Overview of modern antifungal drugs intablets

Update: October 2018

Antimycotics or otherwise antifungal drugs are extensive.
class of various chemical compounds with specific
activity against pathogenic fungi. They are and
natural origin, and obtained by chemical synthesis.
Antifungal drugs are divided into several groups
differing in chemical structure, clinical use in
various mycoses (fungal infections), as well as by features
activity spectrum. Today the need to apply
противогрибковых препаратов в tablets, кремах, гелях, жидкостях
increased significantly. This is due to the frequent use of powerful
broad-spectrum antibiotics, their wrong
application, sometimes inappropriate and unjustified. And also with
increase in the number of patients with various disorders of the immune system and
with an increase in the prevalence of severe forms of systemic
mycosis.

Below is a brief overview of antifungal drugs in
tablets. These medicines have a number of contraindications and
undesirable side effects, so their purpose, dosage and
the duration of treatment should be determined only by the attending physician.

Patients taking oral antimycotic drugs,
It is necessary to strictly observe the scheme and treatment regimen, do not stop
prescribed a course of self-medication, take a dose through
equal time intervals and do not skip the dose. If a
the drug was missed, you should take the next dose as
can be faster, while not doubling the dose. Irregular reception
skipping and premature termination of therapy increases the risk
relapse development.

Antifungal drugs group – Polyene:

Among all antifungal drugs, polyenes have the most
wide spectrum of activity. These include – nystatin, natamycin,
levorin, amphotericin B. They are active when applied topically
mainly on Candida spp., Natamycin (Pimafucin) is active
also in relation to the simplest, for example, Trichomonas. To polyenes
pseudo-Allesheria and dermatomycete fungi, i.e., the region
use of this group of antimycotic drugs – candidiasis
mucous membranes, skin, gastrointestinal tract.

Нистатин — противогрибковый антибиотик из
группы полиенов, высокоактивен в отношении грибов рода НистатинCandida. Practically not absorbed in the digestive tract. AT
Recently, almost not used.

  • Показания к применению: Candidiasis кожи, кишечника, полости рта и
    pharynx Prevention and treatment of gastrointestinal candidiasis arising from
    long-term antibiotic treatment with tetracycline and penicillin
    row. Prevention of candidiasis in the postoperative period with
    gastrointestinal surgery.
  • Contraindications: Hypersensitivity.
  • Side Effects: Allergic reactions, nausea, vomiting, pain
    in the stomach, chills, diarrhea.
  • Price: 15-50 rubles.

Леворин — наиболее активен в отношении Candida
albicans, protozoa – Trichomonas, amoebas, Leishmania. With hypertrophy
prostate gland reduces dysuric phenomena, sometimes
reduces the size of the adenoma.

  • Показания к применению: Candidiasis кожи, кишечника, полости рта и
    pharynx Леворин в tablets применяют при кандидоносительстве,
    candidiasis of the digestive tract, with hypertrophy of the prostate gland in the composition
    complex therapy.
  • Contraindications: hepatic or renal failure,
    acute intestinal diseases of non-fungal origin, peptic ulcer
    stomach disease, pregnancy, pancreatitis. Carefully — детям
    до 2 лет и в период lactation.
  • Side Effects: Decreased appetite, allergic reactions,
    nausea, vomiting, headache.

Пимафуцин (Натамицин) — противогрибковый
polyene antibiotic, has a fungicidal effect. To pimafucin
most moldy, pathogenic yeasts are sensitive,
including the genus Aspergillus, Candida, Fusarium, Cephalosporium,
Penicillium. Таблетки Пимафуцина, покрытые Пимафуцинкишечнорастворимой оболочкой, оказывают действие
only in the intestinal lumen, without any systemic action.

  • Indications for use: intestinal candidiasis, vaginal candidiasis,
    acute atrophic candidiasis in patients with immune deficiency,
    after therapy with corticosteroids, antibiotics, cytotoxic drugs.
    ATозможно его применение при беременности и кормлении грудью.
  • Contraindications: hypersensitivity to the components
    drug.
  • Побочные действия:  диарея, тошнота,
    may occur in the first days of medication, and during treatment
    pass by themselves.
  • Price: average price 400 rubles. for 20 tab.

