Mycosyst (Fluconazole)

Fluconazole acts on a broad spectrum of fungal pathogens, making Mycosyst suitable for several serious infections.

• Candidiasis: effective for oral, esophageal, vaginal and systemic infections caused by Candida species.
• Cryptococcal meningitis: used in induction and consolidation therapy for central nervous system infection.
• Systemic fungal infections: treats invasive infections such as blastomycosis, histoplasmosis and coccidioidomycosis when other agents are unsuitable.

• Fluconazole inhibits the fungal cytochrome P450 enzyme 14α‑demethylase, a key step in ergosterol synthesis. By blocking this enzyme, the drug disrupts the formation of ergosterol, an essential component of the fungal cell membrane, leading to increased membrane permeability and ultimately fungal cell death or growth inhibition.

Fluconazole may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: transient cranial discomfort.
• Abdominal pain: cramping or discomfort in the abdomen.
• Diarrhea: loose stools.
• Rash: skin redness or itching.
• Elevated liver enzymes: mild hepatic enzyme changes.

Serious or Rare Side Effects

• Hepatotoxicity: severe liver injury requiring monitoring.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis: severe skin reactions.
• Anaphylaxis: rare but life‑threatening allergic response.
• QT interval prolongation: potential cardiac rhythm disturbance.
• Severe neutropenia: marked reduction in white blood cells.
• Hepatic failure: rare but critical liver dysfunction.

Before initiating therapy with Mycosyst, consider the following safety measures.

• Assess liver function: obtain baseline liver enzymes and monitor periodically.
• Review concomitant medications: identify potential drug‑drug interactions.
• Evaluate renal function: dose adjustment may be needed in severe impairment.
• Pregnancy and lactation: use only if benefits outweigh potential risks, as data are limited.
• Known hypersensitivity: avoid in patients with documented allergy to fluconazole or other azoles.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Fluconazole can alter the plasma concentrations of several co‑administered drugs.

Major Interactions (Avoid)

• Rifampin: induces metabolism, markedly reducing fluconazole exposure.
• Terbinafine: combined use increases risk of hepatotoxicity.
• Certain azole combinations: additive toxicity may occur.

Moderate Interactions (Monitor Closely)

• Warfarin: fluconazole may increase INR, requiring dose adjustment.
• Phenytoin: may decrease fluconazole levels, reducing efficacy.
• Oral contraceptives: possible reduction in contraceptive effectiveness.
• Cyclosporine or tacrolimus: may increase levels, necessitating monitoring.
• Statins (e.g., simvastatin): increased risk of myopathy, monitor for muscle symptoms.