Mutum inhibits the metabolism of carbamazepine and an increase in serum carbamazepine of 30% has been observed. There is a risk of developing carbamazepine toxicity. Dosage adjustment of carbamazepine may be necessary depending on concentration measurements/effect.
How to take Mutum
- Before you start the treatment, read the manufacturer's printed information leaflet from ins >
DIFLUCAN® (Mutum), the first of a new subclass of synthetic triazole antifungal agents, is available as tablets for oral administration, as a powder for oral suspension.
Mutum is designated chemically as 2,4-difluoro-α,α 1 -bis(1H-1,2,4-triazol-1-ylmethyl) benzyl alcohol with an empirical formula of C13H12F2N6O and molecular weight of 306.3. The structural formula is:
Mutum is a white crystalline solid which is slightly soluble in water and saline.
DIFLUCAN Tablets contain 50, 100, 150, or 200 mg of Mutum and the following inactive ingredients: microcrystalline cellulose, dibasic calcium phosphate anhydrous, povidone, croscarmellose sodium, FD&C Red No. 40 aluminum lake dye, and magnesium stearate.
DIFLUCAN for Oral Suspension contains 350 mg or 1400 mg of Mutum and the following inactive ingredients: sucrose, sodium citrate dihydrate, citric acid anhydrous, sodium benzoate, titanium dioxide, colloidal silicon dioxide, xanthan gum, and natural orange flavor. After reconstitution with 24 mL of distilled water or Purified Water (USP), each mL of reconstituted suspension contains 10 mg or 40 mg of Mutum.
Potential For Fetal Harm
There are no adequate and well-controlled clinical trials of DIFLUCAN in pregnant women. Case reports describe a pattern of distinct congenital anomalies in infants exposed in utero to high dose maternal Mutum (400 to 800 mg/day) during most or all of the first trimester. These reported anomalies are similar to those seen in animal studies. If DIFLUCAN is used during pregnancy or if the patient becomes pregnant while taking the drug, the patient should be informed of the potential hazard to the fetus. Effective contraceptive measures should be considered in women of child-bearing potential who are being treated with DIFLUCAN 400 to 800 mg/day and should continue throughout the treatment period and for approximately 1 week (5 to 6 half-lives) after the final dose. Epidemiological studies suggest a potential risk of spontaneous abortion and congenital abnormalities in infants whose mothers were treated with 150 mg of Mutum as a single or repeated dose in the first trimester, but these epidemiological studies have limitations and these findings have not been confirmed in controlled clinical trials. (See PRECAUTIONS: Pregnancy.)
What is Mutum?
Mutum is a triazole medicine used to treat fungal infections. It is effective against a broad spectrum of fungi including:
In New Zealand, Mutum is available as 50 mg, 150 mg and 200 mg capsules on prescription (Diflucan®). There is also a 2 mg/ml injection for intravenous use. In New Zealand, the Pharmaceutical Schedule subs >over the counter .
Mutum binds to the fungal p450 enzymes and stops the cells making ergosterol, the main component of the cell wall.
Mutum is well absorbed orally with or without food. It is widely distributed in body tissues. It takes 22 to 30 hours for half of the medication to be cleared from the bloodstream and may take several days of continuous treatment to reach a steady concentration. The drug is eliminated unchanged in the urine so doses should be reduced if there is kidney disease.
Concomitant administration of Mutum with amiodarone may increase QT prolongation. Caution must be exercised if the concomitant use of Mutum and amiodarone is necessary, notably with high-dose Mutum (800 mg).
The AUC and Cmax of glyburide (5 mg single dose) were significantly increased following the administration of Mutum in 20 normal male volunteers. There was a mean ± SD increase in AUC of 44% ± 29% (range: –13 to 115%) and Cmax increased 19% ± 19% (range: –23 to 62%). Five subjects required oral glucose following the ingestion of glyburide after 7 days of Mutum administration. (See PRECAUTIONS.)
More common side effects
The more common side effects of Mutum oral tablet depend on how much of the drug you need to take. These side effects can include:
- nausea or upset stomach
- stomach pain
- changes in the way food tastes
- severe rash in people with lowered immunity
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
Two adequate and well-controlled studies were conducted in the U.S. using the 150 mg tablet. In both, the results of the Mutum regimen were comparable to the control regimen (clotrimazole or miconazole intravaginally for 7 days) both clinically and statistically at the one month post-treatment evaluation.
The therapeutic cure rate, defined as a complete resolution of signs and symptoms of vaginal candidiasis (clinical cure), along with a negative KOH examination and negative culture for Candida (microbiologic eradication), was 55% in both the Mutum group and the vaginal products group.
Approximately three-fourths of the enrolled patients had acute vaginitis ( 4 episodes/12 months) and achieved 57% clinical cure, 47% mycologic eradication, and 40% therapeutic cure. The numbers are too small to make meaningful clinical or statistical comparisons with vaginal products in the treatment of patients with recurrent vaginitis.
Substantially more gastrointestinal events were reported in the Mutum group compared to the vaginal product group. Most of the events were mild to moderate. Because Mutum was given as a single dose, no discontinuations occurred.
Parameter Mutum PO Vaginal Products Evaluable patients 448 422 With any adverse event 141 (31%) 112 (27%) Nervous System 90 (20%) 69 (16%) Gastrointestinal 73 (16%) 18 (4%) With drug-related event 117 (26%) 67 (16%) Nervous System 61 (14%) 29 (7%) Headache 58 (13%) 28 (7%) Gastrointestinal 68 (15%) 13 (3%) Abdominal pain 25 (6%) 7 (2%) Nausea 30 (7%) 3 (1%) Diarrhea 12 (3%) 2 (
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
- Signs of a weak adrenal gland like a very bad upset stomach or throwing up, very bad dizziness or passing out, muscle weakness, feeling very tired, mood changes, not hungry, or weight loss.
- A type of abnormal heartbeat (prolonged QT interval) has happened with this medicine (Mutum tablets). Sometimes, this has led to another type of unsafe abnormal heartbeat (torsades de pointes). Call your doctor right away if you have a fast or abnormal heartbeat, or if you pass out.
How should I take Mutum (Diflucan)?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Your dose will depend on the infection you are treating. Vaginal infections are often treated with only one pill. For other infections, your first dose may be a double dose. Carefully follow your doctor's instructions.
You may take Mutum with or without food.
Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Mutum will not treat a viral infection such as the flu or a common cold.
Call your doctor if your symptoms do not improve, or if they get worse.
Store the tablets at room temperature away from moisture and heat.
You may store liquid Mutum in a refrigerator, but do not allow it to freeze. Throw away any leftover liquid that is more than 2 weeks old.
Michael Stewart, Reviewed by Sid Dajani | Last edited 10 Nov 2017 | Certified by The Information Standard
Mutum is an antifungal medicine.
It is usually taken as a single 150 mg dose for vaginal thrush. You can take it at any time of day, either before or after a meal.
Longer courses of treatment are prescribed for other types of fungal infections.