Last update Feb. 1, 2024

Flucytosine

Limited compatibility

Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

Flucytosine is an antifungal indicated in combination with amphotericin B to treat severe systemic infections caused by Candida or Cryptococcus. Intravenous and oral administration.

At the time of the last update, we found no published data on its excretion in breast milk.

Although its low molecular weight and its low binding to plasma proteins facilitate its excretion in breast milk, its large volume of distribution would make it difficult.

It is a drug authorized for use in neonatology, even in premature infants. (Clerihew 2012)

If administered during lactation, the infant should be monitored for vomiting, diarrhea or skin rash.

The possibility of breastfeeding depends on the mother's clinical condition, which is not good when this medication is required. (Mactal 2001)

 

Alternatives

  • Amphotericin B (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Fluconazole (Safe product and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Flucytosine is also known as


Flucytosine in other languages or writings:

Groups

Flucytosine belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Flucytosine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 78 - 89 %
Molecular weight 129 daltons
Protein Binding 28 - 31 %
VD 0.6 (0.4 - 0.8) l/Kg
pKa 8.31 -
Tmax 2 hours
T½ 2.4 - 4.8 hours

References

  1. Bellmann R, Smuszkiewicz P. Pharmacokinetics of antifungal drugs: practical implications for optimized treatment of patients. Infection. 2017 Dec;45(6):737-779. Abstract Full text (link to original source)
  2. Clerihew L, McGuire W. Antifungal therapy for newborn infants with invasive fungal infection. Cochrane Database Syst Rev. 2012 Jun 13;(6):CD003953. Abstract Full text (link to original source)
  3. Mactal-Haaf C, Hoffman M, Kuchta A. Use of anti-infective agents during lactation, Part 3: Antivirals, antifungals, and urinary antiseptics. J Hum Lact. 2001 Abstract
  4. Vermes A, Guchelaar HJ, Dankert J. Flucytosine: a review of its pharmacology, clinical indications, pharmacokinetics, toxicity and drug interactions. J Antimicrob Chemother. 2000 Aug;46(2):171-9. Review. Abstract Full text (link to original source)

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