Mycomax is a modern drug for thrush and vaginal dysbacteriosis. It was developed by modern pharmacists on the basis of fluconazole, which is so afraid of urogenital infections. The main indications of this medicinal product cover the treatment of fungal infections. At the present stage, not only women and men, but also small children need such therapy. How and in what cases to take the medicine? What are the alternative medicines? Are there any contraindications?

Forms of release of the drug "Mycomax"

• Capsules for oral administration - dosage of 100 and 150 mg;
• Syrup - 500 mg of the active ingredient is contained in 100 ml of syrup;
• Solution for infusion - 200 mg fluconazole per 100 ml.

Mycomax in any form of release is stored in places that are not accessible to children. The storage period after the date of issue is no more than three years. The place is chosen dry, without direct sunlight. The drug is sold in pharmacies according to a doctor's prescription (there will be an instruction in the kit). Produced in the Czech Republic.

Indications for use

• Thrush (local fungal infection) or systemic candidiasis, including those accompanied by damage to internal organs;
• In addition to thrush, the medicine is effective against other fungal infections that affect the internal organs;
• Infections of a fungal nature against the background of immunodeficiency states in HIV and AIDS, cancer, when taking cytostatics, after transplantation of organs and tissues;
• Various forms of skin diseases (dermatomycosis), if local treatment does not give a positive result;
• Prevention of thrush in women.

Mycomax and thrush

This remedy is considered the first line medicine for the treatment of thrush. It can be used to treat fungus in adults of both sexes and children from the first days of life. At one time, experts recommend taking 50-100 mg of the drug. The frequency of receptions is one or two per day, and the duration of the course is about 2 weeks, but it is determined individually.

Attention: If it is necessary to treat thrush in children, the multiplicity and dose of the drug is determined for each clinical case, depending on the weight and age of the child (the instructions for use must contain this information).

Features of use for thrush

• Mycomax may be prescribed during pregnancy and during breastfeeding if the benefit to the mother's health outweighs the risk to the fetus or child;
• It is not recommended to take alcohol during the treatment course due to possible side effects (this is certainly reminded of the instructions for use);
• Mycomax is not addictive.

Mikomax: composition of the drug

According to the information contained in the instruction, it speaks of the following composition of Mycomax:

• It contains fluconazole as an active ingredient. It is a modern derivative of triazole. It is currently the most powerful blocker of sterol synthesis itself - a specific substance in fungal cells. Under such conditions, the cell wall of the causative agent of thrush is synthesized incorrectly, which ends with the death of a harmful microorganism.
• Titanium oxide, colloidal silicon oxide, povidone, corn starch are present as inactive substances in Mycomax.

Despite the fact that there are practically no contraindications, it is not the instructions for use, but a qualified doctor who should determine the dosage, the duration of the course and the frequency of doses. Even if there is confidence that it is the thrush that affects the body, self-medication should be abandoned. Fungi develop resistance to various medications, which further complicates the treatment of the disease. If you need individual advice, write to our specialists: they will be happy to answer all questions from readers.

Analogues of the drug "Mikomax"

Fluconazole is an active ingredient that is often prescribed for thrush. In pharmacology, in addition to Mycomax, there are other drugs with a similar spectrum of action that have the same indications for use. Among them:

• Mycosist;
• Flucostat;
• Itracon;
• Diflucan;
• Mifungar.

Contraindications and side effects

Mycomax has few contraindications as such: it is not recommended to take it only in cases of allergy to one of the components of the medication. Side effects are rarely observed. The studies of Mycomax do not describe cases of overdose, but in cases where there is a sharp deterioration in well-being, the medicine is canceled and the doctor is urgently consulted. In a medical institution, gastric lavage, forced diuresis, and hemodialysis should be performed.

Mycomax may cause the following side effects:

• Disorders in the work of the nervous system (headache, sleep problems, parasthesia, dizziness);
• Vomiting, pain in the abdomen, anorexia, nausea, very rarely - toxic hepatitis;
• Decrease in the number of platelets in the blood, blood clotting disorders;
• Various allergic reactions (usually simple urticaria, but sometimes anaphylactic shock) are usually in patients with immunological disorders.

Mikomax from thrush is a modern drug for systemic use, which has an antifungal effect. Created on the basis of the active ingredient fluconazole, which is a derivative of triazole. Mycomax is produced in the Czech Republic by the pharmaceutical company Zentiva. This drug is sold in many domestic pharmacies. Despite the fact that it is intended for non-prescription sale, before starting its use, a patient diagnosed with candidiasis should definitely consult with their doctor.

Chemical composition and dosage form

The active component of the drug Mycomax is a synthetic substance of the triazole class, which has a pronounced antifungal effect and is used in the treatment of candidiasis.

In addition, the product is made using sodium lauryl sulfate, lactose monohydrate, magnesium stearate, colloidal silicon dioxide, starch, gelatin, titanium dioxide, E131 food coloring and Atramentum nigrum black ink.

Unlike most drugs for thrush, which are available in the form of vaginal tablets or suppositories, Mycomax comes in the form of opaque capsules that should be taken orally. The concentration of fluconazole in them is 50 mg, 100 mg and 150 mg. The contents of the dosage form is a white or light yellow powder of a uniform consistency. The appearance of the capsules directly depends on the dosage of the active ingredient:

Mycomax antifungal capsules are packaged in blisters of 1, 3 or 7 pcs. Each blister with the agent is placed in an original cardboard pack and provided with a medical annotation approved by the Ministry of Health of the Russian Federation.

The effect of the drug, contraindications to its use

Fluconazole, which is part of Mycomax, is active against fungi of the genus Candida, which provoke the development of thrush in the fairer sex. When it enters the digestive tract, it is well absorbed and evenly distributed throughout the body, penetrating into all available tissues, organs and fluids. The bioavailability of fluconazole in plasma reaches 90%. Eating food does not affect the rate of absorption of the drug, so it can be taken regardless of food.

The maximum content of the active substance in the blood plasma occurs 30-90 minutes after taking the drug. The half-life of fluconazole averages 30 hours. The substance leaves the body mainly through the urinary tract unchanged.

Indications for the use of Mycomax in gynecology are:

• treatment of acute or chronic recurrent form of vaginal candidiasis, when the use of topical drugs is inappropriate;

Before starting treatment with Mycomax, the patient should make sure that she has no contraindications to this remedy. To do this, she needs to carefully read the annotation, which contains information about which categories of patients are not allowed to take this medication. The manufacturer strongly recommends not treating thrush with Mycomax under the following conditions:

Pregnant women and patients suffering from organic heart disease, renal or hepatic insufficiency, type II diabetes mellitus and ailments accompanied by impaired water and electrolyte balance should take Mycomax capsules for candidiasis under the constant supervision of a treating specialist. In order to avoid deterioration of the health status of these categories of patients, a careful dose adjustment of fluconazole is required.

Method of administration, undesirable effect and overdose

Mycomax with thrush should be taken orally with a sufficient amount of liquid. Capsules should be swallowed whole, without opening the shell and chewing. The dosage and duration of use of the drug may vary depending on the characteristics of the course of the disease. To achieve recovery, a woman should take Mycomax for vaginal candidiasis according to an individual treatment plan drawn up by a gynecologist.

The use of fluconazole can provoke a deterioration in the patient's well-being. Women who use capsules based on this component most often experience side effects in the form of:

• dizziness;
• headaches;
• dyspeptic disorders (pain in the peritoneum, intestinal disorders, flatulence, nausea, vomiting);
• allergies (skin rash, itching);
• increase in the content of ALT, AST and alkaline phosphatase in the blood.

In rare cases, women may experience complaints of insomnia, drowsiness, asthenia, general malaise, increased sweating, tremor of the limbs, decreased appetite, fever, alopecia, angioedema during the use of Mycomax.

The use of the drug in large doses for a long time can lead to convulsions, increased bilirubin levels, hepatitis, hepatocellular lesions, cholestasis, liver failure, anemia, agranulocytosis, thrombocytopenia, leukopenia, neutropenia. If deviations occur, the patient should stop using Mycomax and contact her gynecologist for a treatment correction.

An overdose of fluconazole leads to paranoid personality disorder and hallucinations. Symptomatic therapy is recommended for patients who have taken the drug in a large dose. Emergency care methods consist of gastric lavage, forced diuresis, and hemodialysis.

Drug interactions, analogues and storage conditions

Mycomax should be combined with other drugs with caution, since its active ingredient is able to interact with many other groups of drugs. Simultaneous administration of fluconazole with indirect anticoagulants, hydrochlorothiazide, theophylline, tacrolimus, cyclosporine, cisapride, rifabutin or short-acting benzodiazepines may lead to the development of undesirable effects from therapy. If a woman uses pills belonging to any of the listed groups, she should inform the specialist who prescribed fluconazole capsules for thrush.

Patients driving a car or working at potentially hazardous sites should be aware that taking Mycomax can cause dizziness, lethargy and other unpleasant symptoms that can reduce concentration. In this regard, they should abandon their activities for the entire period of treatment.

Mikomax has many structural analogues that can, if necessary, become a full-fledged replacement for it. These drugs include Fluconazole, Diflucan, etc. The active ingredient in these drugs is fluconazole. They, like Mycomax, are available in the form of oral capsules and are used in the fight against acute and.

Mikomax does not need special storage conditions. The manufacturer recommends keeping it in a place protected from moisture and sunlight at a temperature not exceeding 25 ° C. The shelf life of the drug is 36 months.

Fluconazole* (Fluconazole*)

ATX

J02AC01 Fluconazole

Pharmacological group

• Antifungals

3D images

Composition and form of release

in a blister pack 7 pcs. (for caps. 50 and 100 mg); 1 or 3 pcs. (for caps. 150 mg each); in a pack of cardboard 1 pack.

Description of the dosage form

Capsules of 50 mg: body - white opaque with black marking "MYKO 50"; cap - light blue opaque.

Capsules of 100 mg: body - white opaque with black marking "MYKO 100"; cap - blue opaque.

Capsules of 150 mg: body - white opaque with black marking "MYKO 150"; cap - blue opaque.

The contents of the capsule are powder from almost white to white with a yellowish tint.

pharmachologic effect

Pharmacological action - antifungal.

Pharmacodynamics

Fluconazole, a member of the triazole antifungal class, is a potent selective inhibitor of sterol synthesis in fungal cells.

The drug is effective in opportunistic mycoses, incl. caused by Candida spp., Cryptococcus neoformans, Microsporum spp., Trichophyton spp. Fluconazole has also been shown to be active in models of endemic mycoses, including infections caused by Blastomyces dermatitidis, Coccidiodes immitis, and Histoplasma capsulatum.

Pharmacokinetics

After oral administration, fluconazole is well absorbed, its bioavailability is 90%. Cmax after oral administration on an empty stomach at a dose of 150 mg is 90% of the content in plasma when administered intravenously at a dose of 2.5–3.5 mg / l. Simultaneous food intake does not affect the absorption of the drug taken orally. Cmax in plasma is achieved within 0.5-1.5 hours after administration.

T1 / 2 of fluconazole is about 30 hours. Plasma concentrations are directly proportional to the dose. 90% level of equilibrium concentration is achieved by 4-5 days of treatment with the drug (when taken 1 time / day).

The introduction of a loading dose (on the first day), 2 times the usual daily dose, allows you to reach a level corresponding to 90% of the equilibrium concentration by the second day. The apparent volume of distribution approaches the total body water content. Plasma protein binding - 11-12%.

Fluconazole penetrates well into all body fluids. Concentrations of the drug in saliva and sputum are similar to its levels in plasma. In patients with fungal meningitis, the content of fluconazole in the cerebrospinal fluid reaches 80% of its plasma level.

In the stratum corneum, epidermis, dermis and sweat fluid, high concentrations are achieved that exceed serum levels.

