Mikosist preparation instructions for usedefines as an antifungal agent. The active ingredient of the drug is fluconazole, a selective inhibitor of the synthesis of sterols in fungal cells. It inhibits the cytochrome P450 system in the human body, does not show androgenic activity, is effective against mycosis pathogens.
It is recommended to use the drug "Mycosyst"with thrush, including generalized, disseminated, genital, with other forms of invasive candidiasis infection, candidemia, as well as in the presence of factors that have the appearance of thrush. In addition, the use of the drug for people with candidiasis of the mucous membranes: pharynx; oral cavity, including atrophic candidiasis, caused by wearing dentures; esophagus. The drug "Mikosist" instruction for use advises patients with cryptococcal meningitis or sepsis, cryptococcosis, cryptococcal infection of the skin or lungs. It is also used to prevent the recurrence of these pathologies in AIDS patients and in other cases of immunodeficiency. The medication is used to prevent fungal infections in people with malignant lesions, predisposed as a result of radiation or chemotherapy to these lesions. Also, the drug "Mycosyst" is used in the treatment of mycosis of the inguinal region and trunk, deep endemic mycoses, including paracoccidioidomycosis, coccidioidomycosis, histoplasmosis in patients with normal immunity.
Two dosage forms are medicated"Mycosyst": capsules and solution for infusions. Capsules with a content of 50, 100 and 150 milligrams of fluconazole are produced. All of them are hard gelatinous, with an opaque white body, and differ only in the color of the caps: in capsules containing 50 milligrams of the active ingredient, the lid is light blue, 100 milligrams - turquoise, 150 milligrams - blue. The content is a powdery dense mass or a white (almost white) powder. Auxiliary ingredients are magnesium stearate, anhydrous lactose, colloidal silicon dioxide, talc, titanium dioxide, corn starch, gelatin, indigocarmine. Capsules containing 50 and 100 milligrams of fluconazole are sold in packages with one, two, four blisters, seven each. And those that contain 150 milligrams of active substance - one or two pieces.
Solution for infusions is transparent, slightlycolored or colorless liquid. One milliliter contains two milligrams of the active substance. Secondary components are water for injection and sodium chloride. The solution is dispensed in glass bottles with a volume of one hundred milliliters placed in cardboard packs. One packet includes one bottle.
The usual dose of fluconazole in cryptococcalinfections on the first day of treatment 400 milligrams, in the following days - 200-400 milligrams. The duration of therapy depends on the clinical efficacy confirmed by mycological examination, often it does not exceed six to eight weeks. When cryptococcal meningitis is used, the "Mikosist" medication is recommended for ten to twelve weeks after a negative result of a study of a sample of cerebrospinal fluid was obtained. After the termination of the course of primary treatment, AIDS patients are prescribed for the prevention of recurrences of cryptococcal meningitis for a long period of time the reception of "Mycosyst" in a dose of at least two hundred milligrams per day.
With disseminated candidiasis, candidemia andother invasive candidiasis infections, as a rule, four hundred milligrams of medication are taken the first day, and in the following days - two hundred milligrams daily. In the case of severe systemic thrush, the dose can be increased to eight hundred milligrams per day. Treatment should continue for at least two more weeks after the symptoms are eliminated and negative blood culture is obtained. With oropharyngeal candidiasis, including patients with impaired immunity, the dosage of the drug per day is fifty to one hundred milligrams, it should be taken within seven to fourteen days. At atrophic candidiasis, which has arisen due to the wearing of dentures, usually take a day receiving fifty milligrams of the drug in combination with antiseptic drugs. Treatment continues for two weeks. With other candidiasis infections (candiduria, esophagitis, candidiasis of the mucous and skin), the daily dose of the medication is fifty to one hundred milligrams, the course of therapy is fourteen to thirty days.
In order to eliminate vaginal candidiasisthe drug "Mikosist" instruction for use shows take once in the amount of 150 milligrams. You can drink one capsule (150 mg) once a month for four to twelve months to reduce the frequency of relapses. Often, candidiasis is prescribed in addition to the drug "Mycosyst" candles, for example, "Terzhinan", "Klion-D", "Ginezol". Depending on the degree of risk of fungal infection, for the prevention of candidiasis, the daily recommended dose of medication can vary from fifty to four hundred milligrams.
In the case of deep endemic mycosis,take the drug in a dosage of two hundred - four hundred milligrams per day for two years. The duration of therapy depends on the individual characteristics and clinical picture: with coccidioidomycosis, it can be from eleven to twenty-four months, with paracoccidioidomycosis - from two to seventeen months, with histoplasmosis - from three to seventeen months.
Intravenous drug should be administered drip, withno more than twenty milliliters per minute. It is not necessary to change the daily dosage when transferring the patient from intravenous administration to oral administration of the drug. The solution for infusions is compatible with a 20% solution of glucose; solutions of Hartman and Ringer; solutions of sodium hydrogencarbonate, potassium chloride in glucose, sodium chloride (0.9%). You can infuse fluconazole using conventional transfusion kits, using one of these solutions.