Амфотерицин AT — аналоги Амбизом, Амфоглюкамин,
Amphocyl, Ampholip, Fungizone is a lyophilisate for infusions.
Used in life-threatening, progressive fungal
infections, disseminated forms of candidiasis, infections of the abdominal
cavities, peritonitis, fungal sepsis.

Antifungal drugs group – Azole:

Азолы — группа синтетических антимикотиков,
including the remedy for thrush fluconazole, ketoconazole,
Itraconazole. Ketoconazole after the introduction of the practice of itraconazole
lost its meaning due to its high toxicity and now
time is mainly used only for the local treatment of mycoses.
This group of antimycotics is effective in treating certain types of
depriving, fungal lesions of the skin, nails, scalp,
candidiasis mucous membranes.

Кетоконазол, аналоги Ороназол
Микозорал, Низорал, Фунгавис
— синтетическое производное
imidazoldioxolane, active against yeast-like fungi,
dermatophytes, higher fungi and dimorphic fungi.

  • Indications for use: Infections of the skin, mucous membranes,
    волосистой части головы, вызванные Микозоралдрожжевыми грибами и дерматофитами. Assigned to
    the ineffectiveness of local treatment due to the large size of the affected
    areas of severe damage and resistance to therapy
    other antifungal agents. With lichen colored,
    dermatophytosis, folliculitis, chronic candidiasis of the skin, mouth and
    pharynx, recurrent vaginal candidiasis.
  • Contraindications: Sensitivity to the components of the drug,
    chronic and acute diseases of the kidneys, liver. Carefully –
    during pregnancy, lactation, children under 3 years old, women over 50 years old,
    when taking hepatotoxic drugs.
  • Side effects: Digestive system – nausea, pain in
    stomachache, vomiting, loss of appetite, toxic hepatitis. Nervous
    system: dizziness, headache, drowsiness, increased
    intracranial pressure. Hemolytic organs: hemolytic
    anemia, leukopenia, thrombocytopenia. Genitourinary system:
    impotence, oligospermia, dysmenorrhea. Allergic reactions in the form of
    skin rash, urticaria, fever, photophobia.
  • Цена: средняя цена в аптеках — Фунгавис 160
    руб, Низорал 10 табл .550 руб., 30 табл.1500 руб.,
    Микозорал 30 табл. 330 rub.

Итраконазол – аналоги Ирунин, Итразол,
Кандитрал, Орунгал, Румикоз, Орунит
. Synthetic
antifungal drugs in tablets, have a wide range
action against fungi: dermatophytes, yeast fungi Candida spp,
mold fungi. Эффективность лечения при микозах Румикозследует оценивать через 2-4 недели после окончания,
in the treatment of drugs from nail fungus after 6-9 months.

  • Indications for use: ringworm, vulvovaginal
    candidiasis, versicolor versicolor, keratomycosis, fungal diseases
    nails, oral candidiasis caused by yeast-like fungi and
    dermatophytes, as well as systemic aspergillosis, cryptococcosis,
    candidiasis in immunocompromised individuals. And also with sporotrichosis,
    histaplasmosis, paracoccidioidosis, blastomycosis and others
    mycosis.
  • Contraindications: Hypersensitivity, pregnancy, period
    lactation. With care in childhood and old age, with
    renal / hepatic failure, for hearing impairment, severe
    lung diseases, ischemic heart disease.Ирунин
  • Side effects: Hematopoietic organs: leukopenia,
    neutropenia, thrombocytopenia. Metabolism: hypacalemia.
    Allergic reactions: angioedema, serum
    disease, anaphylactic and anaphylactoid reactions. Nervous
    system: headache, peripheral neuropathy, dizziness.
    Digestive system: vomiting, diarrhea, constipation, hepatitis, violation
    taste perception, acute liver failure. Organs
    feelings: tinnitus, blurred vision. Skin: rash,
    erythema multiforme, urticaria, photosensitization,
    exfoliative dermatitis. Musculoskeletal system – myalgia,
    arthralgia. Genitourinary system – menstrual disorders,
    pollakiuria, urinary incontinence, erectile dysfunction.
  • Цена: Орунгал капсулы 14 PC. 2660- 2800 rubles.,
    Румикоз 6 капсул 270-300 руб. 14 capsules 580-600
    руб., Итразол – 6 капсул 360-380 руб., 14 капсул
    620-800 руб., Ирунин 6 капсул 310 руб, 10 капсул
    450 rub.  14 capsules 560-620 rubles.

