Ancobon 250mg Capsules

Flucytosine is a fluorinated pyrimidine analog. It is transported into fungal cells by cytosine permease. Inside the fungal cell, it is deaminated by the enzyme cytosine deaminase to 5-fluorouracil (5-FU). 5-FU is then metabolized into two active metabolites: 5-fluorodeoxyuridine monophosphate (5-FdUMP) and 5-fluorouridine triphosphate (5-FUTP). 5-FdUMP inhibits thymidylate synthetase, thereby interfering with fungal DNA synthesis. 5-FUTP is incorporated into fungal RNA, disrupting protein synthesis. Mammalian cells lack cytosine deaminase, which accounts for the selective toxicity of flucytosine to fungal cells.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of bleeding, including:
+ Vomiting or coughing up blood
+ Vomit that resembles coffee grounds
+ Blood in the urine
+ Black, red, or tarry stools
+ Bleeding from the gums
+ Abnormal vaginal bleeding
+ Unexplained bruises or bruises that increase in size
+ Uncontrollable bleeding
Signs of kidney problems, such as:
+ Inability to urinate
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Signs of low potassium levels, including:
+ Muscle pain or weakness
+ Muscle cramps
+ Abnormal heartbeat
Signs of low blood sugar, such as:
+ Dizziness
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Rapid heartbeat
+ Confusion
+ Hunger
+ Sweating
Chest pain or pressure
Shortness of breath, sudden weight gain, or swelling in the arms or legs
Confusion
Hallucinations (seeing or hearing things that are not there)
Seizures
Mood changes
Mouth irritation or mouth sores
Hearing loss
Changes in balance
Abnormal burning, numbness, or tingling sensations
Shakiness, difficulty moving, or stiffness
Severe and potentially life-threatening liver problems, characterized by:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it is essential to contact your doctor or seek medical attention if you notice any of the following:

Drowsiness
Dry mouth
Stomach pain or diarrhea
Upset stomach or vomiting
Decreased appetite
Headache
Fatigue or weakness

This list is not exhaustive, and you may experience other side effects not mentioned here. If you have concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you have a dihydropyrimidine dehydrogenase (DPD) deficiency, a condition that affects the body's ability to break down certain medications.

This is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to discuss all of the following with your doctor and pharmacist:

All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your existing health problems

Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to confirm that it is safe to do so. This will help prevent potential interactions and ensure the safe use of this medication.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Be sure to discuss any concerns or questions with your doctor.

This medication may interfere with certain laboratory tests, so it is crucial to notify all your healthcare providers and laboratory personnel that you are taking this drug.

One of the potential risks associated with this medication is that it may impair the bone marrow's ability to produce essential blood cells, leading to severe and potentially life-threatening bleeding problems or infections. If you experience any symptoms of infection, such as fever, chills, severe sore throat, ear or sinus pain, cough, increased or discolored sputum, painful urination, mouth sores, or a wound that does not heal, notify your doctor immediately. Additionally, if you notice any bruising or bleeding, or if you feel extremely tired or weak, seek medical attention right away.

As this medication may increase your risk of bleeding, it is essential to take precautions to avoid injury. Use a soft toothbrush and an electric razor to minimize the risk of bleeding. Furthermore, you may be more susceptible to infections, so it is crucial to practice good hygiene by washing your hands frequently and avoiding close contact with individuals who have infections, colds, or flu.

This medication may also increase your sensitivity to the sun, making you more prone to sunburn. Take necessary precautions when spending time outdoors, and inform your doctor if you experience any unusual sunburn or sensitivity.

Do not take this medication for longer than prescribed, as this may increase the risk of developing a secondary infection.

If you are pregnant, planning to become pregnant, or breastfeeding, it is essential to discuss the potential benefits and risks of this medication with your doctor to ensure the best possible outcome for you and your baby.

• Cytarabine (antagonizes the antifungal activity of flucytosine)

• Amphotericin B (can increase flucytosine toxicity by causing renal impairment, leading to reduced flucytosine excretion and higher serum levels; however, this combination is often used therapeutically for synergy)
• Myelosuppressive agents (e.g., chemotherapy, radiation therapy, other drugs causing bone marrow suppression): Increased risk of severe bone marrow depression (leukopenia, thrombocytopenia, anemia).

• Drugs that impair renal function (e.g., NSAIDs, cyclosporine, aminoglycosides): May decrease flucytosine excretion, leading to increased serum concentrations and potential toxicity.
• Zidovudine: Potential for increased hematologic toxicity.

• Not specifically documented for minor interactions; focus is on major and contraindicated interactions due to narrow therapeutic index.

• Nausea
• Vomiting
• Diarrhea (especially severe or bloody)
• Rash
• Fever
• Sore throat
• Unusual bleeding or bruising
• Fatigue or weakness (signs of anemia)
• Yellowing of skin or eyes (jaundice)
• Signs of infection (e.g., chills, persistent fever)

Category C. Flucytosine has shown teratogenic effects in animals. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Discuss risks and benefits with a healthcare provider.

Flucytosine is excreted in human breast milk. Due to the potential for serious adverse reactions in the nursing infant (e.g., bone marrow suppression), a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Flucytosine has been used in pediatric patients, including neonates and infants, for serious fungal infections. Dosing is typically weight-based (50-150 mg/kg/day). Close monitoring of serum concentrations, renal function, and hematologic parameters is crucial due to potential for toxicity and variability in drug clearance in this population.

Elderly patients are more likely to have decreased renal function, which can lead to reduced flucytosine clearance and increased risk of toxicity. Dose adjustments based on creatinine clearance are often necessary. Close monitoring of renal function, hematologic parameters, and serum drug levels is essential.

• Flucytosine is almost always used in combination with amphotericin B for serious systemic fungal infections (e.g., cryptococcal meningitis, severe candidiasis) to achieve synergistic antifungal activity and to prevent the development of resistance.
• Therapeutic drug monitoring (TDM) is strongly recommended due to its narrow therapeutic index and significant inter-patient variability in pharmacokinetics, especially in patients with renal impairment or those receiving amphotericin B.
• Bone marrow suppression (leukopenia, thrombocytopenia, anemia) is the most serious dose-limiting toxicity. Regular CBC monitoring is critical.
• Gastrointestinal side effects (nausea, vomiting, diarrhea) are common; taking the medication with food can help mitigate these.
• Resistance to flucytosine can develop rapidly when used as monotherapy, which is why combination therapy is preferred.

• Amphotericin B formulations (e.g., conventional, liposomal, lipid complex)
• Azole antifungals (e.g., fluconazole, voriconazole, posaconazole, itraconazole)
• Echinocandins (e.g., caspofungin, micafungin, anidulafungin)

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.