How to properly use the drug Mikosist against fungus? Mikosist for adults - dosages and duration of use for the treatment of various fungal diseases. Fourteen visitors reported dosage

On pharmaceutical market Russian Federation Today there are dozens of analogues of fluconazole. All of them differ in price, many - in quality, release form, dosage and manufacturer. Some have European quality standards (GMP, etc.), some do not.

Let’s immediately define the concept of “analog” - in the pharmaceutical market the term generic or generic drug is more often used. This is a substance “copied” from the molecule of the inventor company active substance. Only one drug on the market is “that” first drug on which all clinical researches, with proven quality and clearly recorded dosages, side effects and contraindications.

A little history of the issue

So, the first manufacturer of fluconazole to be released onto the pharmaceutical market was Pfizer (USA). Currently, the drug of this company in Russia bears the commercial name Diflucan, and all other fluconazoles on the market in our country are its copies (generics).

The generic repeats the formula of the original drug, passes some tests for compliance with the original (pharmacokinetics are compared, sometimes pharmacodynamics are compared) and is considered its complete analogue, it can project all the advantages and disadvantages of a specific active substance onto itself, i.e. All generics of Diflucan and Diflucan itself are considered fluconazoles.

The original drug is always more expensive, which is explained by the costs of invention, research and implementation of a new molecule. For this reason, the original drug has a certain period during which patent protection prevents the emergence of generic forms. After this, a certain number of copies appears from different manufacturers. The more in demand the drug is, the more copies there will be. There are more than 30 fluconazoles in Russia, for example.

Generics are usually cheaper. In addition, the smaller the manufacturing company, the more liberties it can take in the process of registering and introducing its product. It happens that a generic product from some little-known Indian company has advantages that even the original product does not have.

It is important to understand that everything existing studies tests of any active substance were carried out exclusively on original drugs, so the generic has no additional advantages and cannot have them.

In addition, unscrupulous manufacturers deliberately distort contraindications and side effects for the product in order to capture one or another market segment.

So, a generic cannot be better than the original drug, but it can cost significantly less. Insurance medicine developed countries It strictly regulates the prescription of original drugs and generics. As soon as the patent expires, the doctor switches to high-quality generics, since this reduces the cost of treatment with comparable effectiveness.

Why original drugs are more effective than generics

• Only high-quality (original) substance is used - fewer impurities, therefore fewer possible side effects, allergic reactions and so on.;
• Standards for storage and delivery of the product to the consumer are observed;
• Thanks to the work of the manufacturer’s external service, doctors know the specifics of use and correctly prescribe original drugs (in addition, many doctors consider working with an original drug to be prestigious).

Why some generics do not have the required therapeutic effect

• Substance of low quality. Currently China, Pakistan and India are producing great amount starting raw materials. In terms of profitability, the sale of medicines is approaching the arms and drug trade, and corruption in this segment is simply terrifying. For this reason, tons of drugs with low quality substances are imported into the country every day.

You should not buy fluconazoles made in India, companies from Cyprus and some domestic manufacturers (raw materials are purchased there).

• The packaging technology is not followed, or the storage regime of the drugs is violated.

How to choose adequate fluconazole (price/quality)

• Well-known brand (Europe, Russia, USA). Large companies try not to buy raw materials of questionable quality;
• Average price niche. Very cheap drugs imply low quality. The high price for a generic is not acceptable, this indicates a lobby for the drug among doctors;

Generic drugs, for example, from the KRKA company, in some cases can be close in price to the original ones. This is not due to exclusive quality, but to the marketing efforts of medical representatives (the company's external service).

• Availability of the drug in pharmacies. If it is available in all pharmacies, you are prescribed a proven, high-quality product. You should not look for a rare type of fluconazole, since the active substance has been on the market for quite a long time, and there is nothing exclusive in such a prescription, other than the gratitude of the pharmaceutical company to a specific doctor.

Examples of fluconazole drugs on the Russian pharmaceutical market

The comparison is made based on the most common dosage of fluconazoles – 150 mg No. 1 (one capsule).

Diflucan original drug. If the doctor prescribes it, and the amount is not critical for you, buy it with confidence. Cost from 500 rub. Traditionally, it is believed that a generic should be at least 2 times more accessible than the original. Prices are indicative only to visualize the relationships between different manufacturers.

• Mikosist. Gedeon Richter (Hungary) is a well-known European brand, high quality - from 300 rubles;
• Flucostat Pharmstandard OJSC domestic brand, price from 190 rubles;
• Diflazon KRKA (Slovenia) is a well-known generic company operating primarily in the CIS market. The quality is not bad, the price starts from 250 rubles;
• Mycomax Zentiva ( Czech Republic). The quality is good, price from 230 rubles;
• Mycoflucan Reddy's Laboratories Ltd. (India). To the credit of this company, I would like to say that it is one of the few Indian companies that produces high-quality generics. You can safely take mycoflucan, price from 190 rubles;
• Fluconazole VERTEX (Russia) price for 150 mg No. 2 (2 capsules) is up to 50 rubles. Of course, for this money you get the appropriate quality of the product. It cannot be said that absolutely all prescriptions of this kind are ineffective, however, it is not worth replacing Diflucan with fluconazole from VERTEX - resistance to the active substance may develop, and the effect will not be achieved.

The use of cheap generic fluconazole can cause the pathogen to become resistant to all drugs, not only fluconazole itself, but also the triazole group as a whole. As a result, such candidiasis is subsequently extremely difficult to treat.

• Fluconazole-Stada (STADA AG concern). An international concern that includes 4 separate companies. Positioned as a domestic manufacturer (European standards). The quality is acceptable, price from 80 rubles;
• Flucostat Pharmstandard-Leksredstva (Russia). Domestic quality, price from 200 rubles.

Thus, an acceptable price for 1 capsule of 150 mg of fluconazole is in the range from 100 to 300 rubles. An adequate purchase would be products from Zentiva, KRKA, Dr. Reddy´sLaboratoriesLtd. If funds are tight, one of the best offers is Fluconazole-Stada.

Fluconazole has enough wide indications for use, but it is mainly prescribed for. Most patients experience episodes of candidiasis more than once a year. For this reason, it is worth purchasing fluconazole No. 5 or No. 7, since a single dose for chronic candidiasis special effect does not work, and doctors, when recommending the drug for several doses, do not always mention the availability of this form of release.

The instructions for use define the drug "Mikosist" as an antifungal agent. The active ingredient of the drug is fluconazole, a selective inhibitor of sterol synthesis in fungal cells. It inhibits the cytochrome P450 system in the human body, does not exhibit androgenic activity, and is effective against mycosis pathogens.

Pharmacokinetics

After oral administration or intravenous administration the medicine "Mikosist" (the instructions indicate this) penetrates well into body fluids and tissues. In sputum, peritoneal and joint fluid, saliva, breast milk the concentration of the drug is similar to that achieved in blood plasma. Contents in cerebrospinal fluid fluconazole in patients with fungal meningitis is eighty percent of the plasma concentration, which, in turn, is directly proportional dose taken. With daily single use, a 90% equilibrium concentration is achieved by the fourth or fifth day. If on the first day you take a dose twice as high as usual, you can achieve 90% equilibrium cumulation by the second day. Eleven to twelve percent of fluconazole is bound to plasma proteins. IN peripheral blood no metabolites are detected. Pharmacokinetics significantly depends on the functioning of the kidneys, because the drug is excreted from the body mainly by them, with about eighty percent unchanged. Within three hours after hemodialysis, the concentration of the active substance in plasma is halved.

