The drug "Mycosyst": reviews, analogs, price. Medicinal preparation "Mikosist": instructions for use

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

Pharmacokinetics

After oral administration or intravenous administration, the "Mycosyst" medication (the instruction indicates this) penetrates well into the body fluids and tissues. In sputum, peritoneal and articular fluid, saliva, breast milk, the concentration of the drug is similar to that achieved in blood plasma. The content in the cerebrospinal fluid fluconazole in patients with fungal meningitis is eighty percent of the plasma concentration, which in turn is directly proportional to the dose taken. With a daily single application, a 90-percent equilibrium concentration is reached by the fourth or fifth day. If the first day to take a dose that exceeds the usual two times, you can already achieve a 90-percent equilibrium cumulation by the second day. Eleven to twelve percent of fluconazole binds to plasma proteins. In the peripheral blood metabolites are not detected. Pharmacokinetics essentially depends on the work of the kidneys, because the drug is excreted from the body mainly by them, and about eighty percent - in unchanged form. Within three hours after hemodialysis, the concentration of the active substance in the plasma is halved.

Indications for use

It is recommended to use the drug "Mycosyst" for thrush, including generalized, disseminated, genital, with other forms of invasive candidiasis infection, candidemia, as well as in the presence of factors that have the appearance of thrush. In addition, the use of the drug for people with candidiasis of the mucous membranes: pharynx; Oral cavity, including atrophic candidiasis, caused by wearing dentures; Esophagus. The drug "Mikosist" instruction for use advises patients with cryptococcal meningitis or sepsis, cryptococcosis, cryptococcal infection of the skin or lungs. It is also used to prevent relapses of these pathologies in AIDS patients and in other cases of immunodeficiency. The medication is used to prevent fungal infections in people with malignant formations, predisposed as a result of radiation or chemotherapy to these lesions. Also, the drug "Mycosyst" is used in the treatment of mycoses of the inguinal region and trunk, deep endemic mycoses, including paracoccidioidomycosis, coccidioidomycosis, histoplasmosis in patients with normal immunity.

Dosage form, package, composition

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

Solution for infusions has the form of a transparent, slightly colored or colorless liquid. One milliliter contains two milligrams of the active substance. Secondary components are water for injection and sodium chloride. The solution is dispensed in glass bottles in the volume of one hundred milliliters, placed in cardboard packs. One packet 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 clinical efficacy confirmed by mycological examination , often it does not exceed six to eight weeks. When cryptococcal meningitis is used, use the "Mikosist" medication for ten to twelve weeks after a negative result of a study of a sample of cerebrospinal fluid was obtained. AIDS patients after the end of the course of primary treatment are prescribed for the prevention of recurrences of cryptococcal meningitis during a long period of taking the drug "Mycosyst" at a dose of at least two hundred milligrams per day.

With disseminated candidiasis, candidemia and other invasive candidiasis infections, as a rule, four hundred milligrams of medication are taken on the first day, and in the following days - two hundred milligrams daily. In the case of severe systemic thrush, the dose can be increased to eight hundred milligrams per day. Treatment should continue for at least two weeks after the symptoms are eliminated and negative blood culture is obtained. With oropharyngeal candidiasis, including patients with impaired immunity, the dosage of the drug per day is fifty to one hundred milligrams, it should be taken within seven to fourteen days. At atrophic candidiasis, which has arisen due to the wearing of dentures, usually appoint a day reception of fifty milligrams of the drug in combination with antiseptic drugs. Treatment continues for two weeks. With other candidiasis infections (candiduria, esophagitis, candidiasis of the mucous and skin), the daily dose of the medication is fifty to one hundred milligrams, the course of therapy is fourteen to thirty days.

With the goal of eliminating vaginal candidiasis, the drug "Mycosyst" instructions for use shows a single dose of 150 milligrams. You can drink one capsule (150 mg) once a month for four to twelve months to reduce the frequency of relapses. Often, candidiasis is prescribed in addition to the drug "Mycosyst" candles, for example, "Terzhinan", "Klion-D", "Ginezol". Depending on the degree of risk of the appearance of a fungal infection, for the prevention of candidiasis the daily recommended dose of the drug 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 be from eleven to twenty-four months, with paracoccidioidomycosis - from two to seventeen months, with histoplasmosis - from three to seventeen months.

Application rules

Intravenous drug should be administered drip, at a rate of no more than twenty milliliters per minute. It is not necessary to change the daily dosage when transferring the patient from intravenous administration to oral administration of the drug. Solution for infusion is compatible with a 20 % solution of glucose; Solutions of Hartman and Ringer; Solutions of sodium hydrogencarbonate, potassium chloride in glucose, sodium chloride (0.9%). You can infuse fluconazole using conventional transfusion kits, using one of these solutions.