Fluconazole is excreted mainly by the kidneys; Approximately 80% of the administered dose is excreted in the urine unchanged. Fluconazole clearance is proportional to creatinine clearance. Fluconazole metabolites were not detected in peripheral blood.

Indications for Mycomax®

cryptococcosis, including cryptococcal meningitis and other localizations of this infection (including in the lungs, on the skin), both in patients with a normal immune response and with various forms of immunosuppression (including in patients with AIDS, with organ transplantation ); the drug can be used to prevent cryptococcal infection in patients with AIDS;

generalized candidiasis, including candidemia, disseminated candidiasis and other forms of invasive candidal infections (infections of the peritoneum, endocardium, eyes, respiratory and urinary tract); candiduria, . Treatment can be carried out in patients with malignant neoplasms, patients in intensive care units, patients undergoing a course of cytostatic or immunosuppressive therapy, as well as in the presence of other factors predisposing to the development of candidiasis;

candidiasis of the mucous membranes, incl. oral cavity and pharynx (including atrophic candidiasis of the oral cavity associated with wearing dentures), esophagus, non-invasive bronchopulmonary candidiasis; prevention of recurrence of oropharyngeal candidiasis in patients with AIDS;

genital candidiasis: vaginal candidiasis (acute and chronic recurrent), prophylactic use to reduce the frequency of recurrence of vaginal candidiasis (3 or more episodes per year); candidal balanitis;

prevention of fungal infections in patients with malignant neoplasms who are predisposed to such infections as a result of chemotherapy with cytostatics or radiation therapy;

mycoses of the skin, including mycoses of the feet, body, inguinal region, pityriasis versicolor, onychomycosis; skin candidiasis;

deep endemic mycoses, including coccidioidomycosis, paracoccidioidomycosis, sporotrichosis and histoplasmosis in patients with normal immunity.

Contraindications

hypersensitivity to the drug or azole compounds similar in structure;

concomitant use of terfenadine or astemizole and other drugs that prolong the QT interval;

children's age (up to 3 years).

With caution: hepatic and / or renal failure, concomitant use of potentially hepatotoxic drugs, alcoholism.

Use during pregnancy and lactation

The use of the drug in pregnant women is not advisable, except for severe or life-threatening forms of fungal infections, if the intended effect outweighs the possible risk to the fetus.

Fluconazole is found in breast milk at the same concentration as in plasma, so its administration during lactation is not recommended.

Side effects

On the part of the digestive system: changes in taste, vomiting, nausea, diarrhea, flatulence, abdominal pain, rarely - liver dysfunction (jaundice, hepatitis, hepatonecrosis, hyperbilirubinemia, increased activity of ALT, AST, alkaline phosphatase).

From the nervous system: headache, dizziness, rarely - convulsions.

On the part of the hematopoietic organs: rarely - leukopenia, thrombocytopenia, neutropenia, agranulocytosis.

Allergic reactions: skin rash, rarely - malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), anaphylactoid reactions.

Others: rarely - impaired renal function, alopecia, hypercholesterolemia, hypertriglyceridemia, hypokalemia.

Interaction

When using fluconazole with warfarin, PT increases (by an average of 12%). In this regard, it is recommended to carefully monitor the parameters of PT in patients receiving the drug in combination with coumarin anticoagulants.

Fluconazole increases the plasma half-life of oral hypoglycemic sulfonylureas (chlorpropamide, glibenclamide, glipizide, tolbutamide) in healthy subjects. The combined use of fluconazole and oral hypoglycemic agents in diabetic patients is allowed, but the doctor should keep in mind the possibility of developing hypoglycemia.

The simultaneous use of fluconazole and phenytoin can lead to an increase in plasma concentrations of phenytoin to a clinically significant degree. Therefore, if it is necessary to use these drugs together, it is necessary to monitor the concentration of phenytoin with a dose adjustment in order to maintain the level of the drug within the therapeutic interval.

The combination with rifampicin leads to a decrease in AUC by 25% and a shortening of T1 / 2 of fluconazole from plasma by 20%. Therefore, in patients receiving concomitant rifampicin, it is advisable to increase the dose of fluconazole.

It is recommended to monitor the concentration of cyclosporine in the blood in patients receiving fluconazole, because. the use of fluconazole and cyclosporine in patients with a transplanted kidney (when taking fluconazole at a dose of 200 mg / day) leads to a slow increase in the concentration of cyclosporine in plasma.

Patients who receive high doses of theophylline or who are likely to develop theophylline intoxication should be monitored for early detection of symptoms of theophylline overdose, tk. taking fluconazole leads to a decrease in the average rate of clearance of theophylline from plasma.

With the simultaneous use of fluconazole and terfenadine, cisapride, cases of adverse reactions from the heart, including paroxysms of ventricular tachycardia (torsades de pointes), are described.

The simultaneous use of fluconazole and hydrochlorothiazide can lead to an increase in the concentration of fluconazole in plasma by 40%.

There are reports of the interaction of fluconazole and rifabutin, accompanied by an increase in serum levels of the latter. With the simultaneous use of fluconazole and rifabutin, cases of uveitis have been described. It is necessary to carefully monitor patients who simultaneously receive rifabutin and fluconazole.

In patients receiving a combination of fluconazole and zidovudine, there is an increase in the concentration of zidovudine, which is caused by a decrease in the conversion of the latter to its main metabolite, so an increase in the side effects of zidovudine should be expected.

Dosage and administration

Adults with cryptococcal meningitis and cryptococcal infections of other localizations are usually prescribed 400 mg on the first day, and then continue treatment at a dose of 200-400 mg 1 time / day. The duration of treatment for cryptococcal infections depends on clinical efficacy, confirmed by mycological examination; in cryptococcal meningitis, it is usually continued for at least 6–8 weeks.

For the prevention of recurrence of cryptococcal meningitis in AIDS patients, after completion of the full course of primary treatment, fluconazole is prescribed at a dose of 200 mg / day for a long period of time.

With candidemia, disseminated candidiasis and other invasive candidal infections, the dose is usually 400 mg on the first day, and then 200 mg each. With insufficient clinical efficacy, the dose of the drug can be increased to 400 mg / day. The duration of therapy depends on clinical efficacy.

With oropharyngeal candidiasis, the drug is usually prescribed at 50-100 mg 1 time / day; the duration of treatment is 7–14 days. If necessary, in patients with a pronounced decrease in immunity, treatment may be longer.

In atrophic oral candidiasis associated with the wearing of dentures, fluconazole is usually prescribed 50 mg 1 time / day for 14 days in combination with local antiseptic agents for the treatment of the prosthesis.

In other localizations of candidiasis (with the exception of genital candidiasis), for example, with esophagitis, non-invasive bronchopulmonary lesions, candiduria, candidiasis of the skin and mucous membranes, etc., the effective dose is usually 50-100 mg / day with a treatment duration of 14-30 days. To prevent recurrence of oropharyngeal candidiasis in patients with AIDS, after completing the full course of primary therapy, the drug can be prescribed 150 mg once a week.

With vaginal candidiasis, fluconazole is taken once orally at a dose of 150 mg. To reduce the frequency of recurrence of vaginal candidiasis, the drug can be used at a dose of 150 mg once a month. The duration of therapy is determined individually; it varies from 4 to 12 months. Some patients may require more frequent use.

For balanitis caused by Candida, fluconazole is prescribed as a single dose of 150 mg orally.

For the prevention of candidiasis, the recommended dose of fluconazole is 50-400 mg 1 time / day, depending on the risk of developing a fungal infection. In the presence of a high risk of generalized infection, for example, in patients with expected severe or long-lasting neutropenia, the recommended dose is 400 mg 1 time / day. Fluconazole is prescribed a few days before the expected onset of neutropenia; after an increase in the number of neutrophils over 1000/mm3, treatment is continued for another 7 days.

For skin mycoses, including mycoses of the feet, skin of the inguinal region, and skin candidiasis, the recommended dose is 150 mg 1 time per week or 50 mg 1 time / day. The duration of therapy in normal cases is 2-4 weeks, however, with mycoses of the feet, longer therapy (up to 6 weeks) may be required.

With pityriasis versicolor - 300 mg 1 time per week for 2 weeks, some patients require a third dose of 300 mg per week, while in some cases a single dose of 300-400 mg is sufficient; an alternative treatment regimen is the use of 50 mg 1 time per day for 2-4 weeks.

For onychomycosis, the recommended dose is 150 mg once a week. Treatment should be continued until replacement of the infected nail (growth of an uninfected nail). It takes 3–6 and 6–12 months for the re-growth of fingernails and toenails, respectively.

With deep endemic mycoses, it may be necessary to use the drug at a dose of 200-400 mg / day for up to 2 years. The duration of therapy is determined individually; it can be 11–24 months - with coccidioidomycosis; 2–17 months - with paracoccidioidomycosis; 1-16 months - with sporotrichosis and 3-17 months - with histoplasmosis.

In children, as in similar infections in adults, the duration of treatment depends on the clinical and mycological effect. In children, the drug should not be used in a daily dose that would exceed that in adults. The drug is used daily 1 time / day.

For the treatment of generalized candidiasis or cryptococcal infection, the recommended dose is 6-12 mg / kg / day, depending on the severity of the disease.

For the prevention of fungal infections in children with reduced immunity, in whom the risk of developing an infection is associated with neutropenia that develops as a result of cytotoxic chemotherapy or radiation therapy, the drug is prescribed at 3–12 mg / kg / day, depending on the severity and duration of induced neutropenia.

In children with impaired renal function, the daily dose of the drug should be reduced (in the same proportional relationship as in adults) in accordance with the severity of renal failure.

In elderly patients in the absence of impaired renal function, the usual dosing regimen of the drug should be followed. Patients with renal insufficiency (Cl creatinine -

The use of the drug in patients with impaired renal function

Fluconazole is excreted mainly in the urine unchanged. With a single dose, a dose change is not required. When re-administering the drug to patients with impaired renal function, you should first enter a loading dose of 50 to 400 mg. If Cl creatinine is> 50 ml / min, the usual dose of the drug is used (100% of the recommended dose). With Cl creatinine from 11 to 50 ml / min, a dose equal to 50% of the recommended one is applied. Patients who are regularly on dialysis, one dose of the drug is applied after each session of hemodialysis.

Overdose

Symptoms: hallucinations, paranoid behavior.

Treatment: symptomatic, gastric lavage, forced diuresis. Hemodialysis within 3 hours reduces the plasma concentration by approximately 50%.

special instructions

In rare cases, the use of fluconazole was accompanied by toxic changes in the liver, incl. with a fatal outcome, mainly in patients with serious concomitant diseases. In the case of hepatotoxic effects associated with fluconazole, there was no obvious dependence on the total daily dose, duration of therapy, sex and age of the patient. The hepatotoxic effect of fluconazole was usually reversible; its signs disappeared after cessation of therapy. If there are clinical signs of liver damage that may be associated with fluconazole, the drug should be discontinued.

AIDS patients are more likely to develop severe skin reactions with many drugs. In cases where a rash develops in patients with a superficial fungal infection and is regarded as definitely related to fluconazole, the drug should be discontinued. If a rash occurs in patients with invasive / systemic fungal infections, they should be carefully monitored and fluconazole should be discontinued if bullous changes or erythema multiforme appear.

Caution must be exercised when taking fluconazole with cisapride, rifabutin or other drugs metabolized by the cytochrome P450 system.

Storage conditions for Mycomax®

In a dry, dark place, at a temperature not exceeding 25 °C.

Keep out of the reach of children.

Shelf life of Mycomax®

Do not use after the expiry date stated on the packaging.

Composition, action and form of release

The pharmaceutical product "Mycomax" is produced in the form of syrup and capsules of 50-200 mg. The components of the medication are:

• fluconazole;
• milk sugar;
• starch that has undergone a gelatinization process;
• aerosil;
• food additive E572;
• sodium dodecyl sulfate.

