Comparative Pharmacology
Head-to-head clinical analysis: ANCOBON versus DIFLUCAN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANCOBON versus DIFLUCAN.
ANCOBON vs DIFLUCAN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Flucytosine is converted intracellularly to 5-fluorouracil, which inhibits fungal RNA and DNA synthesis by incorporating into RNA and inhibiting thymidylate synthase.
Diflucan (fluconazole) is a triazole antifungal agent that inhibits fungal cytochrome P450 14-alpha-demethylase, thereby blocking the conversion of lanosterol to ergosterol, an essential component of the fungal cell membrane. This leads to increased membrane permeability and inhibition of fungal growth.
50-150 mg/kg/day orally divided every 6 hours; intravenous dosing: 50-150 mg/kg/day divided every 12 hours.
Oral or IV: 200-400 mg loading dose, then 100-200 mg once daily. Dose and duration depend on indication.
None Documented
None Documented
Terminal elimination half-life 2.5-6 hours (normal renal function). Prolonged to 30-250 hours in renal impairment (CrCl < 20 mL/min). Half-life correlates with creatinine clearance.
30 hours (range 20-50 hours); prolonged in renal impairment (up to 98 hours in CrCl <20 mL/min)
Primarily renal excretion of unchanged drug (75-90% within 24 hours). Less than 1% eliminated as 5-fluorouracil metabolite. Biliary/fecal excretion negligible.
Renal: 80% unchanged; fecal/biliary: 11% as metabolites
Category C
Category C
Antifungal
Antifungal