Indications for use

It is recommended to use the drug "Mikosist" for thrush, including generalized, disseminated, genital, for other forms of invasive candidal infection, candidemia, as well as in the presence of factors predisposing to the appearance of thrush. In addition, the use of the drug is indicated for people with candidiasis of the mucous membranes: pharynx; oral cavity, including atrophic candidiasis resulting from wearing dentures; esophagus. The instructions for use recommend prescribing the medicine “Mikosist” to patients suffering from cryptococcal meningitis or sepsis, cryptococcosis, cryptococcal infection of the skin or lungs. It is also used to prevent relapses of these pathologies in patients with AIDS and other cases of immunodeficiency. The medication is used to prevent fungal infections in people with malignant tumors predisposed to these lesions as a result of radiation or chemotherapy. The drug "Mikosist" is also used in the treatment of mycoses groin area and trunk, deep endemic mycoses, including paracoccidioidomycosis, coccidioidomycosis, histoplasmosis in patients with normal immunity.

Dosage form, packaging, composition

The drug "Mikosist" has two dosage forms: capsules and solution for infusion. Capsules containing 50, 100 and 150 milligrams of fluconazole are produced. All of them are hard gelatin, with an opaque white body, and differ only in the color of the caps: for capsules containing 50 milligrams active ingredient, light blue cap, 100 milligrams - turquoise, 150 milligrams - blue. The contents are a powdery dense mass or white (almost white) powder. Auxiliary ingredients are magnesium stearate, anhydrous lactose, colloidal silicon dioxide, talc, titanium dioxide, corn starch, gelatin, indigo carmine. Capsules containing 50 and 100 milligrams of fluconazole are sold in packages with one, two, four blisters, seven pieces each. And those that contain 150 milligrams of the active substance - one or two pieces each.

The solution for infusion appears as a clear, slightly colored or colorless liquid. One milliliter contains two milligrams of the active substance. The minor 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 pack includes one bottle.

How to take Mikosist? Dosage

The usual dose of fluconazole for cryptococcal infections is 400 milligrams on the first day of treatment, and 200-400 milligrams on subsequent days. The duration of therapy depends on the confirmed clinical effectiveness, often it does not exceed six to eight weeks. When using the medicine "Mikosist", the instructions for use recommend within ten to twelve weeks after it was received negative result examination of a cerebrospinal fluid sample. For AIDS patients after completing the course primary treatment prescribed for the prevention of relapses of cryptococcal meningitis during long period taking Mikosist at a dose of at least two hundred milligrams per day.

For disseminated candidiasis, candidemia and other invasive candida infections As a rule, four hundred milligrams of the medicine are taken on the first day, and two hundred milligrams daily in subsequent days. In case of severe systemic thrush, the dose can be increased to eight hundred milligrams per day. Treatment should be continued for at least two more weeks after symptoms resolve and a negative blood culture is obtained. For oropharyngeal candidiasis, including in patients with impaired immunity, the dosage of the medication per day is fifty to one hundred milligrams, it should be taken for seven to fourteen days. At atrophic candidiasis resulting from wearing dentures, fifty milligrams of the drug is usually prescribed per day in combination with antiseptics. Treatment is continued for two weeks. For other candidal infections (candiduria, esophagitis, candidiasis of the mucous membranes 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 candidiasis, the instructions for use of the drug “Mikosist” indicate that it should be taken once in an amount of 150 milligrams. You can take one capsule (150 mg) once a month for four to twelve months to reduce the frequency of relapses. Often, for candidiasis, suppositories are prescribed in addition to the drug "Mikosist", for example, "Terzhinan", "Klion-D", "Ginezol". Depending on the degree of risk of a 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, it may be necessary to take the drug at a dosage of two hundred to four hundred milligrams per day for two years. The duration of therapy depends on individual characteristics And clinical picture: with coccidioidomycosis it can range from eleven to twenty-four months, with paracoccidioidomycosis - from two to seventeen months, with histoplasmosis - from three to seventeen months.

Rules of application

The drug should be administered intravenously by drip, at a rate of no more than twenty milliliters per minute. No need to change daily dosage when transferring a patient from intravenous administration to oral administration medicines. The solution for infusion is compatible with twenty percent Hartmann and sodium bicarbonate, in glucose, sodium chloride (0.9%). Fluconazole infusions can be carried out using ordinary transfusion sets using one of the listed solutions.

Side effects

Most patients who have taken the medicine "Mikosist" leave good reviews about it. The drug is really effective in eliminating fungal infections, however, is capable of causing negative effects. So, from the digestive system there is a risk of nausea, flatulence, liver dysfunction, problems with taste sensations, diarrhea. Also, some people mention the occurrence of headaches, cramps, and dizziness. They say that similar phenomena arose soon after taking the medication "Mikosist". Reviews from other patients contain information about the development of allergies in the form of erythema during drug therapy, skin rash, angioedema, urticaria. Among other possible side effects alopecia, ventricular fibrillation, renal dysfunction, hypertriglyceridemia, hypercholesterolemia and hypokalemia should be noted.

Contraindications

The medicine cannot be prescribed in capsule form to children under six months of age (for newborns, the use of the medicine in the form of a solution for infusion is allowed). The use of the drug "Mikosist" is contraindicated for nursing women (pregnant women should prescribe it with caution), as well as for people with high sensitivity to the ingredients included in the composition. The product should be used with extreme caution in patients with renal/liver insufficiency or intolerance acetylsalicylic acid.

Overdose

Cases of overdose of the drug "Mikosist" have been recorded. Reviews from people who took the medicine in excessive doses indicate the development of diarrhea, nausea, and vomiting. IN severe cases the appearance of seizures, paranoid behavior, and hallucinations is noted. A person with symptoms of overdose must be taken to a hospital, where he will undergo gastric lavage, hemodialysis, forced diuresis, and symptomatic therapy.

"Mikosist" or "Fluconazole": which is better?

This is a question patients often ask. In fact, both drugs act in the same way; we can say that they are identical. The only difference is that the drug Mikosist is produced by the Hungarian pharmaceutical company Gedeon Richter, while Fluconazole is a domestically produced drug. Of course, this directly affects the cost of medicines. When choosing what to buy - Mikosist or Fluconazole - many people prefer the medicine that costs less. And indeed, the difference in price is significant. So, for a package of Mikosist (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. average price A 100-ml bottle of Mikosist infusion solution costs 311 rubles.

Concerning pharmacological properties two drugs, they are practically the same, the difference can only be seen in the rate of absorption: according to available data, the maximum concentration in the body of “Fluconazole” is reached 1-2 hours after use, and “Mikosysta” - after 0.5-1.5 hours. However, not all patients respond equally to the two medications. Some do not see any difference between them, others believe that quality directly depends on the price, which means which medicine is more expensive is better. You can often come across reviews in which women state that after finishing taking Fluconazole, thrush returned, but Mikosist allowed them to get rid of it for a long time. In any case, the choice is yours.