The drug has a beneficial effect on the microflora.

The main purpose of the medical preparation "Mycomax" is to destroy the fungal infection and thereby prevent the development of various fungal pathologies. The chemical composition of the drug completely destroys the structure of the fungus and prevents further growth of its cells. Penetrating into the digestive tract, the capsule instantly dissolves, and its components gradually move through the intestines, and through the muscle tissue penetrate into the vagina. There, the medicinal components begin to fight pathogenic microorganisms and completely destroy the infection, while restoring the vaginal microflora.

The patient's condition improves after taking 2 capsules (150 mg each) of Mycomax, that is, already on the 2nd day. When the medicine does its job and there is no trace of a fungal infection, Mycomax will begin to be excreted from the body through the activity of the kidneys. The described medication is well tolerated, and side symptoms occur extremely rarely.

Observing a negative reaction of the body to the use of "Mycomax", it is necessary to suspend treatment and consult your doctor.

Indications and contraindications

Instructions for use "Mycomax" with thrush

The drug can be used in conjunction with antibacterial drugs.

You can take Mycomax tablets for the treatment of thrush at any time of the day, regardless of the meal. To achieve the desired effect of therapy, it is enough to drink 1 capsule per day. It is allowed to use the medicine for prevention purposes. Then the duration of the prophylactic course can reach several months.

In the acute form of thrush, one capsule of Mycomax should be taken a month before the onset of menstruation. The duration of such treatment is 4-6 months and depends on the severity of the course of the disease, as well as the individual characteristics of the patient's body. Therefore, only a qualified physician can determine the period of the treatment course and the safe dosage.

Modern doctors prescribe Mikomax as an aid to patients who take antibiotics in order to prevent a violation of the vaginal microflora. It is known that the antibiotic has a detrimental effect not only on pathogenic microorganisms, but also affects beneficial bacteria, thereby provoking the development of thrush. With antibiotics, Mikomax is prescribed 300 mg or 150 mg each, if you start taking it before starting antibiotic therapy.

Adverse reactions

When treating thrush with Mycomax, the following negative phenomena may occur:

• dizziness;
• frequent loose stools;
• painful bloating;
• headache;
• rashes on the skin;
• nausea;
• convulsive conditions;
• gagging;
• impaired activity of the kidneys and liver;
• sleep disturbance;
• change in taste preferences.

special instructions

For patients with kidney disease, use the medication under the supervision of a physician.

Before using Mikomax to eliminate candidal colpitis, you should familiarize yourself with the features of its use. Thus, persons with functional disorders of the liver and kidneys require special monitoring of the state of these organs. The patient undergoes regular laboratory tests, which are necessary so that at the first sign of a violation of the liver or kidneys, stop further medication.

It is strictly contraindicated to use alcohol-containing drinks during the elimination of a fungal infection with the pharmaceutical preparation "Mycomax". The ban on alcohol is due to the fact that ethyl alcohol blocks the enzymes that promote the absorption of the medicinal substance, and thereby reduces the effectiveness of the drug.

Compound

One capsule may contain 50 mg 100 mg or 150 mg fluconazole. Additionally: lactose monohydrate, pregelatinized starch, colloidal silicon dioxide, sodium lauryl sulfate, magnesium stearate.

One milliliter of infusion solution contains 2 mg of fluconazole. Additionally: sodium chloride, injection water.

Release form

Mycomax is produced in the form of tablets of 50 mg and 100 mg No. 7 in a blister and 150 mg No. 1 or No. 3 in a blister, as well as in the form of an injection solution of 100 ml No. 1.

pharmachologic effect

Antimycotic (antifungal).

Pharmacodynamics and pharmacokinetics

The drug Mycomax, with the active ingredient fluconazole, is a representative of the class of antimycotic atriasol therapeutic agents that have a powerful selective inhibitory effect on the synthesis of ergosterol occurring in the cell membranes of micromycetes (fungi). The antifungal mechanism of action of fluconazole is based on its ability to specifically inhibit the activity of the P-450 isoenzyme fungal system.

The effectiveness of the drug is observed in relation to opportunistic mycoses, including mycoses provoked by fungi: the genus Candida (Candida spp.), including their generalized forms, manifested against the background of immunosuppression; genus Cryptococcus (Cryptococcus neoformans), including those with intracranial infections; Trichophyton genus (Trichophyton spp.) and Microsporum genus (Microsporum spp.). Also, the effectiveness of fluconazole is noted in relation to endemic mycoses caused by fungi: the genus coccidioides (Coccidiodes immitis), including intracranial infections; Blastomyces genus (Blastomyces dermatilidis) and Histoplasma genus (Histoplasma capsulalum), including their manifestation in immunosuppression.

There are reports of episodes of superinfection caused by fungi of the genus Candida, not belonging to the species Candida albicans (vaginal candidiasis, thrush), which often exhibit natural resistance to the action of fluconazole (in particular Candida krusei). In such cases, it may be necessary to prescribe alternative antifungal medications.

Fluconazole is characterized by high specificity with respect to the isoenzymes of the P450 system of the fungus and a minimal effect on these isoenzymes in the human body. So single and repeated use of 50 mg of fluconazole does not affect the metabolism of antipyrine. Daily intake of 50 mg of fluconazole for 28 days did not lead to a change in the plasma level of testosterone in men or sex hormones in women of childbearing age. The use of fluconazole at a daily dose of 200-400 mg was not accompanied by a clinically significant change in the level of endogenous steroids and fundamentally affected the hormonal response of healthy men to the administration of ACTH.

When taken orally, there is a fairly rapid and complete absorption of fluconazole in the gastrointestinal tract. Bioavailability is at the level of 90%. Plasma Cmax, with internal administration of 150 mg of fluconazole on an empty stomach, is 90% in comparison with this indicator observed with intravenous administration of a similar dose. In parallel, the food taken does not affect the absorption of the drug. TCmax varies within 30-90 minutes.

With internal and / in the application in all biological fluids of the human body, a high concentration of fluconazole is recorded. In sputum and saliva, its level corresponds to the plasma content. The plasma concentration of fluconazole is dose-dependent. In patients with fungal meningitis, the level of fluconazole in the cerebrospinal fluid reaches 80% of its plasma concentration. Css at the level of 90% is achieved after 4-5 days with a daily single dose of fluconazole.

In the case of a loading dose of fluconazole (twice as high as usual) on the first day of therapy, Css at the level of 90% is noted already on the second day. Vd approaches the total water level in the human body. Communication with plasma proteins is carried out by 11-12%.

Fluconazole is found in sweat, stratum corneum, dermis and epidermis at concentrations exceeding plasma values. With a single dose of 150 mg of fluconazole per week, its concentration in the stratum corneum was 23.4 μg / g, and when the same dose was repeated after 7 days, it was already 7.1 μg / g. After a 4-month therapy with a single dose per week of fluconazole at a dose of 150 mg, its concentration in healthy nails was 4.05 µg/g, and in infected nails 1.8 µg/g. Six months after discontinuation of the drug, the concentration in the nails of fluconazole was still measurable.

T1 / 2 is approximately 30 hours. Excretion of fluconazole is mainly carried out by the kidneys (approximately 80% in unchanged form). Fluconazole clearance corresponds to creatinine clearance. Metabolic products of the drug in the peripheral blood were not detected.

Indications for use

Tablets and infusion solution Mikomax are indicated for use in:

• generalized candidiasis, including disseminated candidiasis, candidemia and other invasive candidal infections of tissues / organs (endocardium, spleen, peritoneum, urinary tract, eyes, liver, respiratory tract, etc.), including in patients with diagnosed malignant tumors, immunosuppression and other conditions, predisposing to the occurrence of candidiasis;
• cryptococcosis, including pulmonary and skin forms of this infection, as well as cryptococcal meningitis, including those observed with immunosuppression (organ transplantation, AIDS);
• candidiasis of the mucous membranes of the esophagus, mouth / pharynx, candiduria, bronchopulmonary non-invasive candidiasis, skin candidiasis, including patients with immunosuppression and prevention of relapses of oropharyngeal candidiasis in AIDS patients;
• candidal balanitis;
• vaginal candidiasis in chronic recurrent form and acute form, as well as for their prophylactic recurrence of this mycotic infection;
• passage by patients with malignant neoplasms of radiation or chemotherapy using cytostatics, as a result of which the risk of fungal infections increases (for the purpose of prevention);
• skin mycoses, including mycoses of the body, inguinal region and feet;
• skin candidiasis;
• onychomycosis and pityriasis versicolor;
• endemic deep mycoses, including histoplasmosis, coccidioidomycosis, sporotrichosis and paracoccidioidomycosis in patients with normal immunity.

Contraindications

Mycomax is contraindicated for use in:

• personal hypersensitivity to fluconazole, structurally similar azole compounds or other auxiliary ingredients of tablets or infusion solution;
• pregnancy;
• combined use of terfenadine (for dosages over 400 mg of fluconazole 24 hours), as well as cisapride and astemizole (due to a possible increase in the QT interval and the occurrence of ventricular tachycardias);
• breastfeeding;
• any hereditary sugar intolerance;
• body weight of the patient up to 40 kilograms, mainly in childhood (for tablets of 100 mg and 150 mg).

Mikomax should be administered with caution when:

• liver failure;
• concomitant use of terfenadine (for dosages less than 400 mg fluconazole 24 hours);
• renal failure (adjustment of the dosage regimen is necessary);
• proarrhythmogenic pathologies in patients with numerous risk factors (fluid and electrolyte imbalance, organic heart pathologies, concurrent use of medications that cause arrhythmias);
• ongoing therapy with the use of oral hypoglycemic therapeutic agents, sulfonylurea derivatives (only under the control of blood glucose levels, sometimes with adjustment of hypoglycemic therapy, due to the possible development of hypoglycemia).

Side effects

Sometimes when using Mycomax observed:

• general weakness;
• anaphylactoid reactions;
• motor restlessness;
• Lyell's syndrome;
• muscle weakness;
• neutropenia;
• fever
• hypokalemia;
• Stevens-Johnson syndrome;
• leukopenia;
• convulsions;
• hypercholesterolemia;
• paresthesia;
• thrombocytopenia;
• tremor;
• myalgia;
• constipation;
• agranulocytosis;
• vertigo;
• hypertriglyceridemia;
• insomnia / drowsiness;
• flickering / flutter of the ventricles;
• headache;
• kidney failure;
• dizziness;
• skin rash/itching;
• liver failure;
• taste change;
• alopecia;
• nausea/vomiting;
• hyperhidrosis;
• diarrhea / flatulence;
• an increase in the QT interval;
• abdominal pain;
• angioedema;
• liver necrosis.

Mikomax, instructions for use (Method and dosage)

Instructions for use of Mycomax involves oral administration of the drug tablets and intravenous administration of the solution in the form of infusions (with a solvent at a rate of not more than 20 mg per minute). The transfer of a patient from one dosage form to another does not require changes in the dosage regimen.

For adult patients

In the treatment of cryptococcal meningitis and other cryptococcal infections, on the first day, as a rule, 400 mg of Mycomax are prescribed, after which a single application of 200-400 mg per 24 hours is practiced. The duration of therapy is affected by the clinical efficacy of the drug, confirmed by mycological studies. Cryptococcal meningitis usually responds to treatment for at least 6-8 weeks. For the prevention of recurrence of cryptococcal meningitis in patients with AIDS, after the end of the primary therapeutic course, 200 mg of Mycomax is prescribed every 24 hours for a long time.

With candidiasis / pharynx, a single daily use of 100 mg of fluconazole for 7-14 days is indicated. Patients with a pronounced decrease in immunity may require a longer course of treatment.

