What is Fungosine?
Fungosine is used to treat infections caused by a fungus or yeast. It works by killing the fungus or yeast or preventing its growth.
Fungosine cream is used to treat:
- Athlete's foot (tinea pedis; ringworm of the foot);
- Ringworm of the body (tinea corporis);
- Ringworm of the groin (tinea cruris; jock itch);
- Seborrheic dermatitis;
- "Sun fungus" (tinea versicolor; pityriasis versicolor); and
- Yeast infection of the skin (cutaneous candidiasis).
Fungosine foam or gel is used to treat seborrheic dermatitis (scaly areas on your skin or scalp).
Fungosine 1% shampoo is used to treat dandruff.
Fungosine 2% shampoo is used to treat "sun fungus" (tinea versicolor; pityriasis versicolor).
Fungosine may also be used for other fungus infections of the skin as determined by your doctor.
Most forms of Fungosine are available only with your doctor's prescription. Some forms are available without a prescription. However, your doctor may have special instructions on the proper use for your medical condition.
Fungosine indications
Fungosine is an imidazole antifungal administered topically or by mouth. It is given by mouth in chronic mucocutaneous or vaginal candidiasis, in fungal infections of the gastrointestinal tract, in dermatophyte infections of the skin and fingernails not responding to topical treatment, and in systemic infections including blastomycosis, candidiasis, coccidioidomycosis, histoplasmosis, and paracoccidioidomycosis.
It has been given for the prophylaxis of fungal infections in immunocompromised patients, although fluconazole or itraconazole are usually preferred. It has been recommended that, because of its erratic absorption and slow therapeutic response, Fungosine should not be used for the treatment of life-threatening fungal infections, including fungal meningitis, or for severe infections in immunocompromised patients. Also, because of the risk of hepatotoxicity the use of Fungosine in nonsystemic fungal infections tends to be restricted to serious infections resistant to other treatment.
How should I use Fungosine?
Use Fungosine gel as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Fungosine gel. Talk to your pharmacist if you have questions about this information.
- Wash your hands before and immediately after using Fungosine gel.
- Spread a thin layer of Fungosine gel onto the affected area with the tips of your fingers. Gently rub it in. Be sure to cover the entire affected area and the healthy skin around it.
- Do not touch your eyes or nose while you are applying Fungosine gel.
- Wait for at least 20 minutes after you apply Fungosine gel before you apply makeup or sunscreen.
- Do not wash the area where you applied Fungosine gel for at least 3 hours after you apply it.
- If you miss a dose of Fungosine gel, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Fungosine gel.
Uses of Fungosine in details
Use: Labeled Indications
Fungal infections (systemic):
US labeling: Treatment of susceptible systemic fungal infections, including blastomycosis, histoplasmosis, paracoccidioidomycosis, coccidioidomycosis, and chromomycosis in patients who have failed or who are intolerant to other antifungal therapies
Limitations of use: Fungosine should only be used when other effective antifungal therapy is not available or tolerated and the potential benefits outweigh the potential risks. Fungosine tablets are not indicated for the treatment of onychomycosis, cutaneous dermatophyte infections, or Candida infections.
Canadian labeling: Treatment of serious or life-threatening systemic fungal infections (eg, systemic candidiasis, chronic mucocutaneous candidiasis, coccidioidomycosis, paracoccidioidomycosis, histoplasmosis, and chromomycosis) where alternate therapy is inappropriate or ineffective; may be considered for severe dermatophytoses unresponsive to other therapy
Off Label Uses
Cushing syndrome
Data from a retrospective multicenter study support the use of Fungosine in the management of patients with Cushing disease. The study authors found the side effects of Fungosine to be acceptable; however, close monitoring of liver enzymes is advised. Additional trials may be necessary to further define the role of Fungosine in this condition.