Analogs

In addition to Fluconazole, there are other medications that can replace the drug Mikosist. Analogues of a drug that have the same substance as an active ingredient are represented quite widely. In the form of capsules for the treatment of thrush and other fungal infections, you can use the drugs “Diflucan”, “Flucostat”, “Mikomax” and others. An effective remedy is Mycoflucan (tablets). “Mikosist” differs from all mentioned analogues in such indicators as bioavailability, half-life, absorption rate.

Drug interactions

It is necessary to carefully monitor patients receiving coumarins along with fluconazole, as there is a risk of increased PT. At simultaneous administration with sulfonylurea derivatives, the drug "Mikosist" can increase their half-life, so the possibility of hypoglycemia must be taken into account. In the case of combined use of fluconazole and phenytoin, the concentration of the latter may increase to a clinically significant extent; therefore, if combined use is necessary, its dose must be reduced. When taking Mikosist and rifampicin simultaneously, a decrease in the concentration of fluconazole will be observed, therefore, the dose of Mikosist needs to be increased. The combined use of the drug with azole derivatives in combination with terenadine is contraindicated, as a serious, life-threatening arrhythmia may develop. If you take the medicine "Mikosist" together with cisapride, undesirable reactions from the heart may occur, including: simultaneous use Fluconazole and theophylline reduce the average rate of clearance from the blood plasma of the latter, which means that the likelihood of developing its toxic effects and overdose increases.

special instructions

Treatment with Mikosist should be continued until clinical and hematological remission occurs. Premature cessation of therapy is fraught with relapses. As already mentioned, patients with renal failure should use the medication as carefully as possible, since it is excreted primarily by the kidneys. Dosing at long-term treatment should be carried out taking into account 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 damage are detected, the drug should be discontinued.

Patients taking Mikosist experienced rare cases appearance of exfoliative skin reactions, for example, toxic epidermal necrolysis and Stevens-Johnson syndrome. Sick malignant neoplasms and AIDS are more likely to experience severe skin reactions when using medications containing fluconazole. If a rash appears during treatment for a superficial fungal infection, the medication should be discontinued. If a rash occurs in people with an invasive or systemic fungal infection, the physician should increase monitoring and discontinue the drug if erythema multiforme or bullous lesions develop. During treatment with the drug "Mikosist" (reviews confirm this), dizziness may occur, so patients must be extra careful when working with equipment and operating it vehicles.

pharmachologic effect

Antifungal drug. Fluconazole, a member of the triazole antifungal class, is selective inhibitor synthesis of sterols in fungal cells.

Fluconazole, being highly selective for cytochrome P450 of fungi, practically does not inhibit the cytochrome P450 system in the human body (in comparison with itraconazole, clotrimazole, econazole and ketoconazole, it suppresses cytochrome P450-dependent oxidative processes in human liver microsomes to a lesser extent).

Does not have androgenic activity.

Active regarding pathogens of mycoses caused by Candida spp., Cryptococcus neoformans, Microsporum spp., Trichophyton spp. Fluconazole has also been shown to be active in models of endemic mycoses, including infections caused by Blastomyces dermatitidis, Coccidioides immitis and Histoplasma capsulatum.

Pharmacokinetics

Suction

After oral administration, fluconazole is well absorbed, its bioavailability is 90%. Cmax after oral administration on an empty stomach of 150 mg is achieved after 0.5-1.5 hours and is 90% of the plasma concentration when administered intravenously at a dose of 2.5-3.5 mg/kg. Concomitant food intake does not affect the absorption of the drug taken orally.

Distribution

After oral and intravenous administration, fluconazole penetrates well into all tissues and fluids of the body. In the stratum corneum of the epidermis, dermis and sweat fluid are achieved high concentrations, which exceed serum values. After oral administration of 150 mg on the 7th day, the concentration in the stratum corneum of the skin is 23.4 mcg/g, and 1 week after taking the second dose - 7.1 mcg/kg, the concentration in the nails after 4 months of use at a dose of 150 mg 1 time/week - 4.05 mcg/g in healthy and 1.8 mcg/g in affected nails. Concentrations of the drug in saliva, sputum, breast milk, joint and peritoneal fluid are similar to its concentration in blood plasma. In patients with fungal meningitis, the content of fluconazole in the cerebrospinal fluid reaches 80% of the corresponding concentration in plasma. Constant values ​​in vaginal secretions are achieved 8 hours after oral administration and are maintained at this value for at least 24 hours.

Plasma concentrations are directly proportional to dose. 90% equilibrium concentration is achieved by 4-5 days with daily oral or intravenous administration 1 time / day.

Use on the first day of a dose 2 times higher than usual daily dose, allows you to reach 90% of the equilibrium concentration by the second day. The apparent V d approaches the total volume of water in the body. 11-12% of fluconazole is bound to plasma proteins.

Metabolism and excretion

It is an inhibitor of the CYP2C9 isoenzyme in the liver. No fluconazole metabolites were detected in peripheral blood.

T 1/2 - 30 hours. The pharmacokinetics of fluconazole depends significantly on functional state kidneys, while there is inverse relationship between T1/2 and creatinine clearance. Fluconazole is excreted from the body mainly by the kidneys; in this case, approximately 80% of the administered dose is excreted unchanged. Fluconazole clearance is directly proportional to creatinine clearance.

After hemodialysis for 3 hours, the concentration of fluconazole in plasma decreases by 50%.

Indications

— cryptococcosis: cryptococcal meningitis, cryptococcal infections of the lungs and skin; cryptococcal sepsis; prevention of relapse of cryptococcosis in patients with AIDS, organ transplantation or other cases of immunodeficiency;

- generalized candidiasis; candidemia, disseminated candidiasis and other forms of invasive candidal infections (infections abdominal cavity, endocardium, eyes, respiratory and urinary tract), incl. in patients receiving a course of cytostatic or immunosuppressive therapy, as well as in the presence of other factors predisposing to the development of candidiasis - treatment and prevention;

— candidiasis of the mucous membranes: oral cavity, incl. atrophic candidiasis of the oral cavity associated with wearing dentures; pharynx; esophagus and non-invasive bronchopulmonary infections, candiduria; prevention of relapse of oropharyngeal candidiasis in patients with AIDS;

- genital candidiasis: vaginal (acute or chronic recurrent);

- prevention of fungal infections in patients with malignant neoplasms who are predisposed to such infections as a result of chemotherapy with cytostatics or radiation therapy;

- mycoses of the skin, trunk, groin area;

— deep endemic mycoses, including coccidioidomycosis, paracoccidioidomycosis and histoplasmosis in patients with normal immunity.

Dosage regimen

At cryptococcal infections The usual dose of fluconazole is 400 mg 1 time / day on the first day of treatment, subsequently - 200-400 mg 1 time / day. The duration of treatment for cryptococcal infections depends on clinical effectiveness confirmed by mycological examination, and usually ranges from 6 to 8 weeks.