For the treatment of disseminated candidiasis, candidemia and other invasive candidiasis, 400 mg of Mycomax are usually prescribed on the first day, after which they switch to 200 mg every 24 hours. With unsatisfactory clinical efficacy, an increase in the daily dose to 400 mg is allowed. In the case of life-threatening candidal infections, the single daily dose can be increased to 800 mg. The duration of treatment is determined in accordance with the observed clinical efficacy.

With candidiasis of other localizations (except genital candidiasis), including skin candidiasis, non-invasive bronchopulmonary lesions, esophagitis, candiduria, mucosal candidiasis, etc., it would be advisable to use 100 mg of fluconazole daily for 14-30 days.

Prevention in patients with AIDS of possible recurrence of oropharyngeal candidiasis requires weekly use of 150 mg of Mycomax, after completion of the full primary course of therapy.

Vaginal candidiasis (thrush) can be treated with a single dose of Mycomax 150 mg. To reduce the frequency of relapses, a similar dose of the drug should be taken once a month (as an alternative, candles containing fluconazole can be used). The duration of therapy is set on an individual basis and, as a rule, varies within 4-12 months. Treatment of some women may require more frequent use of the drug or additional administration of suppositories with fluconazole.

In the treatment of candidal balanitis, a single application of 150 mg of Mycomax is most often sufficient.

Prevention of candidiasis, given the risk of developing a fungal infection, is carried out in single doses of 50-400 mg. At high risk of generalized infection, for example, in patients with expected prolonged or severe neutropenia, it is recommended to use a dose of 400 mg, which is prescribed a few days before the expected neutropenia. With an increase in the number of neutrophils by more than 1000/mm3, Mycomax is continued for another 7 days.

For skin mycoses, including mycoses of the body, inguinal region and feet, the recommended weekly single dose is 150 mg, used for 2-4 weeks. Some athlete's foot may require longer treatment (up to 6 weeks).

Onychomycosis is treated with a single weekly dose of 150 mg. Treatment continues until the complete replacement of the infected nail with a healthy one. As a rule, this process, due to individual characteristics and age, takes from 3 to 6 months, and sometimes up to 12 months (with the treatment of the big toe nail). After a complete replacement of the nail plate, its deformed shape may remain.

In the treatment of pityriasis versicolor, a single weekly dose is usually 300 mg taken for 2 weeks. For some patients, a single dose of 300-400 mg of Mycomax is enough, others may need a three-time intake of 300 mg. As an alternative, the use of a therapeutic regimen that takes 2-4 weeks with the intake of 50 mg of Mycomax per 24 hours is practiced.

With endemic deep mycoses, prolonged therapy (up to 2 years) is carried out with the use of 200-400 mg of Mycomax per 24 hours. The duration of treatment is individual for each patient and may vary: 3-17 months for the treatment of histoplasmosis; 2-17 months for the treatment of paracoccidioidomycosis; 1-16 months for the treatment of sporotrichosis; 11-24 months for the treatment of coccidioidomycosis.

For kids

The duration of the use of Mycomax in pediatrics also depends on the mycological and clinical efficacy. Children should not be prescribed daily dosages of the drug that exceed those in adult patients in the treatment of similar infections. In childhood, the dosage of Mycomax is calculated per kilogram of the child's weight and is recommended to be taken once every 24 hours.

During the treatment of mucosal candidiasis, 3 mg / kg is prescribed daily. On the first day of treatment, to achieve a rapid equilibrium concentration, it is recommended to use a shock dosage of fluconazole 6 mg / kg.

In the treatment of cryptococcal mycosis and generalized candidiasis, depending on the observed severity of the disease, it is recommended to take 6-12 mg / kg per day.

Prevention of childhood mycotic infections with reduced immunity, with a risk of their occurrence associated with neutropenia, which may develop as a result of chemotherapy using cytostatics or radiation therapy, is carried out at a daily dosage of 3-12 mg / kg (consistent with the duration and severity of induced neutropenia).

For elderly patients

Elderly patients with normal renal function do not need to adjust the dosage of Mycomax.

For patients with kidney failure

A single use of Mycomax by patients of all age categories with a CC of more than 50 ml / min does not require changes in its dosage. Course therapy of patients of all age categories with impaired renal function is carried out with the initial use of a loading dose in the range of 50-400 mg (depending on the observed mycotic infection). In the future, with a CC of 11-50 ml / min, a dose of fluconazole is prescribed, which is 50% of the recommended dosage of the drug used to treat a particular fungal infection. Patients regularly undergoing hemodialysis are shown the appointment of the usual doses of Mycomax, used after each dialysis session.

Overdose

With an overdose of Mycomax, hallucinations and paranoid manifestations may occur.

Symptomatic treatment is shown, including cleaning of the gastrointestinal tract and forced diuresis. With a 3-hour procedure of hemodialysis of blood plasma, approximately 50% of fluconazole is excreted.

Interaction

The combined use of indirect anticoagulants, coumarin derivatives (for example, Warfarin) can provoke an increase in prothrombin time, which requires constant monitoring of this indicator.

The parallel use of some azoles with terfenadine, due to an increase in the QT interval on the ECG, led to serious cardiac arrhythmias, including torsades de pointes. Conducted studies of fluconazole did not reveal an increase in the QT interval when it was taken at a daily dose of 200 mg. Taking fluconazole in dosage ranges of 400-800 mg led to a significant increase in the serum content of terfenadine. In this regard, the combined use of terfenadine and fluconazole at doses of less than 400 mg requires careful monitoring, and is contraindicated at doses of the drug above 400 mg.

With the combined use of fluconazole and astemizole, as well as other therapeutic agents metabolized by cytochrome P450 isoenzymes, an increase in their serum concentrations is not excluded, and therefore, such a combination of drugs requires constant monitoring of their plasma content and timely adjustment of dosages when it changes.

Hydrochlorothiazide is able to increase the plasma level of fluconazole by 40%, however, this combination of drugs does not need to change the dosage of Mycomax.

With the combined use of Mycomax with oral hypoglycemic drugs, sulfonylurea derivatives (glipizide, Glibenclamide, tolbutamide, etc.), an increase in their plasma content and T1 / 2 was observed. For this reason, with this combination of therapeutic drugs, the likelihood of hypoglycemia should be taken into account and blood glucose levels should be carefully monitored. In some cases, it may be necessary to change the dosage regimen of the hypoglycemic drug taken.

Fluconazole increases the plasma levels of co-administered midazolam, which may cause psychotic symptoms. The effect of this interaction is more pronounced in the case of oral administration of midazolam, compared with the / in the introduction of this drug, and may require a reduction in its dosages.

The concomitant administration of fluconazole and phenytoin resulted in a clinically significant increase in the serum levels of the latter. With the joint appointment of these drugs, it is necessary to monitor the plasma concentration of phenytoin and adjust its dosage regimen in a timely manner.

The combined use of Rifampicin reduces the plasma content of fluconazole by 25% and reduces its T1 / 2 by about 20%, which requires an increase in the dosage of Mycomax.

Co-administration of fluconazole and Rifabutin leads to an increase in the serum level of rifabutin, which may be the cause of uveitis. In this regard, the combined use of these therapeutic agents requires constant monitoring.

There are reports of the development of negative cardiac events (including torsades de pointes) provoked by the simultaneous use of fluconazole and cisapride. Conducted controlled studies have shown a significant increase in serum levels of cisapride and an increase in the QT interval with a single daily intake of 200 mg of fluconazole and a parallel four-time daily intake of 20 mg of cisapride. Due to this interaction effect of these drugs, their simultaneous use is contraindicated.

In patients with a transplanted kidney, the combined use of cyclosporine and a daily dose of fluconazole 200 mg led to a slight increase in the plasma level of cyclosporine. At the same time, in patients with bone marrow transplantation taking fluconazole at a daily dosage of 100 mg, the serum level of cyclosporine changed. For this reason, if it is necessary to simultaneously use Mycomax and cyclosporine, the plasma concentration of the latter should be constantly monitored.

Fluconazole may increase the serum levels of Theophylline. The use of 200 mg of Mycomax for 14 days led to a decrease in the average serum clearance of theophyllinane by 18%. In this regard, patients receiving high doses of theophylline, as well as patients with the likelihood of developing theophylline intoxication, require constant monitoring for the timely detection of symptoms of theophylline overdose.

High doses of fluconazole (above 400 mg) clinically significantly increase the plasma content of zidovudine, due to a decrease in its conversion to the main metabolite, which can lead to an aggravation of the side effects of zidovudine. When a patient uses such a combination of drugs, regular monitoring of his condition is necessary for the formation of zidovudine-negative side effects associated with zidovudine.

The use of fluconazole increases the serum concentration of tacrolimus, which can lead to clinical manifestations of its toxicity (hyperglycemia, nephrotoxicity, hyperkalemia). In this case, it may be necessary to reduce the dosage of co-administered tacrolimus.

Concurrent administration of 50 mg of fluconazole and oral contraceptives did not reveal significant changes in serum concentrations of levonorgestrel and ethinyl estradiol. When taking 200 mg of the drug, an increase of 24% AUC of levonorgestrel and 40% AUC of ethinyl estradiol was noted. As a result of this, a significant effect of fluconazole on the contraceptive effectiveness of oral contraceptives is not expected.

Conducted studies of the interaction of Mycomax did not reveal a significant decrease in the absorption of fluconazole with parallel food intake, the use of Cimetidine, or whole-body irradiation before bone marrow transplantation.

The attending physician prescribing Mycomax should take into account the possible development of its other interactions, since studies of the combination of Mycomax with other medicinal products have not been conducted.

Terms of sale

Mycomax tablets can be purchased without a doctor's prescription, and an infusion solution upon presentation of one.

Storage conditions

The storage temperature of tablets should not exceed 25 ° C, and be in the range of 10-25 ° C for infusion solution.

Best before date

Both dosage forms of Mycomax are subject to storage for 3 years.

special instructions

All of the above indications for the use of the therapeutic drug Mycomax require continued therapy with its use until the onset of complete remission, confirmed by clinical and laboratory parameters. Premature discontinuation of Mycomax often leads to relapses. At the entire stage of the treatment, it is necessary to monitor the functionality of the kidneys / liver of the patient and monitor his hematological parameters.

In rare cases, during fluconazole therapy, liver changes of a toxic nature, which can lead to death, were observed. Such changes were mainly noted in patients with serious comorbidities. The detected hepatotoxic effects of fluconazole did not significantly depend on the use of the total daily dose, duration of therapy, age and sex of the patient. As a rule, the hepatotoxic effect of the drug was reversible with the disappearance of signs after the end of treatment. If any violation of the hepatic / renal function occurs against the background of the use of Mycomax, the ongoing therapy should be interrupted.

Patients with AIDS are more susceptible to the formation of severe skin manifestations with the use of various therapeutic agents. If a rash develops in a patient with a superficial mycotic infection associated with the use of Mycomax, the ongoing therapy should be discontinued. If a rash is detected in patients with systemic invasive mycoses, it is necessary to carefully monitor its development and cancel Mycomax if bullous manifestations or erythema multiforme are detected.

The doctor needs to be aware of the likely development against the background of the use of Mycomax, an increase in the QT interval and torsades de pointes ventricular tachycardia, which is occasionally noted during therapy with fluconazole preparations. This effect in most cases was observed in patients with severe cardiac pathologies and numerous risk factors, including salt metabolism disorders, myopathy, and concomitant use of therapeutic agents that affect the heart rhythm.

Analogues of Mycomax are represented by drugs:

• Vfend;
• Itraconazole;
• Irunin;
• voriconazole;
• Itrazol;
• Biflurin;
• Canditral;
• Vikand;
• Myconihol;
• Teknazol;
• Orungal;
• Rumikozi etc.

