Drug reference

Flucytosine

Antifungal

Also known as Ancotil

AntifungalATC null

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

3 major

SEVERE in our sources

PREGNANCY

Teratogenic in animal studies; manufacturer advises use only if potential beneﬁt outweighs risk.

FDA category + note

Top interactionssee all 6 →

CladribineSevereDatabaseDDInter
ClozapineSevereDatabaseDDInter
DeferiproneSevereDatabaseDDInter

Mechanism

No specific mechanism of action described in the provided text.

Indications

Systemic yeast and fungal infectionsAdjunct to amphotericin in severe systemic candidiasis and in other severe or long-standing infectionsCryptococcal meningitis (adjunct to amphotericin)Cryptococcal meningitis (in combination with amphotericin B)Cryptococcus neoformansTorulaChromoblastomycesFew strains of CandidaCryptococcosis (meningeal and nonmeningeal) in synergistic action with amphotericin BInduction therapy for cryptococcal meningitis (in combination with Amphotericin B)Treatment of candidal meningitis (in combination with Amphotericin B)Treatment of candidal endocarditis (in combination with Amphotericin B)

Dosing

Adult: Systemic yeast and fungal infections: Usual dose 200 mg/kg daily in 4 divided doses usually for not more than 7 days, alternatively 100 150 mg/kg daily in 4 divided doses, lower dose may be sufﬁcient for extremely sensitive organisms (BY INTRAVENOUS INFUSION). Cryptococcal meningitis (adjunct to amphotericin): 100 mg/kg daily in 4 divided doses for 2 weeks (BY INTRAVENOUS INFUSION).
Renal adjustment: Use 50 mg/kg every 12 hours if creatinine clearance 20 40 mL/minute; use 50 mg/kg every 24 hours if creatinine clearance 10 20 mL/minute; use initial dose of 50 mg/kg if creatinine clearance less than 10 mL/minute and then adjust dose according to plasma-ﬂucytosine concentration.

Contraindications

Sole therapy (except occasionally in chromoblastomycosis) due to rapid development of resistance
Other fungi and bacteria (insensitive)

Side effects

Common

diarrhoeaheadachenausearashsedationvertigovomitingDose-dependent bone marrow depressionGastrointestinal disturbances (particularly enteritis and diarrhoea)Mild and reversible liver dysfunctionBone marrow suppressionLiver toxicity

Serious