. Only "Diflucan" is additionally presented as a powder in plastic bottles, from which an orange suspension is prepared. Such a sweet syrup can be prescribed to children of any age, therefore, it is in great demand for candidiasis in infants and preschoolers.
A substitute for "Fluconazole" can also be drugs that contain clotrimazole. One of the most popular among them is Candide. Children are most often prescribed 1% solution or 1% cream - such forms of "Candida" perform local treatment of areas affected by fungi. They are approved for use at any age, even in babies. Analogues of "Candida" are drugs "Candibene", "Clotrimazole", "Candizol", "Amiklon" and others.
For candidiasis, other drugs with antifungal activity can also be used, for example, "Pimafucin", "Nystatin", "Hexoral", "Oralsept" or "Itrazol".
However, a doctor should prescribe any of these drugs as a replacement for Fluconazole, because they differ in their mechanism of action, age restrictions, release forms, and dosages acceptable for children.
See the next video for Fluconazole.