For prevention of relapse of cryptococcal meningitis in patients with AIDS after finishing full course For primary therapy, fluconazole is prescribed at a dose of at least 200 mg/day for a long period.

At candidemia, disseminated candidiasis and other invasive candidal infections The dose of fluconazole is 400 mg on the first day and 200 mg on subsequent days. If necessary, the dose of the drug can be increased to 400 mg/day. The duration of treatment depends on clinical effectiveness.

At severe systemic candidiasis it is possible to increase the dose to 800 mg/day. The duration of therapy depends on clinical effectiveness. Should be continued for at least 2 weeks after a negative blood culture has been obtained or after symptoms have resolved.

At oropharyngeal candidiasis, including patients with impaired immunity, the usual dose of fluconazole is 50-100 mg 1 time / day for 7-14 days. For prevention of relapses of oropharyngeal candidiasis in patients with AIDS after completing the full course of primary therapy - 150 mg once a week. If necessary, treatment can be extended, especially in severe immune disorders.

At atrophic candidiasis of the oral cavity associated with wearing dentures, fluconazole is usually prescribed 50 mg 1 time / day for 14 days in combination with antiseptic agents for treating the prosthesis.

At other candidiasis infections, for example, esophagitis, non-invasive bronchopulmonary infections, candiduria, candidiasis of the skin and mucous membranes the daily dose is 50-100 mg for 14-30 days.

At severe candidiasis of the mucous membranes- 100-200 mg/day.

For prevention of fungal infections in patients with malignant neoplasms the dose of fluconazole is 50 mg 1 time / day as long as the patient is in the group increased risk due to cytostatic or radiation therapy.

At vaginal candidiasis - 150 mg once. To reduce the frequency of relapses, use 150 mg once a month for 4-12 months, sometimes more frequent use may be required.

For prevention of candidiasis The recommended dose of fluconazole is 50-400 mg 1 time/day, depending on the degree of risk of developing a fungal infection. In the presence of high risk generalized infection, for example, in patients with expected severe or long-lasting neutropenia, the recommended dose is 400 mg 1 time / day. Fluconazole is prescribed several days before the expected onset of neutropenia; after the number of neutrophils increases to more than 1000/μl, treatment is continued for another 7 days.

At deep endemic mycoses It may be necessary to use the drug at a dose of 200-400 mg/day for 2 years. The duration of therapy is determined individually; it can be 11-24 months with coccidioidomycosis; 2-17 months at paracoccidioidomycosis and 3-17 months with histoplasmosis.

U children the drug should not be used in a daily dose exceeding that in adults. The duration of treatment depends on the clinical and mycological effect.

At candidiasis of the mucous membranes The recommended dose of fluconazole is 3 mg/kg/day. On the first day, a loading dose of 6 mg/kg may be prescribed to achieve more quick achievement equilibrium concentration.

For treatment of generalized candidiasis and cryptococcal infection The recommended dose is 6-12 mg/kg/day depending on the severity of the disease.

For prevention of fungal infections inchildrenwith reduced immunity, in whom the risk of developing infection is associated with neutropenia developing as a result of cytotoxic chemotherapy or radiation therapy, the drug is prescribed at 3-12 mg/kg per day, depending on the severity and duration of persistence of induced neutropenia.

U newborns fluconazole is eliminated more slowly, so in the first 2 weeks of life the drug is prescribed in the same dose (in mg/kg) as in older children, but with an interval of 72 hours. Children aged 3-4 weeks the same dose is administered at intervals of 48 hours.

U elderly patients in the absence of renal dysfunction, the usual recommendations for dosing of the drug should be followed.

For patients with impaired renal function (KR< 50 мл/мин) the dosage regimen should be adjusted. Fluconazole is excreted primarily by the kidneys unchanged. With a single dose of fluconazole, no dose changes are required. If a course of treatment is necessary in patients (including children) with impaired renal function, it should be initially administered loading dose from 50 mg to 400 mg. Subsequently, the daily dose, depending on the indications, is determined according to the following table.

Rules for using the drug

Administer intravenously at a rate of no more than 20 mg (10 ml) per minute. When converting from intravenous administration to taking capsules and vice versa, there is no need to change the daily dose of the drug.

Mikosist ® solution for infusion is compatible with the following solutions: 20% glucose solution, Ringer's solution, Hartmann's solution, potassium chloride solution in glucose, sodium bicarbonate solution, 0.9% sodium chloride solution. Fluconazole infusions can be administered using conventional transfusion sets using one of the solutions listed above.

Side effect

From the digestive system: nausea, vomiting, diarrhea, flatulence, abdominal pain, change in taste, liver dysfunction (hyperbilirubinemia, increased activity of liver transaminases, alkaline phosphatase, jaundice, hepatitis, hepatocellular necrosis, including fatal).

From the nervous system: headache, dizziness, convulsions.

From the hematopoietic organs: leukopenia, thrombocytopenia, neutropenia, agranulocytosis.

Allergic reactions: skin rash, exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), anaphylactoid reactions (including angioedema, facial swelling, urticaria, skin itching), bronchial asthma(more often with intolerance to acetylsalicylic acid).

From the cardiovascular system: increase in the duration of the QT interval on the ECG, ventricular fibrillation/flutter.

From the side of metabolism: hypercholesterolemia, hypertriglyceridemia, hypokalemia.

Other: renal dysfunction, alopecia.

Contraindications for use

- simultaneous use of terfenadine (against the background constant reception fluconazole at a dose of 400 mg/day and above) and cisapride, because both drugs prolong the QT interval and increase the risk of developing severe violations heart rate;

— simultaneous use astemizole;

- lactation period ( breastfeeding);

- lactose intolerance, lactase deficiency, glucose-galactose malabsorption;

— increased sensitivity to the components of the drug or azole compounds similar in structure.

WITH caution: liver and/or kidney failure; the appearance of a rash during the use of fluconazole in patients with superficial fungal infection and invasive/systemic fungal infections; simultaneous use of fluconazole with rifabutin or other drugs metabolized by isoenzymes of the cytochrome P450 system; simultaneous use of terfenadine and fluconazole at a dose of less than 400 mg/day; potentially proarrhythmogenic conditions in patients with multiple risk factors ( organic diseases heart disorders electrolyte balance, simultaneous administration medicines, causing arrhythmias); intolerance to acetylsalicylic acid; pregnancy.

Use during pregnancy and breastfeeding

The use of Mikosist ® during pregnancy is possible only if the potential benefit to the mother outweighs the risk to the fetus.

Fluconazole is determined in breast milk in the same concentration as in plasma, therefore its administration during lactation is contraindicated.

Use in children

Overdose

Symptoms: nausea, vomiting, diarrhea; in severe cases, convulsions, hallucinations, and paranoid behavior may occur.

Treatment: gastric lavage, forced diuresis, hemodialysis, symptomatic therapy. After a 3-hour hemodialysis session, the concentration of fluconazole in the blood plasma decreases by approximately 50%.

Drug interactions

In patients receiving fluconazole and indirect anticoagulants coumarin series, careful monitoring of prothrombin time is necessary, as it may increase.