Most patients who took the medicine"Mycosyst", reviews about it leave good. The drug really effectively eliminates fungal infections, but can cause negative effects. So, on the part of the digestive system, there is a risk of nausea, flatulence, violations of the liver, problems with taste, diarrhea. Also, some people mention the occurrence of headaches, seizures, dizziness. They say that similar phenomena arose soon after taking the drug "Mycosyst". The reviews of other patients contain information about the development against the background of therapy with the drug allergies in the form of erythema, skin rash, angioedema, urticaria. Other possible side effects include alopecia, ventricular fibrillation, impaired renal function, hypertriglyceridemia, hypercholesterolemia, and hypokalemia.
In the form of capsules, you can not prescribe medicines to childrenup to six months of age (for newborns, use of the drug in the form of a solution for infusions is permitted). Contraindicated use of the drug "Mycosyst" lactating women (pregnant women should be appointed with caution), as well as people who are highly sensitive to the ingredients included in the ingredients. With extreme caution, it is necessary to use the remedy for patients with renal / hepatic insufficiency, with intolerance to acetylsalicylic acid.
Cases of drug overdoseMikosist. Reviews of people who took the medicine in an excessive dose, indicate the development of diarrhea, nausea, vomiting. In severe cases, the appearance of seizures, paranoid behavior, hallucinations. A person with overdose symptoms should be taken to a hospital where he will be washed with stomach, hemodialysis, forced diuresis, symptomatic therapy.
This question is often asked by patients.In fact, both drugs act in the same way, we can say that they are identical. The only difference is that the medicine "Mycosyst" is produced by the Hungarian pharmaceutical company "Gedeon Richter", while "Fluconazole" is a domestic preparation. Of course, this directly affects the cost of medicines. Choosing what to buy - "Mycosyst" or "Fluconazole" - many prefer a drug that is cheaper. Indeed, the difference in price is significant. So, for the packaging of "Mycosyst" (one capsule containing 150 milligrams of fluconazole) you will have to pay an average of 295 rubles, while the same package of "Fluconazole" will cost only 8-20 rubles. The average price of a 100-ml bottle of a solution for infusions of "Mycosyst" is 311 rubles.
In addition to "Fluconazole", there are other medicines,which can replace the drug "Mycosyst". Analogs of the drug, having the same substance as the active ingredient, are presented quite widely. In the form of capsules for the treatment of yeast infections and other fungal infections, you can use preparations "Diflucan", "Flukostat", "Mikomaks" and others. Effective is the drug "Mycoflucan" (pills). "Mycosyst" from all the mentioned analogs differs by such indicators as bioavailability, half-life, suction rate.
It is necessary to closely monitorprothrombin time in patients receiving indirect fluconazole anticoagulants of the coumarin group, since there is a risk of an increase in PTV. With the simultaneous administration of sulfonylurea derivatives, the drug "Mycosyst" can increase the time of their half-elimination, so you need to consider the possibility of hypoglycemia. In the case of the combined use of fluconazole and phenytoin, the concentration of the latter can be increased clinically to a significant extent, therefore, if necessary, the combined dose should be reduced. With the simultaneous administration of "Mycosyst" and rifampicin, there will be a decrease in the concentration of fluconazole, therefore, the dose of "Mycosyst" needs to be increased. The joint use of the drug with azole derivatives in combination with terenadine is contraindicated, since serious, life-threatening arrhythmia can develop. If you take the drug "Mycosyst" with cisapride, you may experience unwanted reactions from the heart, including ventricular tachycardia. With simultaneous use of fluconazole and theophylline, the average clearance rate from the plasma of the latter decreases, which means that the likelihood of its toxic effects and overdose increases.
It should continue treatment with the drug "Mycosyst"until the clinico-hematologic remission appears. Premature termination of therapy is fraught with relapses. As already mentioned, patients with renal insufficiency should use the medication as carefully as possible, since it is excreted mainly by the kidneys. Dosing with long-term treatment should be made, given the QC. Sometimes the use of fluconazole causes toxic effects on the liver, so it is necessary to monitor the functioning of this organ. If signs of lesion are found, the drug should be discontinued.
At patients on a background of reception of means "Mikosist"there were rare cases of appearance of exfoliative skin reactions, for example, toxic epidermal necrolysis and Stevens-Johnson syndrome. Patients with malignant neoplasms and AIDS are more likely to develop severe skin reactions with drugs containing fluconazole. If a rash appears during the treatment of a superficial fungal infection, the medicine should be discarded. If a rash occurs in people with invasive or systemic fungal infection, the doctor should strengthen the observation and cancel the drug in the event that multi-form erythema or bullous lesions develop. During treatment with the drug "Mycosyst" (the reviews confirm this), dizziness may occur, so patients need to be very careful when working with machinery and driving vehicles.