Based on the Endocrine Society
Fungosine description
Fungosine contains the following ingredients: D-Water, maltodextrin (corn), partially hydrolyzed sodium caseinate, lactalbumin hydrolysate, canola oil, medium-chain triglycerides (fractionated coconut oil), L-arginine, corn oil, magnesium chloride, potassium citrate, tribasic calcium phosphate, citric acid, soy lecithin, ascorbic acid, dibasic potassium phosphate, choline chloride, carrageenan, potassium chloride, taurine, L-carnitine, zinc sulfate, ferrous sulfate, α-tocopheryl acetate, niacinamide, calcium pantothenate, manganese sulfate, β-carotene, cupric sulfate, thiamine chloride HCl, pyridoxine HCl, riboflavin, vitamin A palmitate, folic acid, biotin, chromium chloride, sodium molybdate, potassium iodide, sodium selenate, phylloquinone, cyanocobalamin and vitamin D3.
Fungosine is a ready-to-feed enteral product as a supplemental or sole-source nutrition complete and balanced nutrition for tube feeding. It is calorie dense at 1.3 cal/mL and contains a protein system of partially hydrolyzed proteins, including peptides and amino acids, to utilize the dual absorption system of the gut. Fungosine is lactose- and gluten-free.
Caloric Distribution: See Table 1.
Analysis: See Table 2.
Fungosine dosage
Fungosine Dosage
Generic name: Fungosine 200mg
Dosage form: tablet
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
There should be laboratory as well as clinical documentation of infection prior to starting Fungosine therapy. The usual duration of therapy for systemic infection is 6 months. Treatment should be continued until active fungal infection has subsided.
Adults
The recommended starting dose of Fungosine® (Fungosine) Tablets is a single daily administration of 200 mg (one tablet). If clinical responsiveness is insufficient within the expected time, the dose of Fungosine® Tablets may be increased to 400 mg (two tablets) once daily.
Children
In small numbers of children over 2 years of age, a single daily dose of 3.3 to 6.6 mg/kg has been used. Fungosine® Tablets have not been studied in children under 2 years of age.
More about Fungosine (Fungosine)
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Images
- Drug Interactions
- Support Group
- En Espanol
- 4 Reviews - Add your own review/rating
Consumer resources
- Fungosine
- Fungosine (Advanced Reading)
Professional resources
- Fungosine (AHFS Monograph)
- Fungosine (FDA)
Other formulations
- Fungosine
Topical
- Fungosine A-D
Related treatment guides
- Blastomycosis
- Chromomycosis
- Coccidioidomycosis
- Histoplasmosis
- Paracoccidioidomycosis
Fungosine interactions
See also:
What other drugs will affect Fungosine?
Fungosine is a potent inhibitor of the cytochrome P450 3A4 enzyme system. Coadministration of Fungosine Tablets and drugs primarily metabolized by the cytochrome P450 3A4 enzyme system may result in increased plasma concentrations of the drugs that could increase or prolong both therapeutic and adverse effects.
Fungosine Tablets inhibit the metabolism of terfenadine, resulting in an increased plasma concentration of terfenadine.
Fungosine inhibits the metabolism of astemizole. Fungosine potently inhibits the metabolism of cisapride resulting in a mean eight-fold increase in AUC of cisapride.
Fungosine Tablets may alter the metabolism of cyclosporine, tacrolimus, and methylprednisolone, resulting in elevated plasma concentrations of the latter drugs.
Coadministration of Fungosine Tablets with midazolam or triazolam has resulted in elevated plasma concentrations of the latter two drugs.
It is, therefore, advisable to monitor digoxin concentrations in patients receiving Fungosine.
When taken orally, imidazole compounds like Fungosine may enhance the anticoagulant effect of coumarin-like drugs.
a potential interaction involving the latter agents when used concomitantly with Fungosine Tablets (an imidazole) can not be ruled out.
Concomitant administration of Fungosine Tablets with phenytoin may alter the metabolism of one or both of the drugs.
Concomitant administration of rifampin with Fungosine Tablets reduces the blood levels of the latter. INH (isoniazid) is also reported to affect Fungosine concentrations adversely.
Fungosine side effects
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What are the possible side effects of Fungosine?
Topically applied Fungosine appears to have a low order of toxicity and is generally well tolerated. Adverse effects have been reported in up to 5% of patients receiving Fungosine 2% cream and have consisted principally of local reactions such as severe irritation, pruritus, and stinging. A painful allergic reaction, consisting of localized swelling and inflammation, occurred in at least one patient receiving Fungosine 2% cream and contact dermatitis occurred in another.