Adverse events

Most patients who took the drug "Mycosyst", reviews about it leave good. The drug really effectively eliminates fungal infections, but can cause negative effects. Thus, on the part of the digestive system, there is a risk of nausea, flatulence, violations of the liver, problems with taste, diarrhea. Also, some people mention the occurrence of headaches, seizures, dizziness. They say that similar phenomena arose soon after taking the drug "Mycosyst". The reviews of other patients contain information about the development against the background of therapy with the drug allergies in the form of erythema, skin rash, angioedema, urticaria. Other possible side effects include alopecia, ventricular fibrillation, impaired renal function, hypertriglyceridemia, hypercholesterolemia, and hypokalemia.

Contraindications

In the form of capsules, it is not possible to prescribe medicines to children up to six months of age (for infants, the use of a drug in the form of a solution for infusions is permitted). Contraindicated use of the drug "Mycosyst" lactating women (pregnant women should be appointed with caution), as well as people who are highly sensitive to the ingredients included in the ingredients. With extreme caution, it is necessary to use the remedy for patients with renal / hepatic insufficiency, with intolerance to acetylsalicylic acid.

Overdose

Cases of overdose of the drug "Mycosyst" are documented. Reviews of people who took the medicine in an excessive dose, indicate the development of diarrhea, nausea, vomiting. In severe cases, the appearance of seizures, paranoid behavior, hallucinations. A person with symptoms of an overdose should be taken to a hospital where he will be washed with stomach, hemodialysis, forced diuresis, symptomatic therapy.

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

This question is often asked by patients. In fact, both drugs act in the same way, we can say that they are identical. The only difference is that the medicine "Mycosyst" is produced by the Hungarian pharmaceutical company "Gedeon Richter", while "Fluconazole" is a domestic preparation. Of course, this directly affects the cost of medicines. Choosing what to buy - "Mycosyst" or "Fluconazole" - many prefer a drug that is cheaper. Indeed, the difference in price is significant. So, for the packaging of "Mycosyst" (one capsule containing 150 mg of fluconazole) you will have to pay an average of 295 rubles, while the same package of "Fluconazole" will cost only 8-20 rubles. The average price of a 100-ml bottle of a solution for infusions of "Mycosyst" is 311 rubles.

As for the pharmacological properties of the two drugs, they are almost the same, except for the absorption rate: according to the available data, the maximum concentration in the body of "Fluconazole" is reached 1-2 hours after application, and "Mycosyst" - 0.5 -1,5 hour. Nevertheless, not all patients on the two drugs respond in the same way. Some do not see any difference between the two, the latter consider that the quality directly depends on the price, which means which medicine is more expensive, and that is better. You can often meet reviews in which women claim that after the reception of "Fluconazole" thrush came back, but "Mikosist" allowed to get rid of it for a long time. In any case, the choice is yours.

Analogues

In addition to "Fluconazole", there are other medicines that can replace the drug "Mycosyst". Analogs of the drug, having the same substance as the active ingredient, are presented quite widely. In the form of capsules for the treatment of thrush and other fungal infections, you can use preparations "Diflucan", "Flukostat", "Mikomaks" and others. Effective is the drug "Mikoflukan" (tablets). "Mycosyst" from all the mentioned analogs differs by such indicators as bioavailability, half-life, suction rate.

Drug Interactions

It is necessary to thoroughly monitor prothrombin time in patients receiving indirect anticoagulants of the coumarin group along with fluconazole, since there is a risk of an increase in PTW. With the simultaneous administration of sulfonylurea derivatives, the drug "Mycosyst" can increase the time of their half-elimination, so you need to consider the possibility of hypoglycemia. In the case of the combined use of fluconazole and phenytoin, the concentration of the latter can be increased clinically to a significant extent, therefore, if necessary, the combined dose should be reduced. With the simultaneous administration of "Mycosyst" and rifampicin, there will be a decrease in the concentration of fluconazole, therefore, the dose of "Mycosyst" needs to be increased. The combined use of a drug with azole derivatives in combination with terenadine is contraindicated, since serious, life-threatening arrhythmia can develop. If you take the drug "Mycosyst" with cisapride, you may experience unwanted reactions from the heart, including ventricular tachycardia. With simultaneous use of fluconazole and theophylline, the average clearance rate from the plasma of the latter decreases, which means that the likelihood of its toxic effects and overdose increases.

special instructions

It should continue treatment with the drug "Mycosyst", until the clinico-hematologic remission. Premature termination 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 mainly by the kidneys. Dosing with long-term treatment should be made, given the 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 lesion are found, the drug should be discontinued.

Patients who received Mikosist received rare cases of exfoliative skin reactions, for example, toxic epidermal necrolysis and Stevens-Johnson syndrome. Patients with malignant neoplasms and AIDS are more likely to develop severe skin reactions with drugs containing fluconazole. If a rash appears during the treatment of a superficial fungal infection, the medicine should be discarded. If a rash occurs in people with invasive or systemic fungal infection, the doctor should strengthen the observation and cancel the drug in the event that multi-form erythema or bullous lesions develop. During treatment with the drug "Mycosyst" (the reviews confirm this), dizziness may occur, so patients need to be very careful when working with machinery and driving vehicles.