Fluconazole + Tinidazole Pharmacology
Fluconazole + Tinidazole
Fluconazole
2.Nausea
3.Vomiting
4.Diarrhoea
5.Alopecia
6.Headache
7.Rash
8.Alteration in liver enzyme
NEONATES:contraindicated
2.Oropharyngeal candidiasis
3.Vaginal candidiasis
4.Systemic candidiasis
5.Cryptococcal meningitis
6.Coccidioidomycosis
7.Histoplasmosis
8.Prophylaxis in bone marrow transplantation
9.Candidiasis in immunocompromised individuals
10.Peritonitis
Cyclosporine: Increase in serum cyclosporine plasma concentration.
Hydrochlorothiazide: Reduction in renal clearance of fluconazole.
Phenytoin: Efficacy of phenytoin enhanced.
Rifampicin: Efficacy of fluconazole decreased, higher dosage required.
Sulfonylureas: Efficacy of tolbutamide, glyburide and glipizide increased.
Warfarin: Potentiates the anticoagulant effect resulting in increase in prothrombin time.
Systemic candidiasis: Maximum dose: 400 mg .The drug should be administered 2 more weeks after resolution of symptoms.
Oropharyngeal candidiasis: Initial dose: 200 mg once daily followed by 100 mg once daily. The drug should be administered at least 14 days after resolution of symptoms.
Oesophageal candidiasis: Initial dose: 200 mg once daily followed by 100 mg once daily and dose can be increased to 400 mg. The drug should be administered at least 14 days after resolution of symptoms.
Cryptococcal Meningitis: : Initial dose: 400 mg once daily followed by 200 mg once daily for 2 - 3 month until CSF culture is negative.
Vaginal candidiasis: 150 mg once daily
Peritonitis: 50 - 200 mg once daily.
Before bone marrow transplantation as prophylaxis:400 mg once daily for several days before transplantation and after 7 days after Neutrophil count rises above 1000 cells per cub.mm.
Candidiasis in immunocompromised individuals: 100 -200 mg once daily.
CHILDREN:
2 - 8 mg / kg body weight /day
Systemic candidiasis: 6 - 12 mg / kg body weight /day
Oropharyngeal candidiasis: Initial dose: 6 mg / kg body weight / day followed by 3 mg / kg body weight / day. The drug should be administered at least 14 days after resolution of symptoms.
Tinidazole
Metabolism: Metabolized in liver by oxidation &glucuronide conjugation, Excretion: Excreted in urine.
2.Bitter taste
3.Nausea
4.Vomiting
5.Diarrhoea
6.Fatigue
7.Dry mouth
8.Abdominal distress
9.Headache
10.Dizziness
11.Vertigo
12.Rash
13.Urticaria
14.Angioedema
15.Peripheral neuropathy & CNS effects,
2.Blood dyscrasias
3.CNS disorders
2.Alcoholic cirrhosis
3.Obstructive liver diseases
4. Use cautiously along with other hepatotoxic drugs & In visual field changes
5. Avoid alcohol use during therapy
2.Giardiasis
3.Trichomonas vaginitis
4.Anaerobic bacterial infections
5.Prophylactic agent after colorectal surgery
6.H. pylori infections
Ampicillin, Doxycycline and Cotrimoxaole: Synergism with these agents.
Adults: 2gm once daily for 3 days
Children: 30 to 50mg/kg/day or 600mg 12hourly for 5 to 10 days
Trichomoniasis & Giardiasis:
600mg once daily for a week or 2gm single dose
Anaerobic bacterial infections:
2 gm followed by 500mg 12 hourly for 5 days
Prophylaxis after colorectal surgery:
2gm single dose before surgery
H. pylori infections:
0.5gm 12hourly for 7 to14 days in triple combination
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