In several studies evaluating the potential of topical Fungosine for causing dermal irritation, contact sensitization, or phototoxic or photoallergenic reactions in healthy adults, topical application of Fungosine 2% cream caused mild transient erythema in some individuals, but did not cause contact sensitization of the delayed hypersensitivity type, irritation, phototoxicity, or photocontact sensitization.
Contact dermatitis has been reported following topical application of imidazole-derivative azole antifungals (e.g., clotrimazole, econazole, miconazole, oxiconazole, sulconazole, tioconazole). Cross-sensitization appears to occur among the imidazole derivatives; however, cross-sensitivity appears to be unpredictable. The fact that patients with contact sensitivity to one imidazole-derivative azole antifungal may be sensitive to other similar drugs should be considered.
Although hepatotoxicity has occurred during treatment with oral Fungosine, it is unlikely that this adverse effect would occur with Fungosine 2% cream since the drug does not appear to be appreciably absorbed following topical application to skin.
Adverse effects reported in patients receiving topical Fungosine 2% as a shampoo applied to the skin include pruritus, application site reaction, and dry skin. Adverse effects reported in patients receiving Fungosine shampoo to the scalp include increased hair loss, irritation, abnormal hair texture, scalp pustules, dry skin, pruritus, and oiliness or dryness of the hair and scalp. In some patients with permanently waved (“permed”) hair, use of Fungosine 2% shampoo resulted in loss of the curl.
Fungosine contraindications
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What is the most important information I should know about Fungosine?
Drug Interactions
Coadministration of a number of CYP3A4 substrates such as dofetilide, quinidine cisapride and pimozide is contraindicated with Fungosine® Tablets. Coadministration with Fungosine can cause elevated plasma concentrations of these drugs and may increase or prolong both therapeutic and adverse effects to such an extent that a potentially serious adverse reaction may occur. For example, increased plasma concentrations of some of these drugs can lead to QT prolongation and sometimes resulting in life-threatening ventricular tachyarrhythmias including occurrences of torsades de pointes, a potentially fatal arrhythmia.
Additionally, the following other drugs are contraindicated with Fungosine® Tablets: methadone, disopyramide, dronedarone, ergot alkaloids such as dihydroergotamine, ergometrine, ergotamine, methylergometrine, irinotecan, lurasidone, oral midazolam, alprazolam, triazolam, felodipine, nisoldipine, ranolazine, tolvaptan, eplerenone, lovastatin, simvastatin and colchicine.
Enhanced Sedation
Coadministration of Fungosine® Tablets with oral midazolam, oral triazolam or alprazolam has resulted in elevated plasma concentrations of these drugs. This may potentiate and prolong hypnotic and sedative effects, especially with repeated dosing or chronic administration of these agents. Concomitant administration of Fungosine® Tablets with oral triazolam, oral midazolam or alprazolam is contraindicated.
Myopathy
Coadministration of CYP3A4 metabolized HMG-CoA reductase inhibitors such as simvastatin, and lovastatin is contraindicated with Fungosine® Tablets.
Ergotism
Concomitant administration of ergot alkaloids such as dihydroergotamine and ergotamine with Fungosine® Tablets is contraindicated.
Liver Disease
The use of Fungosine® Tablets is contraindicated in patients with acute or chronic liver disease.
Hypersensitivity
Fungosine® is contraindicated in patients who have shown hypersensitivity to the drug.
Active ingredient matches for Fungosine:
Ketoconazole in Mexico.