Synonyms

Synonyms of Mycomax are preparations:

• Fluconazole;
• Diflazon;
• Mycosist;
• Diflucan;
• Funzol;
• Vero-Fluconazole;
• Difluzol;
• Medoflucon;
• Fluconorm;
• Forkan;
• Mycoflucan;
• Flucostat;
• Procanazole;
• Fluzol;
• Nofungi etc.

children

Mycomax tablets in dosages of 100 mg and 150 mg are contraindicated for the treatment of children weighing less than 40 kg.

With alcohol

Given the possible hepatotoxicity of Mycomax and ethanol-containing products or drinks, alcohol intake during therapy is unacceptable.

During pregnancy and lactation

The use of Mycomax during pregnancy is allowed only in exceptional cases of severe generalized mycoses and fungal infections that are potentially life-threatening for the patient.

If therapy with Mycomax is necessary, breastfeeding should be suspended.

Mycomax is a medicinal preparation created for the treatment of fungal diseases caused by a wide range of pathogens (trichophytosis, yeast and yeast-like fungi, etc.).

Manufacturer

Sanofi Pharma (Slovenia).

Approximate price of the drug

Analogs substitutes

• Mycosist,
• Itracon,
• diflucan,
• Flucostat,
• Mifungar.

It is dispensed from a pharmacy without a doctor's prescription.

Shelf life: 2 years.

Indications for use

Indications for the use of Mycomax are:

1. Local (thrush) or systemic candidiasis with or without lesions of internal organs;
2. Fungal infection of an unknown nature with lesions of internal organs, fungal infection against the background of severe immunodeficiency states (HIV, AIDS, conditions after transplantation of organs and tissues against the background of taking cytostatics, malignant tumors, etc.);
3. Skin form of various fungal diseases (dermatomycosis) in the absence of a positive effect from local treatment;
4. Prevention of vaginal candidiasis (thrush).

Compound

• The active substance is fluconazole, a modern synthetic derivative of triazole, which is the most powerful (at present) blocker of the synthesis of specific substances in fungal cells - sterols. As a result, the fungal cell wall is synthesized with deep defects. Which ultimately lead to the death of the microorganism;
• Inactive substances: colloidal silicon oxide, titanium oxide, corn starch, povidone, etc.

Brief annotation to the appointment

Capsules must be taken orally with plenty of liquid. Dosage and duration of use depends on the severity of the condition of the sick person and the severity of the symptoms of the disease.
The average course of treatment can range from 3 days to one and a half months in doses from 50 mg to 400 mg per day;

Mikomax from thrush

Mycomax may be the first line drug in the treatment of thrush. In this case, men, women, children (starting from the first days of life) can be treated. Take 50 mg or 100 mg of the drug in one or two doses for 2 weeks.

Contraindications for use

Mikomax contraindications are intolerance to the components of the drug (allergy).

Side effects

Side effects are observed quite rarely.

Cases of drug overdose are not described. In cases of significant deterioration, it is necessary to cancel the medicine on your own and seek help from your doctor (for gastric lavage, forced diuresis, hemodialysis).

Possible side effects of Mycomax:

• Nervous system disorders (sleep cycle disorder, headaches, paresthesia, dizziness);
• Nausea, abdominal pain, loss of appetite, vomiting, very rarely - toxic hepatitis;
• Violation of blood clotting, a decrease in the number of platelets in the blood (thrombocytopenia);
• allergic reactions of varying severity are possible (from the usual Urticaria to anaphylactic shock), which are much more common in people with severe immune disorders.

Special instructions for use

• Mycomax is prescribed with great caution during pregnancy, lactation (breastfeeding) in cases where the intended benefit to the mother far outweighs the risk to the fetus. In cases of breastfeeding - it is necessary to stop it for the duration of treatment.
• The use of the drug is not addictive.
• Simultaneous use of alcohol and Mycomax due to possible side effects.

Tablets from thrush for women - this is a whole list of medicines that provide effective help in the fight against candidiasis.

The reason for its development is the reproduction in large numbers of a yeast-like fungus of the genus Candida (Candida). The microorganism is part of the normal microflora of the colon, mouth, vagina. Participates in metabolic processes and is harmless to the human body.

However, under the influence of certain factors, the fungus becomes aggressive, begins to multiply uncontrollably and rapidly, and causes unpleasant manifestations. Simultaneously with cheesy white discharge, there is a feeling of itching or burning, swelling and redness of the mucous membranes. On examination, the doctor diagnoses thrush (candidiasis).

• Indications and contraindications for the use of tablets
• The main groups of medicines against candidiasis
• Imidazole group
• Triazoles
• Polyene antibiotics against disease
• Combination drugs

The causes of a fungal disease are:

Women and children are most often affected. Treatment of the disease requires the inclusion of effective antifungal drugs in order to achieve a quick recovery. The list of remedies that will help cure the disease is quite large, so it is not recommended to select them on your own.

These include drugs for use:

In order not to delay the treatment process and not lead to the development of a chronic form of the disease, you should visit a doctor at the first signs of the disease.

Indications and contraindications for the use of tablets

The main indications for prescribing tablets orally in the treatment of candidiasis are based on the action of drugs - the suppression of pathogenic microflora and the restoration of normal microflora. Tableted antifungal drugs help in case of:

With the help of tablets, you can cope with any form of fungal disease.

It is very important to observe one condition - the doctor must choose and prescribe drugs.

Only a specialist can determine the best remedy for thrush in each case and how to drink it. Given the general condition of the body, he will prescribe a course of treatment, which can last from 1 to 10 days.

Before choosing good antifungal drugs, you need to familiarize yourself with the list of contraindications. It includes:

Certain types of tablets for the treatment of candidiasis are forbidden to be taken orally and topically during menstruation. This is due to their influence on the cycle and hormonal levels. Non-compliance with the requirements of the instructions for use, violation of the dosage or duration of administration lead to the manifestation of side effects.

The most common manifestations:

• nausea;
• vomit;
• headache.

More severe symptoms include allergic skin manifestations, hallucinations, disorders of the nervous and vascular systems. At the first sign of such manifestations, it is necessary to stop taking any tablets from thrush and consult your doctor.

The main groups of medicines against candidiasis

Modern pharmacology offers an extensive list of anti-fungal tablets. Information on therapeutic use is available to buyers. Many drugs for thrush are sold without a prescription.

The groups of drugs used for the treatment of candidiasis include:

• antibiotics of the polyene group (Natamycin, Nystatin, Levorin, Pimafucin);
• imidazole derivatives (Clotrimazole, Candide);
• triazoles (Mycosist, Fluconazole,);
• imidazoledioxalane derivatives (Livarol),

Stronger and better remedies for thrush come at a high price. This is one of the disadvantages of such funds. Therefore, women try to choose relatively inexpensive, but effective pills that are commercially available. They help well with thrush, they can be easily purchased at the pharmacy chain. Buying inexpensive drugs, you can cure even a severe form of the disease.

Imidazole group

Among the medicines of this series, the antibiotics Clotrimazole, Candide, Ketoconazole stand out with a pronounced effect. Each tool has its own characteristics and different forms of release.

Clotrimazole is an inexpensive and effective remedy for urogenital candidiasis. This medicine for thrush is available in several forms:

For the treatment of thrush at night, a tablet (vaginal) is inserted into the vagina as deeply as possible. It is best to do this while lying on your back. Additionally, the external genitalia and perineal skin are lubricated with cream.

The course of treatment lasts 4 weeks until the complete disappearance of the manifestations of the disease. Other antifungal drugs (polyene antibiotics), Dexamethasone in high doses should not be taken simultaneously with Clotrimazole. Irritation with the use of Clotrimazole is rare. Vaginal tablets are contraindicated in the first trimester of pregnancy and in case of individual hypersensitivity to the components of the drug. Released without a prescription.

Prices in Moscow pharmacies are quite cheap:

• cream - from 35 to 67 rubles. for tuba;
• tablets - from 18 to 53 rubles. for packing.

In the pharmacies of St. Petersburg, too:

• ointment - from 29 to 43 rubles;
• tablets - from 24 to 71 rubles.

Candide and Ketoconazole. To cure candidiasis, Candide vaginal tablets are used. Indications, method of application, frequency of use of Candida and Clotrimazole are identical. The decision to prescribe Candida to pregnant and lactating women is made exclusively by a doctor.

In the first trimester, tablets are prohibited for use. The simultaneous use of Nystatin and Candida is undesirable. This significantly reduces the activity of Clotrimazole.

The release of Ketoconazole is made in the form of suppositories, cream, tablets. Indications are identical for all drugs of the group. Candles are used once a day, preferably before a night's rest. The medication is not recommended during breastfeeding and pregnancy (contraindications - the first trimester).

Triazoles

Reliable antifungals. The mechanism of action of drugs leads to the death of fungal cells.

Fluconazole is available as capsules, ointments, suppositories and solution for parenteral administration. Take effective capsules once orally, as a whole. In some cases, fluconazole has to be taken for a long time (up to three months). Six months later, the course is repeated.

Only a doctor can prescribe such a scheme. It is required to strictly follow the instructions of a specialist, otherwise a frequent recurrence of relapses of the disease is possible. The drug is contraindicated in children under 4 years of age, pregnant women and patients with pathologies of the liver and kidneys.

Prices in pharmacies in Moscow - from 17 to 78 rubles, St. Petersburg - from 23 to 67 rubles. You can buy medicine without a prescription.

Flucostat is the most popular and inexpensive remedy for thrush. Effective against fungi of the genus Candida. It is taken orally once, quickly relieves itching and burning. Symptoms of candidiasis completely disappear on the second day.

You can drink Flucostat at any time of the day, regardless of food intake, which is very convenient for people with a busy work schedule. Related to this is the cost of the drug. In Moscow and St. Petersburg, the price ranges from 196 to 340 rubles per capsule. You can buy medication without a prescription.

Polyene antibiotics against disease

The effectiveness of drugs in this group is quite high. Polyenes increase the permeability of the cell membrane, which leads to the death of the fungus. Among the medicines of this group, consider Nystatin and Levorin.

Nystatin is a proven remedy by many patients. But this does not give the right to refuse to consult a specialist. Nystatin is not used for hypersensitivity to the component, pregnancy, feeding a child, diseases of the digestive system.

Nystatin tablets can cause unpleasant manifestations - rash, itching, redness and disruption of the gastrointestinal tract. Do not combine the drug with Clotrimazole and alcohol.

The action of Levorin is similar to Nystatin. The difference lies in the list of restrictions for admission - bronchial asthma, liver and kidney failure, feeding the baby. Before starting therapy, the sensitivity of the microflora to Levorin is determined. The dose is calculated depending on the degree and form of the disease, the general condition of the patient, comorbidities.

Combination drugs

Significantly differ in the set of components. They contain an antifungal ingredient, an antibiotic, substances that fight protozoa, a glucocorticoid hormone. It is forbidden to prescribe drugs with a combined action in the first important months of pregnancy and stop feeding the baby if the doctor shows the use of the drug.

A frequently prescribed drug in this group is Terzhinan. The benefits of the drug are significant.

Its distinctive properties - there is no ban on use during menstruation, breastfeeding and late pregnancy.

Vaginal tablets are administered at night, after moistening in a small amount of water. After the introduction of the tablet, it takes 15 minutes not to change the position of the body. Drug prices are not cheap. There are vaginal tablets in pharmacies in Moscow and St. Petersburg from 295 to 569 rubles, depending on the manufacturer.

What other pills do well with thrush? The most common are Diflucan, Livarol, Mikosist, Mikomax. Basically, they are dispensed in the pharmacy network without a prescription. All of them are used to treat one disease, but may have distinctive features. Different active substances in their composition require an individual approach to each medication.

A prerequisite is a thorough study of the instructions for use and consultation with a doctor.

