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Antifungal

Antifungal

Generic and Trade Names:

Amphoterecin BFungizone, Abelcet
ClotrimazoleMycelex
Fluconazole Diflucan
FlucytosineAncobon
Griseofulvin Fulvicin, Grifulvin V, Grisactin
ItraconazoleSporanox
KetoconazoleNizoral
MiconazoleMonistat
NystatinMycostatin
TerbinafineLamisil



Description:

There are various classes of antifungals from topical to intravenous. They are used to treat a wide range of fungal infections from candidiasis to cryptococcosis. The introduction of the new triazoles, fluconazole and itraconazole, has improved the therapeutic chances against several fungal infections .

Nutritional Considerations:

Avoid alcohol. (Pronsky 1999)

Avoid caffeine with Terbinafine because it may decrease caffeine clearance by 19%. (Facts and Comparisons 1999)

Separate calcium and magnesium supplements and antacids by at least 2 hours from the drugs. (Pronsky 1999)

Herbal Considerations

St. John's Wort may interfere with some antifungal agents: ketoconazole and itraconazole, metabolized by the cytochrome P-450 pathway. (FDA 2000)

The German Commission E warns that the presence of antimycotics (antifungal drugs) can also affect the activity of brewer's yeast.

References

Anderson, K.N. (Ed.): Mosby's Medical Dictionary, Fourth Edition. Mosby Year Book, St. Louis, MO. 1994.

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Brinker, Francis Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998.

Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 1999.

Flynn PM et al., Oropharyngeal candidiasis in immunocompromised children: a randomized, multicenter study of orally administered fluconazole suspension versus nystatin. The Multicenter Fluconazole Study Group. J Pediatr, 1995 Aug, 127:2, 322-8.

Martino P & Girmenia C: Are we making progress in antifungal therapy? Curr Opin Oncol, 1997 Jul, 9:4, 314-20.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.

Pronsky, Zaneta Food Medication Interactions, 11th edition 1999.

www.fda.gov/cder/drug/advisory/stjwort.html February 2000.