{"id":4018,"date":"2025-03-31T18:11:55","date_gmt":"2025-03-31T18:11:55","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/fungizonel-txt\/"},"modified":"2025-03-31T18:11:55","modified_gmt":"2025-03-31T18:11:55","slug":"fungizonel-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/fungizonel-txt\/","title":{"rendered":"Fungizonel.txt"},"content":{"rendered":"

Fungizone<\/h1>\n

CLINICAL USE <\/H3>
\nAntifungal agent:
\nSystemic fungal infections (yeasts and <\/p>\n

yeast-like fungi including Candida
\nalbicans)
\n

DOSE IN NORMAL RENAL FUNCTION <\/H3>
\n250 micrograms \u2013 1.5 mg\/kg\/day
\nCan be given on alternate days if using a
\nhigher dose
\n

PHARMACOKINETICS <\/H3>
\n
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \n924.1\n<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \n>90\n<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp :
    \n2\u20135\n<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :
    \n4\n<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :
    \n24\u201348 (up to 15 days
    \nwith long-term use)\/
    \nUnchanged
    \n

    DOSE IN RENAL IMPAIRMENT <\/H3>
    \n

    GFR (mL\/MIN)<\/H4>
    \n
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
    \n
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
    \n
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :
    \nDose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
    \n
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    \nNot dialysed. Dose as in
    \nGFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \nNot dialysed. Dose as in
    \nGFR <10 mL\/min
    \n
  • HDF\/high flux &nbsp :
    \nNot dialysed. Dose as in
    \nGFR <10 mL\/min
    \n
  • CAV\/VVHD &nbsp &nbsp &nbsp:
    \nNot dialysed. Dose as in GFR=10\u2013
    \n20 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS <\/H3>
    \nPotentially hazardous interactions with other drugs
    \nCiclosporin: increased nephrotoxicity<\/p>\n

    Tacrolimus: increased nephrotoxicity<\/p>\n

    Increased risk of nephrotoxicity with <\/p>\n

    aminoglycosides and other nephrotoxic
    \nagents and cytotoxics
    \nCardiac glycosides: increased toxicity if <\/p>\n

    hypokalaemia occurs
    \nCorticosteroids: increased risk of <\/p>\n

    hypokalaemia \u2013 avoid concomitant use
    \nunless corticosteroids are required to
    \ncontrol reactions
    \nFlucytosine: enhanced toxicity in <\/p>\n

    combination with amphotericin
    \n

    ADMINISTRATION <\/H3>
    \n

    Reconstition<\/H4>
    \nSee SPC. Prepare intermittent infusion <\/p>\n

    in glucose 5% (incompatible with sodium
    \nchloride 0.9%, electrolytes or other drugs).
    \nReconstitute vial contents with water for
    \ninjection. pH should be adjusted to >4.2
    \nDilute to a concentration of 10 mg in <\/p>\n

    100 mL
    \n

    Route <\/H4>
    \n

    IV infusion <\/H4><\/p>\n

    Rate of Administration <\/H4>
    \n2\u20136 hours <\/p>\n

    If given over 12\u201324 hours there is a <\/p>\n

    reduced incidence of side effects
    \n

    Comments<\/H4>
    \nMinimum volume peripherally 0.2 mg\/mL, <\/p>\n

    centrally 0.5 mg\/mL. (UK Critical Care
    \nGroup, Minimum Infusion Volumes for
    \nfluid restricted critically ill patients, 3rd
    \nEdition, 2006)
    \nHigher rates of infusion are associated <\/p>\n

    with greater risk of adverse reactions.
    \nAdministration over less than 1 hour,
    \nparticularly in renal failure, has been
    \nassociated with hyperkalaemia and
    \narrhythmias
    \nParacetamol and parenteral pethidine <\/p>\n

    may alleviate rigors associated with
    \namphotericin administration. Can also
    \ngive antihistamines and corticosteroids to
    \ncontrol reactions
    \nFlush existing IV line with glucose 5% <\/p>\n

    before and after infusion administration
    \nFor patients on CAV\/VVHD, amphotericin <\/p>\n

    should be given into the venous return of
    \nthe dialysis circuit
    \nAmphotericin iV \u2013 Fungizone
    \nt is not licensed for use by anyone else.
    \nAMPhoTEriCin iV \u2013 FUnGiZonE 51<\/p>\n

    OTHER INFORMATION <\/H4>
    \n*** AMPHOTERICIN IS HIGHLY
    \nNEPHROTOXIC ***
    \nPermanent renal impairment may <\/p>\n

    occur, particularly in patients receiving
    \nconventional amphotericin B at doses
    \n>1 mg\/kg\/day, or with pre-existing renal
    \nimpairment, prolonged therapy, sodium
    \ndepletion or concurrent nephrotoxic drugs
    \nNephrotoxicity may be reduced by <\/p>\n

    giving an

    IV infusion <\/H4> of sodium chloride
    \n0.9% 250\u2013500 mL over 30\u201345 minutes
    \nimmediately before administering
    \namphotericin B
    \nCan cause distal tubular acidosis<\/p>\n

    May cause polyurea, hypovolaemia, <\/p>\n

    hypokalaemia and acidosis.
    \nAmphotericin and flucytosine act <\/p>\n

    synergistically when co-administered
    \nenabling lower doses to be used effectively
    \nA test dose of amphotericin is <\/p>\n

    recommended at the beginning of a new
    \ncourse (1 mg over 20\u201330 minutes then stop
    \nand observe for 30 minutes)
    \nMonitor renal function, full blood count, <\/p>\n

    potassium, magnesium and calcium levels
    \nLiposomal amphotericin is considerably <\/p>\n

    less nephrotoxic compared with
    \nconventional amphotericin B, but is
    \nconsiderably more expensive
    \nThere are reports of the use of <\/p>\n

    amphotericin in 20% lipid solution
    \nbeing as well tolerated as liposomal
    \namphotericin<\/p>\n","protected":false},"excerpt":{"rendered":"

    Fungizone CLINICAL USE Antifungal agent: Systemic fungal infections (yeasts and<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4018","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4018","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4018"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4018\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4018"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4018"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4018"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}