Thrush, or candida infection, is a disease caused by yeast-like fungi of the genus Candida. Its treatment involves the use of drugs - antimycotics. Fluconazole for thrush is considered a popular and effective remedy. How to use Fluconazole for thrush?

Candidiasis and its symptoms

Candidiasis is commonly referred to as thrush. This disease is caused by the fungal bacteria Candida. Thrush causes damage to the mucous membrane of the genital organs. The disease proceeds in a mild form, which is not difficult to treat at home, after seeing a doctor and undergoing an examination.

Risk factors for thrush in women:

• taking antibiotics;
• hormonal disbalance;
• weakening of the immune system;
• HIV infection;
• endocrine disorders;
• intestinal pathology;
• promiscuous sex life;
• pregnancy;
• menopause.

There is also such a thing as chronic thrush. This phenomenon occurs due to improper treatment or constant exposure to the body of pathogens. Chronic candidiasis requires the simultaneous use of several drugs and adherence to a certain diet. The duration of the course of therapy is determined by the doctor.

Fluconazole from thrush is considered the best solution in conjunction with ointments or suppositories for topical use.

Typical symptoms of candidiasis in women:

• allocation of curdled consistency;
• sour smell;
• burning;
• pain during sexual contact;
• plaque on the genitals;
• swelling of the genitals;
• redness of the mucous membrane.

At the initial stage of the disease, the symptoms do not particularly bother the woman, but if the disease is started, then it can be much more difficult and unpleasant. Whether there can be consequences at untimely treatment? Yes, they can, the most common complication is the transfer of infection to neighboring organs and the addition of bacterial flora.

Forms of drug release

Treatment of thrush with fluconazole may involve therapy from several agents that are used in conjunction with tablets. A wide range of forms allows you to prescribe complex treatment if there are several foci of the disease. The drug is used in the treatment of both sexual partners.

Fluconazole has several forms of release:

• capsules;
• coated tablets;
• injection;
• powder for solution.

How to take Fluconazole for thrush in women or men, only a doctor can tell. You should not self-medicate.

Mechanism of action

Capsules Fluconazole is the usual form used for thrush. The gelatin shell dissolves instantly, and the active substances of the drug are quickly absorbed into the blood.

Fluconazole acts on the walls of fungi, preventing their growth and reproduction. The medicine is effective at all stages of the disease.

How quickly does the medication work? After taking Fluconazole, the active substance acts for three days. After 6-7 hours, the symptoms of thrush are noted to subside.

Capsules are white, consumed with plenty of water, without cracking the shell. You can drink capsules or tablets at any time of the day, regardless of food.

Indications

• candidal colpitis (thrush);
• generalized candida;
• candidiasis of the mucous membranes (including damage to the oral cavity), skin, nails;
• cryptococcosis;
• prevention of fungal infections with prolonged use of antibiotics, etc.

With a mixed bacterial-fungal infection, Fluconazole is prescribed together with antibiotics (metronidazole, penicillins, cephalosporins, etc.). In gynecological practice, capsules are often used simultaneously with topical preparations (suppositories, creams, ointments) to enhance the effect. With a recurrence of thrush, the doctor may recommend a drug from another group (Nystatin, Clotrimazole, etc.).

Fluconazole analogues: Mikosist, Mikomax, Flukostat. If you need to change the drug, you should consult a doctor.

Fluconazole is available in pharmacies without a prescription. Medicine prices may vary.

Dosing regimen

About how to take Fluconazole correctly, whether it is necessary to drink a course and in what dosage, only a specialist can say after conducting the necessary tests. The regimen for taking the drug is shown in the table:

Tip: when using Fluconazole, you should carefully read the instructions for use. The description of the drug indicates how long the medicine can be used and in what dosage. If you do not comply with the indicated dose, you can cause significant harm to health.

fluconazole for men

Quite often, in married couples, the question arises: “Does a man need to use Fluconazole if a woman has a disease?” Any gynecologist will answer that thrush is not an STI. Treatment of the sexual partner is not required. Men usually rarely get candidiasis, as a rule, the disease occurs in a latent form in conjunction with sexually transmitted diseases.

Causes of candidiasis in men:

• pathology of the endocrine system (including diabetes mellitus);
• promiscuity;
• the presence of latent infections in the body;
• decrease in immunity.

It is difficult to identify thrush in men, for this you need to undergo an examination and pass special tests for fungal crops. Antifungal drugs are prescribed only when a candidal infection is detected in the laboratory and in the presence of typical symptoms.

How to take fluconazole for men:

• once in the acute stage;
• twice a week for a month, if the disease is neglected;
• the use of tablets or capsules in conjunction with ointments or creams for prevention.

The doctor will tell you the exact treatment regimen after examining and examining the patient.

fluconazole during pregnancy

Many pregnant women often face the problem of candidiasis. This is due to the restructuring of hormones in the body. Is it possible in this case to use Fluconazole for the treatment of thrush? How to take it correctly? During pregnancy, treatment with this medication is prohibited, especially in the first three months. But there are exceptions when the disease can threaten the fetus with possible deviations. In this case, the drug is prescribed individually, under the supervision of doctors.

fluconazole in childhood

Is it possible to use medication for thrush in children? It is possible, the dosage of the drug is prescribed by a pediatrician or pediatric gynecologist. Fluconazole is usually given to children as a suspension or syrup. Depending on the form of release of the drug, there are restrictions for children: the suspension is used from the first year of life, other forms after the age of three.

Contraindications and side effects

Like any medication, Fluconazole has a number of contraindications:

• liver or kidney failure;
• violation of the heart rhythm;
• arterial hypertension;
• age after 65 years (how to drink Fluconazole with thrush for older people, you should ask a doctor);
• pregnancy (including at the stage of conception);
• lactation period.

The active substances that make up the drug can cause side effects:

• headache;
• nausea;
• dizziness and convulsions;
• drowsiness and disorientation;
• problems with the digestive system;
• skin rashes and itching;
• cardiac arrhythmia and increased blood pressure.

The drug weakens the effect of hormonal contraceptives. It is necessary to use additional means of contraception for the entire period of treatment.

After completion of the course of therapy, probiotics are indicated to restore the normal microflora of the vagina.

It is important to know: at the first manifestation of adverse symptoms, you need to consult your doctor. He will change the treatment regimen or reduce the dosage. An overdose of the drug can only be if the patient has violated the doctor's instructions.

The use of Fluconazole for thrush is an effective and quick way to get rid of the problem. The drug should be used only according to the prescribed scheme after consulting a doctor. Failure to follow the rules for taking the medicine can be harmful to health.

One capsule of Mycomax contains 150 mg of fluconazole. Capsules with a lower dosage are also produced - 50mg and 100mg. The drug is produced in blisters of 10 pieces. The effectiveness of the drug is due to the pathological effect of fluconazole on fungal cells, in which metabolic processes are disturbed, they lose their ability to reproduce and die.

Tablets are perfectly absorbed into the patient's blood, the maximum absorption is 90%, it is noted 30 minutes after ingestion. The effectiveness of the drug does not depend on food intake. The active substance, which is part of the product, is excreted by the kidneys and intestines after 24 hours. In patients with renal insufficiency, the excretion of fluconazole slows down and is 38 hours.

Indication for use

Composition and instructions for use of Sebozol shampoo

Mikomax is often prescribed for thrush and candidal balanitis in men. The drug can be used both as part of a complex treatment, and as the main drug, if local remedies have not brought results.

Mikomax instructions for use prohibit the use of children under 16 years of age, women during pregnancy and lactation, as well as people with personal intolerance to lactose and the components of the drug. Do not use the medicine after the expiration date, and if the integrity of the package is violated.

The drug reacts with drugs such as:

• Cisapride - increases the toxicity of this substance and its negative effect on the liver;
• Terfenadine and Astemizol - their absorption into the blood decreases, and the heart rhythm is disturbed;
• with the joint use of Mycomax with drugs based on sulfonylurea, the level of sugar in the blood rises, this can be a critical moment for diabetics;
• reduces the amount of hormones - estradiol and levonorgestrel in the blood, with the combined use of hormonal contraceptives and Miromax;
• Fluvastatin - increases the risk of myopathy.

In no case should you mix the medication with alcoholic beverages, they increase the effect of fluconazole on the patient's body, and can provoke allergic reactions and liver failure.

Manufacturer

Sanofi Pharma (Slovenia).

Approximate price of the drug

Analogs substitutes

• Mycosist,
• Itracon,
• diflucan,
• Flucostat,
• Mifungar.

It is dispensed from a pharmacy without a doctor's prescription.

Shelf life: 2 years.

Compound

• The active substance is fluconazole, a modern synthetic derivative of triazole, which is the most powerful (at present) blocker of the synthesis of specific substances in fungal cells - sterols. As a result, the fungal cell wall is synthesized with deep defects. Which ultimately lead to the death of the microorganism;
• Inactive substances: colloidal silicon oxide, titanium oxide, corn starch, povidone, etc.

The dosage of Mycomax, the duration of the course of treatment, the frequency of administration (application) is determined only by the doctor! Do not self-medicate, even in cases of your confidence in the accuracy of the diagnosis.

Brief annotation to the appointment

Capsules must be taken orally with plenty of liquid. Dosage and duration of use depends on the severity of the condition of the sick person and the severity of the symptoms of the disease.
The average course of treatment can range from 3 days to one and a half months in doses from 50 mg to 400 mg per day;

Mikomax from thrush

Mycomax may be the first line drug in the treatment of thrush. In this case, men, women, children (starting from the first days of life) can be treated. Take 50 mg or 100 mg of the drug in one or two doses for 2 weeks.

For children, the dose of the drug and the frequency of administration is calculated individually, depending on the age and body weight of the baby.

Composition, action and form of release

The pharmaceutical product "Mycomax" is produced in the form of syrup and capsules of 50-200 mg. The components of the medication are:

• fluconazole;
• milk sugar;
• starch that has undergone a gelatinization process;
• aerosil;
• food additive E572;
• sodium dodecyl sulfate.

The drug has a beneficial effect on the microflora.

The main purpose of the medical preparation "Mycomax" is to destroy the fungal infection and thereby prevent the development of various fungal pathologies. The chemical composition of the drug completely destroys the structure of the fungus and prevents further growth of its cells. Penetrating into the digestive tract, the capsule instantly dissolves, and its components gradually move through the intestines, and through the muscle tissue penetrate into the vagina. There, the medicinal components begin to fight pathogenic microorganisms and completely destroy the infection, while restoring the vaginal microflora.

The patient's condition improves after taking 2 capsules (150 mg each) of Mycomax, that is, already on the 2nd day. When the medicine does its job and there is no trace of a fungal infection, Mycomax will begin to be excreted from the body through the activity of the kidneys. The described medication is well tolerated, and side symptoms occur extremely rarely.

Observing a negative reaction of the body to the use of "Mycomax", it is necessary to suspend treatment and consult your doctor.

Instructions for use "Mycomax" with thrush

The drug can be used in conjunction with antibacterial drugs.

You can take Mycomax tablets for the treatment of thrush at any time of the day, regardless of the meal. To achieve the desired effect of therapy, it is enough to drink 1 capsule per day. It is allowed to use the medicine for prevention purposes. Then the duration of the prophylactic course can reach several months.

In the acute form of thrush, one capsule of Mycomax should be taken a month before the onset of menstruation. The duration of such treatment is 4-6 months and depends on the severity of the course of the disease, as well as the individual characteristics of the patient's body. Therefore, only a qualified physician can determine the period of the treatment course and the safe dosage.

Modern doctors prescribe Mikomax as an aid to patients who take antibiotics in order to prevent a violation of the vaginal microflora. It is known that the antibiotic has a detrimental effect not only on pathogenic microorganisms, but also affects beneficial bacteria, thereby provoking the development of thrush. With antibiotics, Mikomax is prescribed 300 mg or 150 mg each, if you start taking it before starting antibiotic therapy.