Fluconazole, when taken simultaneously, can prolong T1/2 of sulfonylurea derivatives, therefore, when joint use the possibility of hypoglycemia should be taken into account.

The simultaneous use of fluconazole and phenytoin may be accompanied by an increase in the concentration of phenytoin to a clinically significant extent, which requires a reduction in its dose.

When taking rifampicin and fluconazole simultaneously, the Cmax and T1/2 of the latter decreases, therefore, if combined use is necessary, the dose of fluconazole should be increased.

The combined use of fluconazole and rifabutin is accompanied by an increase in the serum concentration of the latter, and the development of uveitis is possible.

When using fluconazole and cyclosporine together, it is recommended to monitor the concentration of the latter in the blood, as it may increase.

Given the occurrence of serious, life-threatening arrhythmias in patients taking antifungal agents- azole derivatives in combination with terfenadine, their joint reception contraindicated.

When taking fluconazole and cisapride simultaneously, cases have been described adverse reactions from the heart, including paroxysms of ventricular tachycardia. Simultaneous use is contraindicated.

When combined with fluconazole, it is possible to increase the concentration of zidovudine in the blood plasma. Patients receiving this combination should be monitored for side effects zidovudine.

Taking fluconazole leads to a decrease in average speed clearance of theophylline from blood plasma, therefore, the risk of developing the toxic effect of theophylline and its overdose increases.

The simultaneous use of fluconazole and midazolam leads to a significant increase in the concentration of the latter in the blood plasma and the risk of developing psychomotor reactions.

When taking fluconazole and hydrochlorothiazide simultaneously, the concentration of fluconazole in the blood plasma increases by 40%.

When fluconazole and tacrolimus are taken simultaneously, the concentration of the latter in the blood serum increases, which leads to an increased risk of nephrotoxicity.

Caution must be exercised when using fluconazole in patients simultaneously receiving other drugs metabolized by isoenzymes of the cytochrome P450 system.

Conditions for dispensing from pharmacies

The drug in capsule form is approved for use as an over-the-counter product.

The drug in the form of a solution for infusion is available with a prescription.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature not exceeding 30°C. The shelf life of capsules is 5 years, solution for infusion is 2 years.

Use for liver dysfunction

In rare cases, the use of fluconazole was accompanied by toxic changes in the liver, incl. with a fatal outcome, mainly in patients with serious concomitant diseases. The hepatotoxic effect of fluconazole is usually reversible; its signs disappeared after cessation of therapy. When clinical signs liver damage that may be associated with fluconazole, the drug should be discontinued.

Use for renal impairment

Patients with renal failure (KR<50 мл/мин) correction of the dosage regimen is required.

Fluconazole is excreted mainly in the urine unchanged. When taken once, no dose change is required. When re-prescribed to patients with impaired renal function, a loading dose of 50 mg to 400 mg should be administered.

At CC>50 ml/min the average recommended dose of the drug is used; at CC from 11 to 50 ml/min a dose of 50% of the recommended dose is used. For patients regularly undergoing hemodialysis, one dose of the drug is administered after each hemodialysis session.

Use in elderly patients

U elderly patients in the absence of signs of renal failure, the usual dosage regimen of the drug should be followed.

special instructions

Treatment with fluconazole must be continued until clinical and hematological remission occurs. Premature cessation of treatment leads to relapses.

Since fluconazole is eliminated primarily by the kidneys, caution should be exercised in patients with renal impairment. At long-term treatment fluconazole dosing should be carried out taking into account QC.

In rare cases, the use of fluconazole was accompanied toxic effect on the liver, incl. and death, mainly in patients with serious underlying medical conditions. It is necessary to monitor liver function. If signs of liver damage appear that may be associated with taking fluconazole, the drug should be discontinued.

While taking the drug, patients experienced rare cases of exfoliative skin reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Patients with AIDS and cancer are more likely to develop severe skin reactions when using many drugs. If a patient develops a rash during treatment for a superficial fungal infection that can be associated with the use of fluconazole, the drug should be discontinued. If rash occurs in patients with invasive/systemic fungal infections, they should be monitored closely and fluconazole should be discontinued if bullous lesions or erythema multiforme develop.

Caution is required when taking fluconazole simultaneously with rifabutin or other drugs metabolized by isoenzymes of the cytochrome P450 system.

It is necessary to monitor prothrombin time in patients simultaneously receiving fluconazole and indirect coumarin anticoagulants.

Impact on the ability to drive vehicles and operate machinery

Patients should be careful when driving or operating machinery, as dizziness may occur during treatment with fluconazole.

The antimycotic agent Mikosist is one of the drugs with wide range actions. It is used in the treatment of various pathological conditions caused by a fungus. The medication copes with systemic diseases, which are actively developing on skin, mucous membranes and nails.

Effective against fungal diseases, including systemic ones caused by fungi of the genus Candida and Cryptococcus neoformans

There are two types of the drug on sale. These are capsules (tablets) and solution. In others dosage forms this drug not released. The active substance of the capsules and solution is fluconazole. It is he who is responsible for suppressing the activity of the causative agent of an infectious disease.

Mikosist (capsules) are produced in three different doses. In them active substance may be contained in amounts of 50 mg, 100 mg or 150 mg. This information is indicated next to the name of the medicine on its packaging. The description also contains information about the dosage of a particular fluconazole preparation.

In addition to fluconazole, the capsules contain Excipients. These include:

1. Colloidal silicon dioxide.
2. Magnesium stearate.
3. Povidone.
4. Lactose.
5. Talc.
6. Corn starch.

Inside each capsule there is a white powder. The body is solid. It is made from gelatin mass. The capsule also has an individual cap, which is painted in a specific color. It depends on the amount of active substance in the drug.

The product in the form of a solution is released in bottles made of glass. Their volume is 100 ml. The solution contains 200 mg of fluconazole. It also contains excipients:

1. Sodium chloride.
2. Deionized water.

There is no need to look for packages of suppositories under this name in pharmacies. Suppositories and other dosage forms of Mikosist, except capsules and solution, do not exist.

Pharmacological properties

The antifungal drug is based on the active substance fluconazole. It belongs to the group of triazole agents, which are a pronounced selective inhibitor of the synthesis of elements such as sterols present in fungal cells.

The active component of the drug is effective against many fungal pathogens. It copes with pathogens of opportunistic and endemic mycoses.

Indications for use

The use of Mikosist should be indicated to the patient. Otherwise, such therapy may not give the desired result and even worsen the person’s general condition. The medicinal product in the form of capsules or injection solution is suitable for the treatment of the following painful conditions:

• Candidiasis of areas covered with mucous membranes.
• Undergoing immunosuppressive or cytostatic therapy.
• Generalized form of candidiasis.
• Cryptococcal infection.
• Transplantation of internal organs (to prevent the development of fungus).
• Bronchopulmonary infections.
• Genital form of candidiasis.
• Fungus of the skin and organs.
• Fungus during the development of tumor formations.
• Mycoses of the groin area and various parts of the body.
• Onychomycosis.
• Pityriasis versicolor.
• An endemic form of mycosis in patients with normal immunity.

