Comparative Pharmacology
Head-to-head clinical analysis: ANCOBON versus LAMISIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANCOBON versus LAMISIL.
ANCOBON vs LAMISIL
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.
Allylamine antifungal that inhibits squalene epoxidase, an enzyme in the ergosterol biosynthesis pathway, leading to accumulation of squalene and disruption of fungal cell membrane function.
50-150 mg/kg/day orally divided every 6 hours; intravenous dosing: 50-150 mg/kg/day divided every 12 hours.
250 mg orally once daily for 2-6 weeks for dermatophyte infections; 250 mg orally once daily for 12 weeks for onychomycosis.
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 17-24 hours in healthy adults. However, it can prolong to about 36-40 hours in patients with renal or hepatic impairment. The prolonged half-life allows for once-daily dosing. Due to extensive tissue distribution, the functional half-life (terminal phase from tissues) may be longer.
Primarily renal excretion of unchanged drug (75-90% within 24 hours). Less than 1% eliminated as 5-fluorouracil metabolite. Biliary/fecal excretion negligible.
Approximately 70% of the administered dose is excreted in the urine as metabolites, with less than 5% as unchanged drug. About 20% is eliminated via feces. Terbinafine undergoes extensive hepatic metabolism; renal elimination of metabolites is the primary route.
Category C
Category C
Antifungal
Antifungal