Adverse reactions

When treating thrush with Mycomax, the following negative phenomena may occur:

• dizziness;
• frequent loose stools;
• painful bloating;
• headache;
• rashes on the skin;
• nausea;
• convulsive conditions;
• gagging;
• impaired activity of the kidneys and liver;
• sleep disturbance;
• change in taste preferences.

Pharmacological properties

Pharmacodynamics

Fluconazole is a potent selective inhibitor of ergosterol synthesis in micromycete cell membranes and belongs to the class of triazole antifungal agents.

The mechanism of the antifungal action of fluconazole is based on specific inhibition of the activity of the fungal isoenzyme system P450.

The use of Mycomax is effective in the following cases:

• opportunistic mycoses, including those caused by Candida spp., including generalized forms of candidiasis in patients with immunosuppression; Cryptococcus neoformans, including intracranial infections; Trichophyton spp.; Microsporum spp.;
• endemic mycoses caused by Blastomyces dermatitidis, Coccidioides immitis, including intracranial infections, and Histoplasma capsulatum (including in patients with immunosuppression).

There is evidence of the development of superinfections caused by Candida species that do not belong to Candida albicans and often show natural resistance to fluconazole (in particular Candida krusei). These patients may require alternative antifungal drugs.

Fluconazole exhibits high specificity with respect to the fungal isoenzymes of the P450 system and has little effect on the isoenzymes of the P450 system in humans. Single or repeated use of fluconazole at a dose of 50 mg does not affect the metabolism of antipyrine. When conducting a course lasting 28 days at the indicated dose, the concentration of steroid hormones in women of childbearing age or the plasma concentration of testosterone in the blood in men does not change.

The use of 200–400 mg of fluconazole per day has no clinically significant effect on endogenous steroid concentrations or hormonal response to the administration of adrenocorticotropic hormone in healthy male volunteers.

Pharmacokinetics

Fluconazole is well absorbed after oral administration. Its bioavailability is 90%. Cmax (maximum concentration of a substance) in plasma after taking it on an empty stomach in an amount of 150 mg is 90% of its plasma concentration when administered intravenously at the same dose. Simultaneous food intake does not affect the absorption of fluconazole taken orally. The time to reach Cmax after oral administration is 0.5-1.5 hours, its T1 / 2 (half-life) is approximately 30 hours.

Fluconazole after intravenous and oral administration penetrates well into body fluids and tissues. Concentrations of the substance in sputum and saliva are similar to its plasma levels. The content of fluconazole in the cerebrospinal fluid with fungal meningitis reaches 80% of the plasma level.

Plasma concentration is dose-dependent. After 4-5 days of daily therapy, a 90% steady-state concentration is reached.

When used on the first day of the course of the loading dose of Mycomax, which is 2 times higher than the usual daily dose, it is possible to achieve the desired level of equilibrium concentration by the second day. The volume of distribution of fluconazole is close to the total body water content. The substance binds to plasma proteins by 11-12%.

In the epidermis, stratum corneum, sweat fluid and dermis, high concentrations of fluconazole are achieved, which are higher than its serum concentration. When using 150 mg of fluconazole once every 7 days, the concentration of fluconazole in the stratum corneum is 23.4 μg / g, and a week after the second dose - 7.1 μg / g. The concentration of fluconazole in the nails after 4 months of therapy according to the same scheme is 4.05 µg/g and 1.8 µg/g in healthy and affected nails, respectively. Six months after the end of therapy, the concentration of fluconazole, which can be determined, is still preserved in the nails.

The substance is excreted mainly through the kidneys, about 80% of the dose is unchanged. Fluconazole clearance is proportional to creatinine clearance.

Metabolites of the substance are not found in the peripheral blood.

Instructions for use Mycomax: method and dosage

• Capsules: taken orally;
• Solution: injected intravenously (in / in) drip, infusion rate is not more than 20 mg (10 ml) per minute. To prepare the infusion solution, you can use a 20% glucose solution, a solution of potassium chloride in glucose, Ringer's solution, isotonic sodium chloride solution, Hartman's solution, 4.2% sodium bicarbonate solution. Do not change the dose when transferring the patient to receive Mycomax inside;
• Syrup: taken orally with a measuring cup. Before swallowing, the syrup should be held in the mouth for 2 minutes. The special cap of the bottle opens in the direction opposite to the clockwise movement after some hard pressing.

In the treatment of adults and children, the doctor prescribes the dose and period of Mycomax use based on clinical indications and comorbidities.

• Cryptococcal meningitis and other localizations of cryptococcal infections: on the first day of therapy 400 mg (80 ml), then 200-400 mg (40-80 ml) 1 time per day. The period of treatment depends on the clinical effect, confirmed by mycological examination, for cryptococcal meningitis it usually lasts at least 6-8 weeks;
• Prevention of recurrence of cryptococcal meningitis in patients with AIDS: 200 mg per day (40 ml) after a full course of primary therapy, for a long time;
• Candidemia, disseminated candidiasis and other invasive candidal infections: on the first day - 400 mg (80 ml), and then - 200 mg (40 ml) 1 time per day. To achieve a clinical effect, it is allowed to increase the dose of Mycomax to 400 mg (80 ml) per day. After an intensive course of antitumor chemotherapy, bone marrow transplantation, extensive surgical interventions on the heart or organs of the gastrointestinal tract, patients are shown an initial dose of 10 mg per 1 kg and a maintenance dose of 5 mg per 1 kg of the patient's weight per day. The period of treatment depends on the clinical effect and is determined individually;
• Oropharyngeal candidiasis: 50-100 mg (10-20 ml) 1 time per day for 7-14 days, with a significant decrease in immunity, the course of treatment can be extended;
• Atrophic candidiasis of the oral cavity (against the background of wearing dentures): 50 mg (10 ml) 1 time per day, a course of treatment for 14 days in combination with antiseptic preparations for processing the prosthesis;
• Esophagitis, non-invasive bronchopulmonary candidiasis, candiduria, candidiasis of the mucous membranes and skin, other localizations of candidiasis (except genital): 50-100 mg (10-20 ml) 1 time per day for 14-30 days;
• Prevention of recurrence of oropharyngeal candidiasis in patients with AIDS: 150 mg (30 ml) once a week after a full course of primary therapy;
• Vaginal candidiasis, Candida balanitis: 150 mg (30 ml) orally once. Patients with three or more relapses of the disease per year to reduce the frequency of vaginal candidiasis are usually prescribed Mycomax prophylactic at a dose of 150 mg (30 ml) once a month for 4-12 months. Some patients may need more frequent appointments;
• Prevention of candidiasis: 50-400 mg (10-80 ml) 1 time per day. The dose of Mycomax and the period of treatment depend on the degree of risk of developing a fungal infection;
• Mycosis of the skin of the feet, inguinal region and skin candidiasis: 150 mg (30 ml) 1 time per week or 50 mg (10 ml) 1 time per day. The duration of treatment is 2-4 weeks, with mycoses of the feet - up to 6 weeks;
• Pityriasis versicolor: 300 mg (60 ml) 1 time per week, course of treatment 1-3 weeks or 50 mg (10 ml) 1 time per day for 2-4 weeks;
• Onychomycosis: 150 mg (30 ml) 1 time per week, treatment is continued until the complete regrowth of the uninfected nail (on the fingers - 3-6 months, on the feet - 6-12 months);
• Deep endemic mycoses: 200-400 mg (40-80 ml) 1 time per day, the duration is determined individually (with coccidiomycosis - 11-24 months, paracoccidioidomycosis - 2-17 months, sporotrichosis - 1-16 months, histoplasmosis - 3-17 months).

In the treatment of children, Mycomax is used once a day at a dose calculated taking into account the weight of the child, but not more than that in adult patients.

• Candidiasis of the mucous membranes: on the first day - 6 mg per 1 kg, then - 3 mg per 1 kg of the child's weight;
• Generalized candidiasis and cryptococcal infections: 6-12 mg per 1 kg of weight;
• Prevention of fungal infections with reduced immunity in children with neutropenia developing against the background of radiation or cytotoxic chemotherapy: 3-12 mg per 1 kg, the dose depends on the duration of preservation and the severity of induced neutropenia.

Due to the delayed excretion of fluconazole in newborns, in the first 2 weeks of a child's life, it is recommended to administer Mycomax with an interval of 72 hours, the next 2-4 weeks - with an interval of 48 hours.

Elderly patients (in the absence of impaired renal function) dose adjustment is not required.

In patients with functional disorders of the kidneys with a single dose of the drug, the dose is not changed. With repeated use, the daily dose should be reduced taking into account the severity of renal pathology, it is recommended to first introduce a loading dose of 50-400 mg, then with a creatinine clearance (CC) of more than 50 ml / min, the usual recommended dose is used, with a CC of 11-50 ml / min the patient is prescribed ½ of the usual dose. Patients on regular dialysis are advised to take one dose of Mycomax after each hemodialysis session.

special instructions

Treatment of all clinical indications must be continued until complete clinical and laboratory remission, since premature discontinuation of the drug leads to relapses of the disease. The use of Mycomax should be accompanied by regular monitoring of liver and kidney function, hematological parameters.

Rare cases of toxic changes in the liver, including those with a fatal outcome, were mainly observed against the background of concomitant severe diseases. There was no obvious dependence of the hepatotoxic effects of fluconazole on the daily dose, treatment period, age or gender of the patient, the effect is usually reversible. Therefore, if symptoms of impaired liver and / or kidney function appear, Micomax should be discontinued.

The tendency to develop severe skin pathologies in AIDS patients while taking many drugs requires special attention to this category of patients. If the appearance of a skin rash with a superficial fungal infection can definitely be attributed to the action of fluconazole, Mycomax should be discontinued. In invasive or systemic fungal infections, the developing rash should be carefully monitored and only in the event of erythema multiforme or bullous changes stop treatment with fluconazole.

In rare cases, the action of Mycomax causes a prolongation of the QT interval and the development of ventricular tachycardia of the pirouette type. More often this effect is observed in severe heart disease and multiple risk factors, such as the simultaneous use of drugs that contribute to rhythm disturbance, myopathy and impaired water and electrolyte balance.

Influence on the ability to drive vehicles and complex mechanisms

Usually, the use of Mycomax does not affect the patient's ability to drive vehicles and mechanisms. However, if dizziness, drowsiness, vertigo occur, the patient should refuse to perform potentially hazardous activities.

Use during pregnancy and lactation

• pregnancy: Mycomax is contraindicated except in cases of life-threatening or severe forms of fungal infections, when the expected benefit is estimated to be higher than the possible harm;
• lactation period: the use of the drug is contraindicated.

Application in childhood

• capsules (in any of the dosages): for children weighing up to 40 kg, therapy is contraindicated;
• syrup: children under 6 months Mycomax is prescribed with caution.

For impaired renal function

Mycomax for patients with renal insufficiency is prescribed under medical supervision.

Terms and conditions of storage

Keep out of the reach of children:

• Capsules: at temperatures up to 25°C;
• Solution and syrup: in a dark, dry place at a temperature of 10-25°C.

Shelf life - 3 years.

Terms of dispensing from pharmacies

Capsules are available without a prescription, syrup and solution are available by prescription.

Terbinafine tablets

The active substance of this drug is the terbinafine of the same name (in the form of hydrochloride). Terbinafine tablets are available in packs of 7 and 10 pieces. The drug is an allylamine, which is active against many fungi that affect the skin, hair, nails, and mucous membranes. So, an antifungal drug helps to overcome fungi of the following kind:

• Microsporum canis;
• Trychophyton spp.;
• Epidermophyton floccosum;
• Scopulariopsis brevicaulis;
• candida albicans.

