RE: Jill - azoles, safety & all that

[Guest guest]

, I've found a few sites that spell it out where we are with Antifungal ...see what you think ...its plain enough to me !!..

On the subject of the safety of antifungal meds in particular Fluconazole , read the following extract,It’s part of ” The use of fluconazole and itraconazole in the treatment of Candida albicans infections: a review” The document is very much worth reading. Note the dosage for systemic Candida infections, up to 400mg per day . Later studies recommend that the dose start at 400mg The optimal dose quoted is between 400 & 800mg per day .

http://jac.oupjournals.org/cgi/content/full/44/4/429

Fluconazole Saftey

Fluconazole is generally well tolerated over a wide dose range. 7 ,82 ,83 ,84 Clinical experience is extensive, with over 16 million patient-days of treatment with fluconazole since its introduction in the UK, and 300 million patient-days world-wide. The incidence of side effects is low, and symptoms are generally mild and do not require discontinuation from therapy.7 The most common side effects are associated with the gastrointestinal tract (nausea, abdominal discomfort, vomiting, diarrhoea). Others include headache and rashes, but these are rarely encountered (incidence of <2%). Tolerability is high even in special patient groups including children and severely ill patients with AIDS or cancer.7,85

Although not licensed, high doses of fluconazole (up to 800 mg/day) are well tolerated in the treatment of immunocompromised patients with severe systemic mycoses.86,87 Doses of up to 1600 mg fluconazole have been shown to be well tolerated in studies of AIDS patients with histoplasmosis88 and cryptococcal meningitis.83,87

In rare cases, particularly in patients with serious underlying diseases such as AIDS and cancer, abnormalities of hepatic, renal, haematological and other biochemical function tests have been observed, but the clinical significance and relationship of these to treatment is uncertain.7 Very rarely, post-mortem examinations of patients who died with severe underlying disease and had received multiple-dose fluconazole therapy have revealed hepatic necrosis: an assessment of the risk–benefit ratio of continued fluconazole administration for patients in whom a significant rise in liver enzymes occurs is, therefore, recommended. 89 ,90

Safety profile with children

http://pharmainfo.net/displayarticle10358.html

Azoles are not exclusive Antifungal drugs

http://www.use.hcn.com.au/subject.%60Tetrazoles%60/home.html

-----Original Message-----From: infections [mailto:infections ]On Behalf Of HodologicaSent: 18 April 2005 16:04infections Subject: [infections] Jill - azoles<jenbooks13@h...> wrote:> Has anyone thought about the fact that metrodinAZOLE and tinidAZOLE > work in lyme, and this is fluconAZOLE? They may be different and yet > they are all azoles.Would be a good point, but are you sure? I have no idea whether theybear chemical relation. To my knowledge, which is limited, they bearno relation in biochemical action. Antifungal triazoles inhibit CYP 450 enzymes and block fungalergosterol synth; nitromidazoles (flagyl, tini), i understand, aremetabolized into DNA-damaging species. That may not be the *whole* story tho - chemicals dont necessarilyhave just one action; they do exactly whatever nature may bid them todo, and there could easily be a well-known relation I'm unaware of. Ido know tini has some anti-fungal power according to the Brorson group.