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Flucytosine
📖 About
Always check the BNF link here.
- 💊 Antifungal agent, but resistance develops rapidly if used alone.
- ⚡ Usually given in combination with amphotericin B.
⚙️ Action
- 🔬 Converted (deaminated) inside fungal cells to 5-fluorouracil (5-FU).
- 🧪 5-FU inhibits DNA and RNA synthesis → blocks nucleic acid production.
🧪 Properties
- 🧠 Good tissue distribution, including CSF (useful in meningitis).
- ⏱️ Plasma half-life: ~3–4 hours.
💉 Indications
- 🦠 Severe yeast infections.
- 🧠 Cryptococcal infections, e.g. cryptococcal meningitis (with amphotericin B).
🔄 Interactions
- 📌 See BNF for full details.
⚠️ Cautions
- 💧 Reduce dose in renal impairment.
- 🧪 Higher risk of toxicity in patients with AIDS → monitor levels closely.
⛔ Contraindications
- 📌 See BNF for complete list.
💥 Side Effects
- 🩸 Bone marrow suppression → ↓ Hb, WCC, platelets (cytopenias).
- 🤢 GI toxicity → nausea, vomiting, diarrhoea, toxic enterocolitis.
📊 Dose
- 💊 Flucytosine: 50–150 mg/kg/day in divided doses every 6 hrs.
- ⚡ Almost always given with amphotericin B to reduce resistance.
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