Mikosist can be used to prevent re-infection with a fungal infection if the patient is at risk and is exposed to negative factors.

Contraindications and restrictions

The drug should be used with extreme caution during pregnancy

Mikosist for thrush and other similar pathologies is not prescribed to patients who have contraindications to its use. These include the diseases and conditions presented in the table.

The patient must inform the doctor about any contraindications he has, so that he can build a treatment regimen that is more effective and safe for his health.

Use during pregnancy and breastfeeding

Mikosist, for which numerous positive reviews have been written, cannot be used in the treatment of pregnant or lactating women. Doctors have not yet conducted any studies that would confirm the safety of this therapy for the expectant mother and her child. However, sometimes specialists still prescribe this medicine to pregnant patients, taking into account the patient’s current condition and possible risks to the fetus.

Treatment of pregnant women with Mikosist is advisable if safer drugs do not give any result and the fungal infection continues to develop.

Pregnant and breastfeeding women can only take the drug if they have received permission from their doctor to do so.

Use for liver dysfunction

Sometimes taking Mikosist leads to toxic changes in the liver. Such an effect can lead to serious complications and death. Patients who already have diseases of the internal organ are most susceptible to this.

Doctors say that the hepatotoxic effect of the drug is completely reversible. Its symptoms disappear after the patient stops taking the capsules or solution. If, during therapy, the doctor reveals signs in a person that indicate liver damage, he will immediately cancel the prescribed medication and select a safer drug.

Use for renal impairment

If the patient is diagnosed with renal failure, then in the process of prescribing Mikosist, the doctor will determine the most optimal dosage for the patient, which will not worsen his current condition.

Official information about the drug states that the main part of its active substance is excreted from the human body along with urine. If a single dose of capsules or solution is required, then there is no point in adjusting the dosage. If the medicine is taken repeatedly, then patients with problem kidneys will need to administer a larger dosage of the drug, which is in the range of 50-400 mg.

Side effects

Taking this medicine may cause nausea

If certain Mikosist substances are used incorrectly or are incompatible with the body, the patient may experience adverse reactions. The negative effects indicated in the table are observed.

If adverse reactions occur, you should stop taking the medication and consult a specialist about this problem. He will select a lower dose of the drug or replace it with another drug.

Interaction with drugs and alcohol

In no case should an antifungal agent be combined with alcoholic beverages, since such an interaction causes a double blow to the liver and other internal organs, the functioning of which can be severely impaired.

Mikosist, like its analogues, should not be combined not only with alcohol, but also with some medications. Neglect of this recommendation leads to adverse reactions that negatively affect the general health of the patient. We are talking about the interaction of the antimycotic with the following medications and substances:

1. When combined with Zidovudine, an increase in the concentration of the active component in the blood plasma is observed. As a result, the patient is more likely to develop side effects.
2. Interaction with Midazolam is fraught with an increase in the amount of the active component of the drug in the blood. This change leads to the development of adverse psychomotor reactions.
3. When combining the drug with Tacrolimus, you should expect an increase in the likelihood of developing kidney problems.
4. Interaction with ascorbic acid leads to blood thinning. This change causes internal bleeding in a person, as well as increased blood pressure.
5. If you combine the drug with Phenytoin, you can achieve an increase in the concentration of the active substance in the patient’s blood.
6. Joint use with Ursofalk leads to an increase in the level of acid in the body, resulting in an increased likelihood of bile backflow into the liver.
7. Interaction with Rifabutin increases the possibility of the patient developing uveitis.

To avoid problems, it is necessary to warn the attending physician about all medications that the patient is forced to take during treatment for a fungal infection by Mycosist.

Instructions for use

Before starting to use the drug, you should read the instructions very well

Before drinking Mikosist, you must read all the provisions contained in its instructions for use. The patient can receive detailed advice on this matter at an appointment with his or her attending physician.

Pills

Adults who have been diagnosed with cryptococcal infection or cryptococcal meningitis can take 400 mg of the drug on the first day of therapy. After treatment is continued at a dose of 200-400 mg 1 time per day. The duration of the course is usually limited to a period of 6-8 weeks. The exact timing is determined based on the patient’s test results, the severity of the disease and the effectiveness of therapy.

To prevent the development of the above pathologies in patients with AIDS, the doctor will prescribe Mikosist in an amount of 200 mg per day. This therapy can be continued for a long time.

Disseminated candidiasis, candidemia and other invasive infections of the body are treated with Mikosist at a dose of 400 mg on the first day. Then the dosage is reduced to 200 mg per day. If the capsules do not give results, then it is increased to the original one. The duration of therapy depends on the degree of clinical effect.

For oropharyngeal type candidiasis, you need to take a dose of Mikosist 50 mg. It is allowed to increase it to 100 mg. The frequency of administration is limited to 1 time per day. The duration of treatment should not exceed 2 weeks. If required, therapy is extended for patients with reduced immunity.

Atrophic oral candidiasis, which is caused by wearing dentures, is treated with the drug at a dosage of 50 mg. It is taken once a day for a two-week period. Additionally, it is required to use local antifungal agents and antiseptics for the treatment of dentures.

Other candidal lesions of the mucous membranes, except those in the intimate area, are treated with the drug at a dose of 50-100 mg. Capsules are usually taken once a day for 2 weeks to a month.

If a patient with AIDS requires prophylaxis against recurrent fungal infection, he should take Mikosist 150 mg once a week for the period indicated by the doctor.

Mycoses of the skin, including the feet, are treated with capsules in a dosage of 150 mg. They are taken once a week. Also, the course of treatment may consist of taking 50 mg of medication once a day. The duration of therapy is limited to 2-4 weeks. In some cases it is extended to 1.5 months.

For pityriasis versicolor, the patient is prescribed 300 mg of medication, which must be taken once every 7 days for 2 weeks.

Onychomycosis Mycosist has been treated for a long time. Patients should take 150 mg of the drug once a week. Therapy is continued until a healthy plate grows at the site of the infected nail.

Deep endemic mycoses are usually treated with doses of 200 to 400 mg per day. This scheme is followed for up to 2 years. The duration of therapy should be determined individually in each individual case.

Children who have been diagnosed with a fungal infection can also be treated with Mikosist. Their daily dosage should in no case exceed the dose specified for an adult patient. Capsules are taken 1 time per day throughout the entire treatment period. The scheme could be as follows:

1. The generalized form of candidiasis and cryptococcal infection are treated by taking the drug in an amount of 6-12 mg per kilogram of the child’s weight.
2. To prevent the development of fungus in a child who has a weakened immune system, it is necessary to give him 3-12 mg of the drug per kilogram of weight per day. The final dose of the medication depends on the type of disease and the severity of the pathological process.
3. Candidiasis of the mucous membranes is usually treated with 3 mg of medication per kilogram of the child’s weight. On the first day, the optimal dosage can be increased to 6 mg.

Elderly patients are prescribed the standard dosage of Mikosist for an adult.

Solution

The fungus is treated with Mikosist not only in the form of capsules, but also as a solution for injection. In this case, the drug enters the human body by droplets. The rate of administration should not exceed 20 mg of the active substance per minute. If it is necessary to transfer the patient from solution to capsules, then the dosage does not need to be changed. The daily dose remains the same.

