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INFORMATION: Antifungals
Ketoconazole(Nizoral)
Ketoconazole, administered orally, has broad therapeutic potential for the treatment of a number of superficial and systemic fungal infections.
Therapeutic Uses: Ketoconazole is effective in infections of the skin
hair&nails by dermatophytes and or yeasts, ringworm, tinea, versicolor, chronic mucocutaneous candidiasis, Candida vulvovaginities, and oral and esphageal candidiasis. Efficacy is poor in immunosuppressed
patients and in meningitis. The usual adult dose is 400mg. taken once daily. Children are given 3.3 to 6.6 mg//kg daily. Duration of theraphy is 5 days for Candida vulvovaginitis, 2 weeks for Candida
esophagitis, and 6 to 12 months for deep mycoses. The slow response to theraphy has made ketoconazole inappropriate for patients with servere or rapidly progressive mycoses. For all of the above indications,
itraconazole(SPORAL/SPORANOX) has replaces ketoconazole for patients who can afford the more exprensive. newer product.
Itraconazole(Sporal/Sporanox)
This Itraconazole is closely related to ketoconazole. Itraconzole is administered orally; it appears to have fewer adverse effects than does ketoconazole, and it has a
wider spectrum of activity.
Therapeutic Uses: Itraconazole
(SPORAL/SPORANOX) is now preferred over ketoconazole for the treament of nonmeningeal histoplasmycosis. Itraconazole, 200mg twice daily, is the regimen of choice for maintenance therapy of AIDS patients with
disseminated histoplasmosis whose disease has stabilized during amphotericin B therapy. Itra conazole is useful for cutaneous sporotrichosis for patients unable to tolerate iodides. Intr conazole can be used to treat
oropharyngeal, esophageal. or vaginal candidiasis, as well as onychomycosis, griseofulvin-resistant ringworm, and extensive tinea versicolor.
Itraconazole is available as 100 mg. capsules. Itra conazole is given as
200mg. once or twice daily with food. Fluconazole(Diflucan)
Fluconazole is a fluorinated bistriazole.
Therepeutic Uses:
Fluconazole 50 to 100 mg daily is effective in oropharyngeal cadidiasis. Esophageal candidiasis responds to 100 to 200mg daily. This dose has been used to decrease to decrease candiduria in high risk patients. A single dose of 150mg. is effective in vaginal candidiasis.
Terbinafin(Lamisil)
Terbinafins has broad spectrum fungicidal activity.
Therepeutic Uses:
Oral trbinnafine has appeared to be effective in treatment of ringworm and in some cases of onychomycosis(Fungal infection of the nails), Tinea capitis, fungal infections of skin, for the trearment of tinea corporis, tinea cruris, tinea pedis and yeast infections of the skin caused by the genus candida where oral therapy is generally considered appropriate owing to the site, severity or extent of the infection.
Dosage: Adults 250mg. once a day. For skin infections recommended duration of trement Tinea pedis 2 to 6 weeks, Tinea corporis, cruris: 2 to 4 weeks, Cutaneous candidiasis: 2 to 4 weeks, Hair and scalp infections;
Tinea capitis: 4 weeks, Onychomysis; for most patients the duration of successful treatment is 6-12week, Fingernail onychomycosis; 6 week of therapy is sufficient.
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