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Fluconazole 200mg Capsules

Document: leaflet MAH GENERIC_PL 10622-0088 change

Package leaflet: Information for the user

Fluconazole 50mg and 200mg Capsules

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you..

•    Keep this leaflet. You may need to read it again.

•    If you have any further questions, ask your doctor or pharmacist.

•    This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

•    If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1.    What Fluconazole is and what it is used for

2.    What you need to know before you take Fluconazole.

3.    How to take Fluconazole.

4.    Possible side-effects

5.    How to store Fluconazole.

6.    Contents of the pack and other information

1. What Fluconazole is and what it is used for

Fluconazole is one of a group of medicines called “antifungals”. The active substance is fluconazole.

Fluconazole Capsules are used to treat infections caused by fungi and may also be used to stop you from getting candidal infection. The most common cause of fungal infections is a yeast called Candida.

Adults

You might be given this medicine by your doctor to treat the following types of fungal infections:

   Cryptococcal meningitis - a fungal infection in the brain

•    Coccidioidomycosis - a disease of the bronchopulmonary system

•    Infections caused by Candida and found in the blood stream, body organs (e.g. heart, lungs) or urinary tract

•    Mucosal thrush - infection affecting the lining of the mouth, throat and denture sore mouth

•    Genital thrush - infection of the vagina or penis

•    Skin infections - e.g. athlete's foot, ringworm, jock itch, nail infection

You might also be given Fluconazole Capsules to:

•    stop cryptococcal meningitis from coming back

•    stop mucosal trush from coming back

•    reduce recurrence of vaginal trush

•    stop you from getting an infection caused by Candida (if your immune system is weak and not working properly)

Children and adolescents (0 to 17 years old)

You might be given this medicine by your doctor to treat the following types of fungal infections:

Mucosal thrush - infection affecting the lining of the mouth, throat

•    Infections caused by Candida and found in the blood stream, body organs (e.g. heart, lungs) or urinary tract

•    Cryptococcal meningitis - a fungal infection in the brain

You might also be given Fluconazole Capsules to:

•    stop you from getting an infection caused by Candida (if your immune system is weak and not working properly).

•    stop cryptococcal meningitis from coming back

2. What you need to know before you take Fluconazole.

Do not take Fluconazole

•    if you are allergic (hypersensitive) to fluconazole, to other medicines you have taken to treat fungal infections or to any of the other ingredients of this medicine (listed in section 6).. The symptoms may include itching, reddening of the skin or difficulty in breathing

•    if you are taking astemizole, terfenadine (antihistamine medicines for allergies)

•    if you are    taking cisapride (used for stomach upsets)

•    if you are    taking pimozide (used for treating mental illness)

•    if you are    taking quinidine (used for treating heart arrhythmia)

•    if you are    taking erythromycin (an antibiotic for treating infections)

Warnings and precautions

Talk to your doctor or pharmacist before taking Fluconazole

•    if you have liver or kidney problems

•    if you suffer from heart disease, including heart rhythm problems

•    if you have abnormal levels of potassium, calcium or magnesium in your blood

•    if you You develop severe skin reactions (itching, reddening of the skin or difficulty in breathing)

Ketoconazole is known to cause adrenal insufficiency (a condition in which the adrenal glands do not produce adequate amounts of steroid hormones), and this could also although rarely seen be applicable to fluconazole.

Other medicines and Fluconazole

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Tell your doctor immediately if you are taking astemizole, terfenadine (an antihistamine for treating allergies) or cisapride (used for stomach upsets) or pimozide (used for treating mental illness) or quinidine (used for treating heart arrhythmia) or erythromycin (an antibiotic for treating infections) as these should not be taken with Fluconazole Capsules (see section: “Do not take Fluconazole”).