The drug for infusion is compatible with different solutions. These include solutions:

• Dextrose.
• Hartman.
• Sodium chloride.
• Ringer.
• Potassium chloride in dextrose.

Infusions are carried out using traditional transfusion sets. In this case, you need to use one of the above dilution liquids.

Use in children

The method of drug administration depends on the patient’s condition and the severity of the fungal infection.

Mikosist 100 mg and other dosages are suitable for treating children with fungus. The medication can be used by a child who has already reached the age of five. Younger patients need therapy based on safer medications that do not harm the fragile body.

The maximum dosage of the drug that is selected for a child should be several times less than that offered to an adult patient. The therapeutic course based on Mikosist is continued until the first signs of improvement in the patient’s general condition begin to appear. It is strictly forbidden to stop treatment after the main symptoms of infection disappear. Such actions increase the likelihood of relapse of the pathology.

The exact dosage of the medicine that will help the child and will not lead to side effects is calculated taking into account his weight. On average, children are prescribed 3-10 mg of medication per kilogram of body weight per day. That is, if the patient weighs 10 kilograms, then he needs to be given 30-100 mg of Mikosist per day. The maximum dosage of the drug is prescribed only in severe cases of the pathological process.

Use during pregnancy and breastfeeding

Doctors allow the use of Mikosist by pregnant women only if the potential benefit of such treatment for the mother significantly outweighs the possible threat to the fetus. In other cases, it is best to avoid such therapy, since the effect of the active substance of the drug on the child’s body has not yet been fully studied.

During lactation, taking capsules or solution is strictly prohibited, as their active substance can pass into breast milk.

special instructions

Treatment with a fluconazole-based drug must be continued until clinical remission occurs. Premature refusal to continue taking the medication leads to an increased likelihood of developing a relapse of the disease in the near future.

Most of fluconazole is excreted from the human body through the kidneys. Therefore, the drug is prescribed with caution to patients diagnosed with renal failure. If long-term treatment with Mikosist is necessary, the dosage must be carefully selected.

In rare cases, treatment with the drug is accompanied by the development of toxic changes in the liver. Such violations threaten health complications and death. Therefore, throughout the course, careful monitoring of the functions of this organ is required.

Patients diagnosed with AIDS or malignant neoplasms in the body are most at risk of experiencing side effects after taking Mikosist.

Caution should be exercised when taking this drug to patients who are additionally forced to take Rifabutin or other drugs that can be metabolized by isoenzymes of the cytochrome P450 system.

It is mandatory to monitor prothrombin time throughout treatment in patients receiving the active substance Mikosyst and indirect coumarin anticoagulants.

During the research, experts discovered the effect of the drug on the patient’s ability to drive vehicles and operate complex machinery. Therefore, throughout the entire medication course, patients need to be especially careful in their professional activities.

Overdose

If the dose of the drug is selected incorrectly, it can lead to an overdose. This condition is accompanied by the following symptoms:

1. Nausea.
2. Vomit.
3. Stool disorder.
4. Cramps.
5. Hallucinations.
6. Paranoid behavior.

If symptoms of overdose are detected, the patient must first perform gastric lavage. He should undergo hemodialysis and symptomatic therapy. Upon completion of these procedures, after about 3 hours, the concentration of the active substance of the drug in the blood decreases by 50% or more.

Price and analogues

The antifungal drug Fucis is one of the analogues of Mikosist

In many pharmacies you can purchase the drug Mikosist. The price of the drug depends on the form of its release. Capsules sell for an average of 282 rubles. The solution can be purchased for 317-410 rubles.

Each existing dosage form of Mikosist has a number of analogues with which this drug can be replaced, if necessary. Instead of capsules, it is recommended to take Flucoside, Fluconazole, Fluconorm. Substitutes for the solution are Novigan, Fucis and Procanazole.

If the doctor prescribes this particular drug to the patient, then it should be taken. If negative reactions develop, you can ask a specialist to replace Mikosist with an analogue. Changing the prescribed remedy yourself is strictly prohibited.

Mikosist is a medicinal product intended for the treatment of fungal diseases of various natures. It is highly effective against yeast, yeast-like fungi and trichophytoses. The active work of the drug is ensured by the active substance – fluconazole. is a synthesized compound that belongs to the group of triazole substances. It has powerful selective and suppressive effects. With its help, it is possible to stop the production of enzymes, which ensure the rapid division of pathogenic microorganisms. In this case, the active substances affect exclusively the fungal compound without affecting humans.

Release form

Forms of release of the drug

Today, Mikosist has two dosage forms: capsules and solution for internal administration. They all have similar indications for use. The active substance of these products is fluconazole, the effectiveness of which is increased by certain auxiliary ingredients. Mikosist capsules are available in 3 dosages: 50, 100 and 150 mg of fluconazole. Finding out what exactly you are buying is very simple: just look at the name. The manufacturer indicates the amount of active substance on the pack. Mikosist solution is available in dosages of 1 or 2 ml.

Experts note that for the treatment of any diseases, capsules with a dosage of 150 ml are most often prescribed. They have an excellent effect and a minimum of side effects. It must be taken into account that Mikosist is not tablets, but capsules. Most often they are prescribed in the fight against thrush. The medicine is not available in the form of a suppository; the manufacturer is not developing a gel.

Compound

Packaging Mycogsist

The composition of Mikosist was developed taking into account the characteristics of fungal organisms. It effectively copes with all types of pathogens. The most important component in this drug is fluconazole. It is he who provides anti-inflammatory, antifungal, immunomodulatory effects. Its regular use can reduce the body's susceptibility to pathogenic substances. The medicine contains the following components:

• Silicon dioxide – increases the absorption of the active components of the drug;
• Titanium dioxide – is responsible for preventing irritation of the gastric walls;
• Corn starch - fills the free space in the capsule;
• Gelatin – responsible for the integrity of the capsule;
• Lactose – protects the body from allergic reactions;
• Indigo carmine – colors the tablets a certain color.

The composition of the Mikosist solution for injection is more meager. It is based on a certain dose of fluconazole, purified water, novocaine and sodium chloride. For some lesions of the body, the use of this dosage form is more justified.

When is it appointed?

Mikosist is an antimycotic agent that can quickly suppress the activity of pathogens of this kind. Before use, we recommend that you read the instructions, which indicate when it is best to use this product. Typically, tablets or injections are prescribed for:

• Candidiasis of the mucous membranes or candiduria;
• Generalized candidiasis, infectious infection of internal organs and systems;
• During cytostatic or immunosuppressive therapy;
• To prevent exacerbation of recurrent mycosis;
• Cryptococcal infection of the body;
• Fungal infection of the skin and internal organs;
• After organ transplantation to prevent infection;
• Bronchopulmonary infections;
• Genital candidiasis caused by yeast-like fungi;
• Fungal infections in patients suffering from tumors or during chemotherapy;
• Mycoses of the trunk and groin;
• Fungal infection of the nail plates;
• Pityriasis versicolor;
• Endemic mycosis in patients with normal immune abilities.

