Flugal 200 mg capsule

Overview

Flugal 200mg Capsule contains Fluconazole, a potent synthetic triazole antifungal agent. It acts by inhibiting the cytochrome P450-dependent enzyme 14α-lanosterol demethylase, which is essential for ergosterol biosynthesis in fungal cell membranes. Depletion of ergosterol leads to accumulation of 14α-methylsterols and disruption of membrane structure and function. The 200mg strength is used for more serious or systemic fungal infections including oropharyngeal and esophageal candidiasis, invasive candidal infections, and cryptococcal meningitis maintenance therapy.

Dosage and Administration

Oropharyngeal Candidiasis: 200 mg on day 1, followed by 100 mg once daily for at least 14 days. Esophageal Candidiasis: 200 mg on day 1, then 100 mg daily for minimum 21 days and at least 2 weeks after resolution. Systemic Candidal Infections: 400 mg on day 1, then 200 mg daily; severe infections may require 400 mg/day. Cryptococcal Meningitis (acute): 400 mg on day 1, then 200–400 mg daily for 6–8 weeks; relapse prevention 200 mg daily indefinitely. Onychomycosis: 150–200 mg once weekly for 6–12 months. May be taken with or without food.

Interaction

Warfarin: significantly prolongs prothrombin time — close monitoring required. Sulphonylureas: enhanced hypoglycaemic effect. Hydrochlorothiazide: raises fluconazole plasma concentration by ~40%. Phenytoin: increased plasma levels. Rifampicin: reduces fluconazole AUC and half-life by approximately 25% and 20% respectively. Cyclosporin: plasma levels elevated — monitor carefully. Theophylline: reduced clearance. Oral contraceptives: minor pharmacokinetic interaction.

Contraindications

Contraindicated in patients with known hypersensitivity to fluconazole or any other azole/triazole antifungal agents. Concomitant use with terfenadine or cisapride is contraindicated due to risk of life-threatening cardiac arrhythmias.

Side Effects

Commonly reported adverse effects include nausea, abdominal discomfort, diarrhoea, and flatulence. Rash may occur and warrants discontinuation if exfoliative or bullous lesions develop. Rare but serious effects include anaphylaxis, hepatotoxicity, and severe cutaneous reactions. Transient liver enzyme elevations are possible, particularly with prolonged therapy.

Pregnancy and Lactation

Fluconazole is not recommended during pregnancy and is contraindicated in women of childbearing potential not using effective contraception. It passes into breast milk at levels close to plasma concentrations and should not be used by nursing mothers.

Precautions and Warnings

Monitor hepatic function in patients receiving prolonged treatment or those with pre-existing liver disease. Renal impairment requires dose adjustment based on creatinine clearance. Rare cases of severe exfoliative skin reactions have been reported, particularly in immunocompromised patients — discontinue if such reactions occur. Use with caution in patients with known or potential QT prolongation.

Storage Conditions

Store in a dry place, protected from light and heat. Keep below 30°C. Keep out of reach of children.

Frequently Asked Questions

Q: What is the difference between Flugal 150mg and 200mg capsules?
A: Flugal 150mg is primarily used for vaginal candidiasis and tinea infections as single or weekly doses, while Flugal 200mg is used for more serious infections such as oropharyngeal, esophageal, and systemic candidal infections requiring higher daily doses and longer treatment durations.

Q: Do I need to take Flugal 200mg with food?
A: Fluconazole may be taken with or without food as absorption is not significantly affected by meals. However, taking it with food may help reduce any gastrointestinal discomfort.