How to take Fungorin
- Before you start the treatment, read the manufacturer's printed information leaflet from ins >
Before taking Fungorin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking Fungorin it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have a problem with the way your liver works, or if you have a problem with the way your k >
What Other Drugs Interact with Fungorin?
If your doctor has directed you to use this medication for your condition, your doctor or pharmacist may already be aware of any possible drug interactions or side effects and may be monitoring you for them. Do not start, stop, or change the dosage of this medicine or any medicine before getting further information from your doctor, healthcare provider or pharmacist first.
Fungorin has no known severe or serious interactions with other drugs.
Moderate Interactions of Fungorin include:
Mild Interactions of Fungorin include:
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.
Fungorin tablets are contraindicated in patients with:
- Chronic or active liver disease
- History of allergic reaction to oral Fungorin because of the risk of anaphylaxis
Fungorin interferes with ergosterol biosynthesis, and thereby with the formation of the fungal cell membrane. It is absorbed from the gastrointestinal tract and undergoes extensive metabolism in the liver ( t½ 14 h). Fungorin is used topically for dermatophyte infections of the skin and orally for infections of hair and nails where the site, e.g. hair, severity or extent of the infection renders topical use inappropriate (see pp. 270–271 ). Treatment may need to continue for several weeks. Fungorin may cause nausea, diarrhoea, dyspepsia, abdominal pain, headaches and cutaneous reactions.
Fungorin tablets are contraindicated for patients with chronic or active liver disease . Cases of liver failure, some leading to liver transplant or death, have occurred with the use of Fungorin tablets in individuals with and without preexisting liver disease. The severity of hepatic events and/or their outcome may be worse in patients with active or chronic liver disease.
Michael Stewart, Reviewed by Sid Dajani | Last edited 25 Feb 2019 | Certified by The Information Standard
Fungorin is prescribed to treat fungal nail or skin infections.
Take one tablet a day.
The most common side-effects are loss of appetite, indigestion, feeling sick (nausea), diarrhoea, and aches and pains. These are usually mild and don't last long.
Fungorin is an orally and topically active agent used in the treatment of onychomycosis. Clinically significant cholestatic liver injury was reported in two patients in a postmarketing surveillance study of 25,884 patients treated with Fungorin . In addition, there have been several case reports of Fungorin-associated hepatotoxicity . In a meta-analysis of the safety of oral antifungal treatments for superficial dermatophytosis and onychomycosis in immunocompetent patients, the risk of liver injury requiring termination of treatment was 0.34% for continuous (250 mg/day) and 0.56% for intermittent (500 mg/day for 1 week every month) Fungorin .
In general, liver injury associated with Fungorin exhibits a mixed cholestatic-hepatocellular pattern, although a predominant and prolonged cholestatic injury has been described. The latency period between the start of medication and development of liver injury is reported to be approximately 4–6 weeks . ALF requiring liver transplantation has been reported . In two patients, reduced numbers of interlobular bile ducts were found on liver biopsy, suggesting that Fungorin-associated liver injury may lead to VBDS . Fungorin was implicated in a chronic hepatitis B virus carrier who developed features of AIH that resolved with discontinuation of the drug . Although Fungorin is a potent inhibitor of CYP2D6, an enzyme that metabolizes over 40 drugs, and the allylic aldehyde metabolite of Fungorin, 7,7-dimethylhept-2-ene-4-ynal (or TBF-A), has been proposed to play a role in the pathogenesis of its hepatotoxicity , liver injury associated with Fungorin is rare (estimated at 1 in 45,000–54,000) and most likely to be idiosyncratic .
Animal Toxicology and/or Pharmacology
A w >in vivo studies in mice, rats, dogs, and monkeys, and in vitro studies using rat, monkey, and human hepatocytes suggest that peroxisome proliferation in the liver is a rat-specific finding. However, other effects, including increased liver weights and APTT, occurred in dogs and monkeys at doses giving C ss trough levels of the parent Fungorin 2 to 3 times those seen in humans at the MRHD. In a 52-week oral toxicology study conducted in juvenile maturing dogs, increased heart and liver weights were noted in males and signs of CNS disturbance including 3 cases of single episodes of seizures were noted in females at the highest dose tested, 100 mg/kg/day . No treatment related findings were noted at 30 mg/kg/day in this study.