| Unit description / dosage (Manufacturer) | Price, USD |
| Cream; Topical; Ketoconazole | |
| Tablet; Oral; Ketoconazole | |
List of Fungosine substitutes (brand and generic names): | |
| Fungores (Poland) | |
| Funole | |
| Funole 150 mg Tablet (Pharma Plus) | $ 0.21 |
| Furid | |
| Furid 200 mg Tablet (Medo Chem Lab (P) Ltd.) | $ 0.10 |
| Gold Daktarin (China) | |
| Grazol (Indonesia) | |
| Grazol 200 mg x 3 x 10's | |
| Grenfung (Argentina) | |
| HC Ketoconazole (Hong Kong) | |
| Hetonazol (Bulgaria) | |
| Hexal Konazol (Australia) | |
| Hexal Konazol Shampoo (Australia) | |
| Hitoral (Vietnam) | |
| Hitoral Ketoconazole 2%w/w CREAM / 20gm (Synmedic Laboratories) | |
| Hitoral 200 mg x 10 Blister x 10 Tablet (Synmedic Laboratories) | |
| Hitoral 200 mg Tablet (Synmedic Laboratories) | $ 0.09 |
| Hongosan Ket (Paraguay) | |
| Honzil (Mexico) | |
| Hyphoral (India) | |
| Hyphoral Capsule/ Tablet / 200mg / 10 units (IPCA Laboratories Ltd.) | $ 1.70 |
| Hyphoral Ketoconazole 2%w/w, ZPTO 1%w/v LOTION / 50ml (IPCA Laboratories Ltd.) | $ 1.30 |
| Hyphoral 200 mg Tablet (IPCA Laboratories Ltd.) | $ 0.18 |
| Hyphoral Skin 50 ml Lotion (IPCA Laboratories Ltd.) | $ 1.51 |
| HYPHORAL 200 MG TABLET 1 strip / 10 tablets each (IPCA Laboratories Ltd.) | $ 2.89 |
| Hyphoral 200mg Tablet (IPCA Laboratories Ltd.) | $ 0.29 |
| Hyphoral Tablets | |
| Tablet; Oral; Ketoconazole | |
| I-KET (India) | |
| I-KET soap 2 % x 75g (Casca) | $ 1.02 |
| Ilgem (Greece) | |
| Ilgem 2% (Cyprus, Greece) | |
| Ilggem (Ethiopia) | |
| Interzol Cream (Indonesia) | |
| Interzol Cream 2 % x 5 g | $ 1.86 |
| Interzol Scalp Solution (Indonesia) | |
| Interzol Scalp Solution 1 % x 100 mL | $ 4.34 |
| Interzol Scalp Solution 2 % x 80 mL | $ 5.58 |
| Iycotic (India) | |
| Iycotic Ketoconazole 2%w/w CREAM / 20gm (Rowan Bioceuticals (P) Ltd.) | $ 0.87 |
| Iycotic Ketoconazole 2%w/v SHAMPOO / 60ml (Rowan Bioceuticals (P) Ltd.) | $ 1.19 |
| Iycotic Skin 60 ml Shampoo (Rowan Bioceuticals (P) Ltd.) | $ 1.19 |
| Iycotic Skin 20 gm Cream (Rowan Bioceuticals (P) Ltd.) | $ 0.87 |
| Iycotic 200 mg Tablet (Rowan Bioceuticals (P) Ltd.) | $ 0.21 |
| IYCOTIC 2% CREAM 1 tube / 20 GM cream each (Rowan Bioceuticals (P) Ltd.) | $ 1.03 |
| IYCOTIC 2% LOTION 1 bottle / 100 ML lotion each (Rowan Bioceuticals (P) Ltd.) | $ 1.86 |
| IYCOTIC 200 MG TABLET 1 strip / 10 tablets each (Rowan Bioceuticals (P) Ltd.) | $ 2.03 |
| IYCOTIC SHAMPOO 1 bottle / 60 ML shampoo each (Rowan Bioceuticals (P) Ltd.) | $ 1.95 |
| IYCOTIC cream 2 % x 20g (Rowan Bioceuticals (P) Ltd.) | $ 1.08 |
| IYCOTIC lotion 2 % x 100ml (Rowan Bioceuticals (P) Ltd.) | $ 1.95 |
| IYCOTIC tab 200 mg x 10's (Rowan Bioceuticals (P) Ltd.) | $ 2.17 |
| Iycotic 2% Cream (Rowan Bioceuticals (P) Ltd.) | $ 1.08 |
See 2049 substitutes for Fungosine | |
References
- DailyMed. "KETOCONAZOLE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "ketoconazole". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "ketoconazole". http://www.drugbank.ca/drugs/DB01026 (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Fungosine are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Fungosine. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
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Information checked by Dr. Sachin Kumar, MD Pharmacology
