Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
(5-fluCYTOSINE, 5-FC) (Special Access Medication) *
Refer to the Procedure for Safe Handling of Hazardous Drugs (CYTOTOXIC and non-CYTOTOXIC) and Safe Handling of Hazardous Drugs Policy on the LHSC Intranet
Indication
- For the treatment of suspected or confirmed susceptible Candida species or Cryptococcus meningitis, in combination with Amphotericin B (synergistic effect)
Dosage Guidelines
| Less than or equal to 2 kg | Greater than 2 kg |
|---|---|---|
0 to 7 days | 25 mg/kg/dose oral q8h | 18.75 mg/kg/dose oral q6h |
Greater than 7 days | 18.75 mg/kg/dose oral q6h | 18.75 mg/kg/dose oral q6h |
Administration
- Oral
Adverse Effects
- Nausea, vomiting, diarrhea, skin rash, decreased liver function (dose related and reversible), hepatomegaly, bone marrow depression (leucopenia and thrombocytopenia) with levels greater than 100 microgram/mL
Comments
- Must obtain approval from Special Access Program prior to initiation
- Efficacy is best judged by clinical response
- Resistance may develop if flucytosine is used alone
- Monitor renal function, liver function tests and CBC weekly
- Adjust dose in renal impairment – Contact Pharmacist
Supplied As
- Oral suspension (50 mg/mL)
References
LexiComp Pediatric and Neonatal