There are some medicines that may interact with fluconazole. Make sure your doctor knows if you are taking any of the following medicines:

•    rifampicin or rifabutin (antibiotics for infections)

•    alfentanil, fentanyl (used as anaesthetic)

•    amitriptyline, nortriptyline (used as anti-depressant)

•    amphotericin B, voriconazole (anti-fungal)

• medicines that thin the blood to prevent blood clots (indanedione, warfarin or similar medicines)

• benzodiazepines (midazolam, triazolam or similar medicines) used to help you sleep or for anxiety

•    carbamazepine, phenytoin (used for treating fits)

•    nifedipine, isradipine, amlodipine felodipine and losartan (for hypertension- high blood pressure)

•    ciclosporin, everolimus , sirolimus or tacrolimus (to prevent transplant rejection)

•    cyclosphosphamide, vinca alkaloids (vincristine, vinblastine or similar medicines) used for treating cancer

•    halofantrine (used for treating malaria)

•    statins (atorvastatin, simvastatin and fluvastatin or similar medicines) used for reducing high cholesterol levels

•    methadone (used for pain)

•    celecoxib, flurbiprofen, naproxen, ibuprofen, lornoxicam, meloxicam, diclofenac (Non-Steroidal Anti-Inflammatory Drugs (NSAID))

•    oral contraceptives

•    prednisone (steroid)

•    zidovudine, also known as AZT; saquinavir (used in HIV-infected patients)

•    medicines for diabetes such as chlorpropamide, glibenclamide, glipizide or tolbutamide

•    theophylline (used to control asthma)

•    vitamin A (nutritional supplement)

•    hydrochlorothiazide (a ‘water pill’)

•    amiodarone (used for treating heart problems)

Fluconazole with food and drink

You can take your medicine with or without a meal.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

When driving vehicles or using machines, it should be taken into account that occasionally dizziness or fits may occur.

Fluconazole Capsules contains Lactose

This product contains a small amount of lactose (milk sugar). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3. How to take Fluconazole

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

Swallow the capsule whole with a glass of water. It is best to take your capsules at the same time each day.

The usual doses of this medicine for different infections are below:

Condition

Dose

To treat cryptococcal meningitis

400 mg on the first day then 200 mg to 400 mg once daily for 6 to 8 weeks or longer if needed. Sometimes doses are increased up to 800 mg

To stop cryptococcal meningitis from coming back

200 mg once daily until you are told to stop

To treat coccidioidomycosis

200 mg to 400 mg once daily from 11 months for up to 24 months or longer if needed. Sometimes doses are increased up to 800 mg

To treat internal fungal infections caused

by Candida

800 mg on the first day then 400 mg once daily until you are told to stop

To treat mucosal infections affecting the lining of mouth, throat and denture sore mouth

200 mg to 400 mg on the first day then 100 mg to 200 mg until you are told to stop

To treat mucosal thrush - dose depends on where the infection is located

50 mg to 400 mg once daily for 7 to 30 days until you are told to stop

To stop mucosal infections affecting the lining of mouth, throat

100 mg to 200 mg once daily, or 200 mg 3 times a week, while you are at risk of getting an infection

To treat genital thrush

150 mg as a single dose

To reduce recurrence of vaginal trush

150 mg every third day for a total of 3 doses (day 1, 4 and 7) and then once a week for 6 months while you are at risk of getting an infection

To treat fungal skin and nail infections

Depending on the site of the infection 50 mg once daily, 150 mg once weekly, 300 to 400 mg once weekly for 1 to 4 weeks (Athlete’s foot may be up to 6 weeks, for nail infection treatment until infected nail is replaced)

To stop you from getting an infection caused by Candida (if your immune system is weak and not working properly)

200 mg to 400 mg once daily while you are at risk of getting an infection

Use in children and adolescents Adolescents from 12 to 17 years old

Follow the dose prescribed by your doctor (either adults or children posology).

Children to 11 years old

The maximum dose for children is 400 mg daily.

The dose will be based on the child’s weight in kilograms.

Condition

Daily dose

Mucosal thrush and throat infections caused by Candida - dose and duration depends on the severity of the infection and on where the infection is located

3 mg per kg of body weight (6 mg per kg of body weight might be given on the first day)

Cryptococcal meningitis or internal fungal infections caused by Candida

6 mg to 12 mg per kg of body weight

To stop children from getting an infection caused by Candida (if their immune system is not working properly)

3 mg to 12 mg per kg of body weight

Use in children 0 to 4 weeks of age

Use in children of 3 to 4 weeks of age:

The same dose as above but given once every 2 days. The maximum dose is 12 mg per kg of body weight every 48 hours.

Use in children less than 2 weeks old:

The same dose as above but given once every 3 days. The maximum dose is 12 mg per kg of body weight every 72 hours.

Doctors sometimes prescribe different doses to these. Always take your medicine exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

Elderly

The usual adult dose should be given unless you have kidney problems. Your doctor will decide what dose to give you

Patients with kidney problems

Your doctor will decide what dose to give you depending on your kidney function.

