フルシトシン

使用用途

• Cryptococcosis
• Candidiasis
• Susceptible fungal infections (Psittacines)
• Susceptible fungal infections (Raptors)
• Susceptible fungal infections (Psittacines and Mynahs)
• Susceptible fungal infections (Ratites)
• Cryptococcosis
• Candidiasis

投与方法

考えられる副作用

• Gastrointestinal disturbances (nausea, vomiting, diarrhea)
• Dose-dependent bone marrow depression (anemia, leukopenia, thrombocytopenia)
• Cutaneous eruption and rash (primarily on scrotum and nasal planum in dogs)
• Oral ulceration
• Increased hepatic enzymes
• Severe drug reaction in dogs within 10-14 days of treatment
• Aberrant behavior and seizures (reported in cats)
• Toxic epidermal necrolysis (anecdotal in cats)

注意事項と禁忌

• Known hypersensitivity to flucytosine
• > **Extreme Caution:** Use with extreme care in patients with renal impairment, as the drug is renally excreted. Dosage intervals must be adjusted based on creatinine clearance to prevent toxic accumulation. * **Hematologic Risk:** Use with extreme caution in patients with preexisting bone marrow depression, hematologic diseases, or those receiving other bone marrow suppressant drugs. * **Hepatic Disease:** Use cautiously with enhanced monitoring in patients with liver disease. * **Pregnancy:** Teratogenic in rats (FDA Category C). Use only when benefits outweigh risks. Consider milk replacer for nursing offspring. * **Laboratory Interference:** May cause false elevations in serum creatinine levels when using the Ektachem® analyzer.

薬物相互作用

• Amphotericin B: Synergistic antifungal efficacy against Cryptococcus and Candida. However, amphotericin B-induced nephrotoxicity can decrease flucytosine excretion, leading to flucytosine accumulation and enhanced bone marrow toxicity. Dosage adjustments and strict monitoring are required.

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