Comparative Pharmacology
Head-to-head clinical analysis: ANCOBON versus DIFLUCAN IN DEXTROSE 5 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANCOBON versus DIFLUCAN IN DEXTROSE 5 IN PLASTIC CONTAINER.
ANCOBON vs DIFLUCAN IN DEXTROSE 5% IN PLASTIC CONTAINER
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) inhibits fungal cytochrome P450 14α-demethylase (CYP51), blocking the conversion of lanosterol to ergosterol, a key component of the fungal cell membrane. This disrupts membrane integrity and function, leading to fungal cell death. At high concentrations, it may also directly damage fungal membranes.
50-150 mg/kg/day orally divided every 6 hours; intravenous dosing: 50-150 mg/kg/day divided every 12 hours.
200 mg IV loading dose, then 100-200 mg IV once daily; for invasive candidiasis, 800 mg IV loading dose then 400 mg IV once daily.
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.
Terminal elimination half-life is approximately 30 hours (range 20-50 hours) in adults with normal renal function; prolonged to 98 hours in end-stage renal disease, requiring dose adjustment.
Primarily renal excretion of unchanged drug (75-90% within 24 hours). Less than 1% eliminated as 5-fluorouracil metabolite. Biliary/fecal excretion negligible.
Approximately 80% of the dose is excreted unchanged in urine via glomerular filtration and tubular secretion; about 11% is excreted as metabolites in urine; fecal excretion accounts for less than 5%.
Category C
Category C
Antifungal
Antifungal