If you take more Fluconazole than you should

Taking too many capsules at once may make you unwell. Contact your doctor or your nearest hospital casualty department at once.

The symptoms of a possible overdose may include hearing, seeing, feeling and thinking things that are not real (hallucination and paranoid behaviour). Symptomatic treatment (with supportive measures and gastric lavage if necessary) may be adequate.

If you forget to take Fluconazole

Do not take a double dose to make up for a forgotten dose. If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose though, do not take the dose that you missed.

If you stop taking Fluconazole

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side-effects

Like all medicines, this medicine can cause side-effects, although not everybody gets them.

A few people develop allergic reactions although serious allergic reactions are rare. If you get any of the following symptoms, tell your doctor immediately.

•    Sudden wheezing, difficulty in breathing or tightness in the chest

•    Swelling of eyelids, face or lips

•    Itching all over the body reddening of the skin or itchy red spots

•    Skin rash

•    Severe skin reactions such as a rash that causes blistering (this can affect the mouth and tongue).

Fluconazole may affect your liver. The signs of liver problems include:

•    Tiredness

•    Loss of appetite

•    Vomiting

•    Yellowing of your skin or the whites of your eyes (jaundice)

If any of these happen, stop taking Fluconazole Capsules and tell your doctor immediately.

Other side effects:

Additionally, if any of the following side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Common side-effects, which may affect up to 1 in 10 people are listed below:

•    Headache

•    Stomach discomfort

•    Diarrhoea

•    Feeling sick

•    Vomiting

•    Increases in blood tests of liver function

•    Rash

Uncommon side effects which may affect up to 1 in 100 people are listed below:

•    Reduction in red blood cells which can make skin pale and cause weakness or breathlessness

•    Decreased appetite

•    Inability to sleep,

•    Feeling drowsy

•    Fit,

•    Dizziness,

•    Sensation of spinning, tingling, pricking or numbness,

•    Changes in sense of taste,

•    Constipation,

•    Difficult digestion,

•    Wind,

•    Dry mouth

•    Muscle pain

•    Liver damage and yellowing of the skin and eyes (jaundice)

•    Wheals,

•    Blistering (hives),

•    Itching,

•    Increased sweating

•    Tiredness,

•    General feeling of being unwell

•    Fever

Rare side effects which may affect up to 1 in 1,000 people are listed below:

•    Lower than normal white blood cells that help defend against infections and blood cells that help to stop bleeding

•    Red or purple discoloration of the skin which may be caused by low platelet count,

•    Other blood cell changes

•    Blood chemistry changes (high blood levels of cholesterol, fats)

•    Low blood potassium

•    Shaking

•    Abnormal electrocardiogram (ECG),

•    Change in heart rate or rhythm

•    Liver failure

•    Allergic reactions (sometimes severe), including widespread blistering rash and skin peeling, severe skin reactions, swelling of the lips or face

•    Hair loss

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard

By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Fluconazole capsules

Keep this medicine out of the sight and reach of children.

This medicinal product does not require any special storage conditions.

Do not use this medicine after the expiry date which is stated on the carton after ‘EXP’. The expiry date refers to the last day of that month.

Do not throw away medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer required use. These measures will help protect the environment.

6. Contents of the pack and other information

What Fluconazole contains:

The active substance is fluconazole.

The other ingredients are lactose monohydrate, microcrystalline cellulose, pregelatinized maize starch, colloidal anhydrous silica, magnesium stearate and sodium laurilsulfate. The capsule shell contains titanium dioxide (E171) and gelatin. The 50mg Capsules also contain quinoline yellow (E104), yellow iron oxide (E172) and patent blue V (E131).

What Fluconazole looks like and contents of the pack

Fluconazole 50mg Capsules are hard green and white capsules. Fluconazole 200mg Capsules are hard white capsules.

Fluconazole Capsules are available in blister packs of 7 hard capsules.

Marketing Authorisation Holder

PLIVA Pharma Ltd, Vision House, Bedford Road, Petersfield, Hampshire, GU32 3QB, United Kingdom.

Manufacturer

Pharmathen S.A., 6 Dervenakion str.,

15351 Pallini Attikis, Athens, Greece.

This leaflet was last revised in January 2016