Mode of application

Drug treatment regimens

The exact dosage of the drug depends on the disease, as well as the severity of its course. It is necessary to continue therapy with this drug until all clinical indications return to normal. You should not end treatment immediately after disappearance. The only exception is vaginal candidiasis. Usually a single use is enough to overcome all negative manifestations of the disease. In general, you can adhere to the following scheme:

• For candidiasis or candidemia - 4 capsules of 200 mg on the 1st day, on the second and subsequent days - 2 capsules 1 time per day;
• For cryptococcal infections - 2 capsules of 100 mg 2 times a day, for the second and subsequent ones - 1 capsule of 100 mg 2 times a day;
• For streptococcal infections - a single dose of 4 capsules of 150 mg each;
• For oropharyngeal candidiasis - 100 mg or 1 capsule, 1 time per day for 1-2 weeks;
• To prevent candidiasis in AIDS-positive people - 1 capsule of 150 mg once a week for life;
• For atrophic candidiasis - 1 capsule of 50 mg once a day for 2 weeks;
• For candidiasis of the mucous membranes - 200 mg, or 2 capsules of 100 mg, per day for 2-4 weeks;
• For esophagitis - 1 capsule of 50 mg 2 times a day for 4 weeks;
• For bronchopulmonary infections - 1 capsule of 50 mg 2 times a day for 2 weeks;
• For vaginal candidiasis - a single dose of Mikosist 150 mg capsule;
• For candidal balanitis - a one-time dose of 150 mg of medication;
• For recurrent thrush - 1 capsule of 150 mg once a week for six months;
• For immune suppression – 2 capsules of 100 mg 2 times a day for a month;
• To prevent immune suppression – 1 capsule of 150 mg once a week for six months;
• For endemic mycoses - 1 capsule of 100 mg 2 times a day for a year;
• For histoplasmosis – 2 capsules of 150 mg 2 times a day for 2 years;
• For paracoccidioidomycosis – 1 capsule of 150 mg per day for 1-2 years;
• For mycosis of the skin - 150 mg once or 50 mg once a day for 2-4 weeks;
• For dermatophytosis – 2 capsules of 150 mg per day for 6 weeks;
• For pityriasis versicolor – 1 capsule Mikosist 50 mg per day for 2 weeks;
• For generalized lichen – 1 capsule of 100 mg for 4 weeks;
• For onychomycosis - 1 capsule of 150 mg per week for 3-6 months, it all depends on the growth rate of the nail plates (if the fungus has infected the thumb, treatment often takes 6-12 months).

Mikosist can be used by children over 5-6 years of age. The maximum dose for them should be significantly lower than the maximum permissible dose for adults. It is necessary to continue treatment with this drug until signs of clinical recovery appear. If you stop giving your child the medicine immediately after signs of illness disappear, you risk a subsequent relapse.

The exact dose of the medicine must be calculated strictly based on body weight. On average, a child should receive about 3-10 mg of fluconazole per 1 kg of body weight per day. If he weighs 10 kg, then he can drink from 30 to 120 mg per day. For mild infections, it is necessary to adhere to the minimum dose; for severe fungal infections, take the maximum dose.

Mikosist for newborns can only be used in the form of an injection solution. They will not be able to swallow a capsule large enough. The dose of the medicine is calculated according to the same scheme as for older children. However, if the child has not reached the age of 1 month, Mikosist should be administered once every 3 days. This way it is possible to avoid negative effects on internal organs.

Contraindications

Despite the safety of Mikosist, the medicine is strictly prohibited from being taken in the following cases:

• If you are allergic or sensitive to the components of the drug;
• With simultaneous therapy with drugs that contain cisapride, terfenadine, astemizole;
• When using quinidine or pimozide;
• If you have kidney or liver disease;
• For cardiovascular diseases;
• If the concentration of magnesium, potassium or calcium in the blood is low;
• In case of cardiac muscle dysfunction;
• Children under 5-6 years of age;
• For kidney diseases and renal failure.

Side effects

Mikosist is a fairly safe medicine that rarely causes any side effects. In extremely rare cases, therapy with such drugs can cause the following side effects:

• Disturbances in the gastrointestinal tract;
• Headache, dizziness, seizures;
• Thrombocytopenia, agranulocytosis, leukopenia;
• Increased cholesterol or triglyceride levels in the blood;
• Decreased glucose concentration, hypokalemia;
• Impaired kidney function;
• Various manifestations of allergic reactions, bronchial asthma.

special instructions

Treatment with Mikosist must be continued until laboratory tests confirm the onset of stable remission. If you stop taking the medicine too early, you risk going into remission. In this case, it will be much more difficult to cure the disease. Due to the fact that the active substance of the drug is excreted through the kidneys, people with insufficiency in the functioning of this organ need to be careful.

In rare cases, doctors note the toxic effects of Mikosist on the liver, even fatal outcomes are possible. This is usually observed in patients with serious aggravating diseases: cirrhosis, fatty degeneration, hepatitis and many others. Skin reactions are also possible. It is not recommended to treat Mikosist in people with tumors or AIDS. They have a significantly increased risk of developing serious side effects.

If an adult develops a fungal infection while taking the drug, Mikosist should be stopped immediately. This condition can easily cause erythema or bullous lesions. People with metabolic disorders should take the medicine with caution. During therapy, it is very important to constantly monitor blood sugar, insulin and cholesterol levels. Due to the fact that the medicine can cause dizziness, it is necessary to take Mikosist with extreme caution while driving or working with machinery.

Precautionary measures

Mikosist is a safe medicine that in rare cases can cause serious harm to the body. People who have hypersensitivity to milk sugar should always be on the alert. The capsules contain a certain amount of anhydrous lactose, which can cause serious side effects. Also, you should not take the medicine if there are components to which you have an allergic reaction. You should not self-medicate; an experienced doctor will be able to choose for you the most optimal and completely safe scheme for treating the disease.

Interaction with other drugs

Mikosist is a medicine that has a powerful effect on the body. This drug may not always be combined with other medications. Due to its use with the following drugs, certain reactions may occur:

Use during pregnancy and breastfeeding

The manufacturer has not tested how Mikosist affects the period of gestation and the child himself during breastfeeding. Each case is individual; consultation with your doctor is necessary. Typically, therapy with this drug is indicated for women suffering from serious fungal infections. Please note that pregnant and lactating women should take the medicine only after consulting with their doctor to avoid the development of serious complications.

The active substance fluconazole enters the baby's body through breast milk and can interfere with its nervous development.

Analogs

Both dosage forms of Mikosist have a large number of analogues of the active substance. If Mikosyst is not on sale, you can always replace it with those capsules that contain fluconazole: Flucoz. Fluconorm, Flucoside, Flucoral Fluconazole. You can also purchase solutions of Fucis, Procanazole or Novigan. If your doctor has prescribed you exclusively Mikosist, it is best to look for the specified drug. Despite the similarity of action and composition, all drugs have different features and contraindications.

Flucoral
Fluconazole
Fucis Procanazole Novigan

Price

The cost of Mikosist is quite low - this medicine can be easily found in almost any pharmacy. The price of the drug may vary between 10-20% due to various trade markups. Usually the medicine is sold at the following prices.