Antifungals
PREGNANCY CATEGORY C
Therapeutic Actions
Antifungals bind to or impair sterols of fungal cell membranes, allowing increased permeability and leakage of cellular components and causing the death of the fungal cell.
Indications
Systemic fungal infections: Candidiasis, chronic mucocutaneous candidiasis, oral thrush, candiduria, aspergillosis, blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, paracoccidioidomycosis, dermatophytosis, ringworm infections of the skin
Treatment of onychomycosis, pityriasis versicolor, vaginal candidiasis; topical treatment of tinea corporis and tinea cruris caused by Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum; treatment of tinea versicolor caused by Malassezia furfur (topical); and reduction of scaling due to dandruff (shampoo)
Contraindications and Cautions
Contraindicated with allergy to any antifungal, fungal meningitis, pregnancy, lactation.
Use cautiously with hepatocellular failure (increased risk of hepatocellular necrosis).
Adverse Effects
CNS: Headache, dizziness, somnolence, photophobia
GI: Hepatotoxicity, nausea, vomiting, abdominal pain
GU: Impotence, oligospermia (with very high doses), nephrotoxicity
Hematologic: Thrombocytopenia, leukopenia, hemolytic anemia
Hypersensitivity: Urticaria to anaphylaxis
Local: Severe irritation, pruritus, stinging with topical application
Other: Pruritus, fever, chills, gynecomastia, electrolyte abnormalities (amphotericin B)
