Flucytosine Brand Name– Ancobon
What is Flucytosine
Flucytosine is an oral antifungal agent. It is a fluorinated pyrimidine that is structurally similar to both fluorouracil and floxuridine.
Flucytosine is also known as 5-FC. It was approved by the FDA in 1971 and until recently was used mainly in combination with amphotericin B in the treatment of cryptococcal meningitis.
Since the release of fluconazole in 1990, flucytosine use has declined significantly.
Indications
- Aspergillus sp.
- Candida sp.
- candidemia
- candidiasis
- candiduria
- chromomycosis
- Cladosporium sp.
- cryptococcal meningitis
- cryptococcosis
- Cryptococcus neoformans
- Cryptococcus sp.
- cystitis
- endocarditis
- endophthalmitis
- meningitis
- Phialophora sp.
- pyelonephritis
- Sporothrix schenckii
- urinary tract infection (UTI)
Side Effects
- abdominal pain
- agranulocytosis
- anemia
- anorexia
- aplastic anemia
- ataxia
- azotemia
- bone marrow suppression
- cardiac arrest
- chest pain (unspecified)
- colitis
- confusion
- crystalluria
- diarrhea
- drowsiness
- dyspnea
- elevated hepatic enzymes
- eosinophilia
- fatigue
- fever
- GI bleeding
- hallucinations
- headache
- hearing loss
- hepatic failure
- hepatitis
- hepatotoxicity
- hyperbilirubinemia
- hypoglycemia
- hypokalemia
- jaundice
- leukopenia
- nausea
- pancytopenia
- paresthesias
- peptic ulcer
- peripheral neuropathy
- photosensitivity
- pruritus
- pseudoparkinsonism
- psychosis
- rash
- renal failure (unspecified)
- respiratory arrest
- seizures
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vertigo
- vomiting
- weakness
- xerostomia
Monitoring Parameters
- CBC
- LFTs
- serum alkaline phosphatase
- serum creatinine/BUN
- serum flucytosine concentrations
Contraindications
- bone marrow suppression
- breast-feeding
- children
- electrolyte imbalance
- hematological disease
- hepatotoxicity
- hypokalemia
- infants
- neonates
- pregnancy
- radiation therapy
- renal disease
- renal failure
- renal impairment
- sunlight (UV) exposure
Interactions
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Alkylating agents
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Antimetabolites
- Busulfan
- Carbamazepine
- Chlorpromazine
- Clozapine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Cytarabine, ARA-C
- Dacarbazine, DTIC
- Dextromethorphan; Promethazine
- Dichlorphenamide
- Fluphenazine
- Ganciclovir
- Hydroxyurea
- Lamivudine, 3TC; Zidovudine, ZDV
- Mechlorethamine, Nitrogen Mustard
- Meperidine; Promethazine
- Mesoridazine
- Mitomycin
- Perphenazine
- Perphenazine; Amitriptyline
- Phenothiazines
- Phenylephrine; Promethazine
- Porfimer
- Procarbazine
- Prochlorperazine
- Promethazine
- Saccharomyces boulardii
- Streptozocin
- Temozolomide
- Thiethylperazine
- Thioridazine
- Thiotepa
- Trifluoperazine
- Valganciclovir
- Verteporfin
- Zidovudine, ZDV