The action of Terbinafine has an overwhelming effect on molds, many yeast fungi, as well as dermatophytes. Suppression of activity occurs by inhibition of biosynthesis in the cells of the fungus even at its early stages. With the internal use of Terbinafine, its accumulation occurs, which leads to a gradual recovery.

The maximum concentration of the active ingredient in the blood plasma is observed two hours after the first application. The drug penetrates into the hair follicles, nail plates, and begins its active effect after a week of admission. Excretion of Terbinafine occurs mainly through the kidneys. A small part of it comes out through the skin. It is worth noting that the active ingredient can be excreted along with breast milk.

Among the indications for the use of Terbinafine tablets, the following problems are noted:

• Fungal lesions of the skin and nails;
• Mycosis of the scalp;
• Dermatomycosis of the surface of the body and limbs;
• Mucosal candidiasis;
• Skin candidiasis.

But, this medication has a large number of contraindications. So, Terbinafine is contraindicated in chronic liver diseases, as well as in their acute form. Further, it is worth noting renal failure, which is also a contraindication to the use of Terbinafine. Experts do not recommend the use of Terbinafine tablets in children under three years of age, and whose body weight is less than twenty kilograms. Since the active substance is excreted along with breast milk, the use of this drug during lactation is not recommended for mothers.

Other contraindications include the following: high sensitivity to individual components of the drug, chronic kidney disease, alcoholism, hematopoietic disorders, oncological diseases, malignant tumors, metabolic disorders, lupus. The drug is used with caution in diabetes mellitus. It is not recommended to use Terbinafine tablets during the entire period of pregnancy.

Instructions for use also indicate the desired dosage of the drug for thrush. Tablets are used only inside, and after eating. Children from the age of three with a body weight of up to 40 kilograms should be given 125 mg 1 time per day. With a weight of over 40 kilograms - 250 mg 1 time per day. This dosage is also intended for adults. The duration of such a course of treatment is set only by the attending physician, depending on the location of the problem. The minimum period is two weeks, the maximum is three months.

The instruction also indicates cases of overdose. Overuse and not following directions can cause the following symptoms:

• Headache;
• Dizziness;
• Nausea and vomiting;
• Frequent urination;
• Stomach ache;
• Allergic rashes on the skin.

The use of a new drug for the body can provoke adverse reactions that eventually disappear on their own. If, with repeated use of Terbinafine, the symptoms do not disappear, the use of tablets should be discontinued. Among the frequent manifestations, one can single out disorders in the work of the gastrointestinal tract, loss of appetite. Rarely, various liver dysfunctions occur. Some patients have experienced cases of anaphylactic shock, taste bud disorders, urticaria, toxic dermatitis, increased fatigue, inhibition of reactions.

You should definitely know that the early termination of the prescribed course of treatment with Terbinafine will lead to an early relapse. Concomitant diseases can also have a great influence on the duration of the course. The instruction indicates that if there is no improvement in the condition after taking the drug for two weeks, you need to consult a doctor again. This applies to fungal infections of the skin. In this case, repeated tests will be prescribed to identify the causative agent of the disease. The use of Terbinafine at the time of diagnosis should be discontinued. During the period of treatment with Terbinafine, it is very important to observe all the rules of personal hygiene.

What remedies for thrush for a woman are inexpensive and more effective

• What affects the price difference
• Medications for oral administration
• Vaginal suppositories
• vaginal tablets
• Ointment and cream
• Revitalizing treatment

In order to prevent complications and recover on time, it will be useful for every woman to know that the prices for modern remedies vary greatly, but cheap pills can be just as effective as expensive ones.

What affects the price difference

Pharmaceutical manufacturers produce drugs that are called differently, but have the same active ingredient. The agent that serves as the basis for the production of so-called generics is the cheapest, and the difference in price is explained by the costs of advertising, development and promotion, as well as the presence of excipients and the peculiarities of the technology of the produced analogues. In most cases, the use of cheap means is more justified in terms of efficiency and cost. In addition, inexpensive medicine is much less likely to be counterfeited.

When prescribing a remedy for the treatment of thrush, the doctor is limited by the right to indicate only the name in the prescription, INN - international non-proprietary.

Therefore, women should clarify which drug will be more effective in this case, and whether it is possible to purchase a cheaper analogue.

Thrush is treated with both systemic agents and antifungal drugs. Usually several forms are used at once - the standard course of therapy includes tablets, suppositories, ointments and gels.

Medications for oral administration

One of the most commonly prescribed and effective drugs is fluconazole, which comes in both tablets and capsules. It is produced by about 30 pharmaceutical companies, the cheapest being Fluconazole Stada. The drug has a directed action against the fungus, is successfully used in advanced and recurrent cases, including lesions of other internal organs. With vaginal candidiasis, it is enough to take just one capsule of 150 g of the drug.

Treatment with a short course of Fluconazole is usually well tolerated by women, but there are also contraindications: first of all, it is individual intolerance to the components of the drug and allergic skin reactions, including the development of Quincke's edema. Side effects of fluconazole may increase with long-term use of large doses and cause digestive disorders, nervous system functions and cardiac activity.

For the treatment of thrush, one capsule of Fluconazole is required, the cost of which is within 100 rubles.

Enough already to endure this thrush and cystitis! Write down the recipe...

Thrush and cystitis will be gone forever! Write down the recipe!

Mycomax. This is a generic of Fluconazole, which, in addition to the active substance, includes several auxiliary components. Available in the form of capsules, syrup and injection, it is used in both women and men. Contraindications are pregnancy and lactation, individual intolerance, as well as joint administration with Cisapride, Terfenadine and Astemizole. Do not apply to children under 3 years of age.

Mikomax tablets and capsules are almost twice as expensive as Fluconazole, which is typical for an advertised generic, the price starts from 195 rubles.

Mycosist. Another generic Fluconazole, produced mainly in the form of a solution for infusion, but also available in capsules of 50, 100 and 150 mg. It has all the properties of Fluconazole, including contraindications. The cost of Mycosyst in pharmacies reaches 350 rubles.

Nystatin. The cheapest drug for thrush used in women. It is presented in pharmacies in several dosage forms - tablets, suppositories and gel. It is used to treat candidiasis of the skin and vagina. The drug is effective, and costs no more than 35 rubles.

Vaginal suppositories

The use of topical drugs against thrush includes the use of various suppositories for injection into the affected area, and in most cases a course of treatment is prescribed in combination with systemic tablets. One of the budgetary medicines of this type is Primafungin, which contains the antimycotic active ingredient Natamycin. Candles are inserted into the vagina at night for 3-6 days; if a burning sensation occurs during the introduction, it does not require cancellation. Approved for use during pregnancy and lactation. The price of a package of 3 candles starts from 200 rubles.

Candles with Nystatin are the most budget option for women suffering from thrush, and cost from 32 rubles per pack.

Clotrimazole suppositories are very effective in combating thrush, destroying not only the Candida fungus, but also other pathogenic bacteria and microorganisms. It is also available in the form of vaginal tablets, which are considered more effective than candles. The advantage is the price - 49 rubles per pack.

Candles Fluconazole is also an inexpensive option, it is used even in the treatment of chronic forms of thrush in women. Price - from 34 rubles per pack. The therapeutic course is 6-7 days, like most suppositories.

Ointment and cream

These types of drugs are used to treat candidiasis in the same way as suppositories, for local effects on the focus of the disease. The most commonly prescribed Clotrimazole and Pimafucin. Ointments are applied at least 2 times a day using a special vaginal applicator. After application, it is recommended to lie down until completely absorbed for 15-20 minutes. Both drugs have a low price and are suitable for both women and men.

One of the new pharmaceutical products is Ginofort cream. Its active ingredient, butoconazole, is able to get rid of candidiasis in one application. True, this miracle cream is not cheap - from 650 rubles.

Capsules

Mycomax capsules have a hard shell. Color of a basis - white, caps - blue. The case is marked in black ink.

In addition to 150 mg of fluconazole (the main active ingredient), 1 capsule also contains auxiliary substances:

• silica;
• sodium lauryl sulfate;
• magnesium stearate (7.5 mg);
• pregelatinized starch;
• lactose monohydrate.

The composition of the lid and capsule body contains:

• titanium dioxide;
• blue dye;
• gelatin;
• black ink.

Solution for infusion

Mycomax solution has no color. Produced in colorless glass bottles of 100 ml, which are placed in cardboard packaging.

In addition to the active substance, 1 vial contains:

• sodium chloride;
• distilled water.

Syrup

Mycomax syrup is colorless, it is produced in transparent 100 ml bottles, which are placed in a cardboard box.

1 vial contains:

• fluconazole (0.5 g);
• glycerol 85% (10 g);
• liquid sorbitol 70% (30 g);
• sodium benzoate (0.25 g);
• carmellose sodium (0.5 g);
• sodium saccharinate (0.1 g);
• citric acid monohydrate (0.3 g);
• purified water (100 ml);
• cherry flavor (0.13 g).

Adults

With cryptococcosis, the most commonly prescribed daily dose is from 200 to 400 mg. To prevent the recurrence of fungal diseases in AIDS patients, the drug is prescribed in a daily dosage of 200 mg.

With candidal lesions of the mucous membrane of the esophagus and other organs of the gastrointestinal tract, a daily dose of 100 mg is prescribed. The course of treatment lasts 10-14 days.

With disseminated candidiasis on the first day of treatment, the dose is 400 mg per day, then - no more than 200 mg. In especially severe cases, it is possible to use 800 mg. The duration of treatment depends on the effectiveness of therapeutic measures.

To prevent the recurrence of candidiasis, 50 mg of the drug is prescribed. With induced neutropenia, the dose is increased to 400 mg.

For elderly patients

The dosage for elderly patients is no different from the dosage for an adult (with the exception of the presence of liver failure in the patient).

Alcohol compatibility

During the course of treatment with Mycomax, it is forbidden to drink alcohol.

ATX

J02AC01 Fluconazole

Nosological classification (ICD-10)

• B20.3 HIV disease with manifestations of other viral infections
• B20.4 HIV disease with manifestations of candidiasis
• B35.1 Mycosis of nails
• B35.3 Foot mycosis
• B35.4 Trunk mycosis
• B35.6 Athlete's groin
• B36.0 Lichen versicolor
• B36.9 Superficial mycosis, unspecified
• B37.0 Candidal stomatitis
• B37.1 Pulmonary candidiasis
• B37.3 Vulvar and vaginal candidiasis (N77.1*)
• B37.6 Candida endocarditis (I39.8*)
• B37.7 Candidal septicemia
• B37.8 Candidiasis of other sites
• B37.9 Candidiasis, unspecified
• B38 Coccidioidomycosis
• B39 Histoplasmosis
• B41 Paracoccidioidomycosis
• B42 Sporotrichosis
• B45 Cryptococcosis
• B45.0 Pulmonary cryptococcosis
• B45.1 Cerebral cryptococcosis
• B45.2 Cutaneous cryptococcosis
• N51.2 Balanitis in diseases classified elsewhere
• Y43.3 Adverse reactions in therapeutic use of other anticancer drugs
• Y84.2 Abnormal reaction or late complication in a patient without mention of accidental harm during a radiological procedure and radiotherapy
• Z51.0 Course of radiotherapy
• Z51.1 Chemotherapy for neoplasm
• Z94.9 Presence of transplanted organ and tissue, unspecified
• Z97.2 Presence of dental prosthetic device (complete) (partial)

3D images

Use during pregnancy and lactation

The use of the drug in pregnant women is not advisable, except for severe or life-threatening forms of fungal infections, if the intended effect outweighs the possible risk to the fetus.

Fluconazole is found in breast milk at the same concentration as in plasma, so its administration during lactation is not recommended.

A few words about Mikomax

The price of Mikomax is about 200 rubles for a package with one capsule (No. 1) and 550-600 rubles for a package of three capsules (No. 3).