Флуконазол – аналоги ATеро-флуконазол,
Дифлюкан, Медофлюкон, Дифлазон, Микомакс, Противогрибковые препараты ФлуконазолМикосист, Микофлюкан,
Flucostat.
Antifungal drugs in tablets with
highly specific action, inhibit the activity of enzymes
fungi, violate their growth and replication.

  • Indications for use: Generalized candidiasis with a lesion.
    respiratory organs, abdominal organs, eyes and urinary
    organs. Systemic lesions with fungi Cryptococcus – sepsis,
    meningitis, infections of the lungs and skin, in patients with various
    immunity disorders and with a normal immune response. Candidiasis
    oral mucosa, esophagus, pharynx, non-invasive
    bronchopulmonary candidiasis. Genital candidiasis, prevention
    fungal lesions in patients with malignant tumors.
    Fungus of the foot, mycoses of the skin: body, nails (onychomycosis),
    pityriasis versicolor. Deep endemic mycoses sporotrichosis,
    coccidioidosis, and histoplasmosis in patients with normal
    immunity.
  • Contraindications: Hypersensitivity, simultaneous reception
    терфенадина и астемизола, период lactation. Carefully
    for patients with hepatic impairment
    pregnancy, people with organic heart disease.
  • Side Effects: Digestive System: nausea, diarrhea,
    flatulence, abdominal pain, change in taste, impaired function
    the liver. Nervous система: головная боль, головокружение, судороги.
    Organs кроветворения: нейтропения, лейкопения, thrombocytopenia.
    Allergic reactions: skin rash, exudative erythema, edema
    facial, angioedema, urticaria, itchy skin.
    Cardiovascular system: ventricular blinking / fluttering,
    increase the length of the Q-T interval.
  • Цена: Флуконазол -150мг.1 PC.- 15 руб., 50мг.
    7PC.-32 руб., Дифлюкан — 150мг.-720 руб. 50mg 7pcs
    -850 rub. Микосист 150мг. 1 pc. – 270 rub., 50 mg. 7
    PC. – 550 rubles. Флюкостат -150мг. 1 PC.- 150 руб.,
    50мг.7 PC. – 250 rubles.

Противогрибковые таблетки —  азолы следует запивать
plenty of water and take with meals. If
Patients low stomach acid these medicines need
to be taken with acidic liquids. At reception
системных азолов нельзя принимать астемизол, терфенадин,
pimozide, cisapride, quinidine, lovastatin and simvastatin. It is impossible
use azoles in pills for pregnant and lactating women.

See candles from thrush

Antifungal tablets of the group – Allylamines:

Allylamines – synthetic antimycotics, the main indications for
the use of which are ringworms – fungal
diseases of the nail, skin, hair, lichen.

Тербинафин — аналоги Terbinox,
Тербизил, Экзитерн, Брамизил, Ламизил
. This is allylamine,
having a broad spectrum of action against mushrooms,
causing diseases of the nails, skin, hair, including
dermatophytes. In low concentrations, has an effect on
mold and dimorphic fungi.Тербинафин

  • Indications for use: mycosis of the scalp, nails
    (onychomycosis), treatment of ringworms of the legs, trunk, feet,
    when the prevalence of infection is pronounced
    character and oral administration is shown antifungal
    means.  For treatment of multi-colored lichen Terbinafine
    used only as a topical treatment, oral
    in this disease is not very effective.
  • Contraindications: Do not recommend to patients with active,
    chronic liver and kidney disease. Pregnancy and
    lactation.
  • Side effects: Immune system: systemic and skin red
    lupus. Nervous система: головная боль; taste disorders
    sensations, dizziness. Digestive system: dyspepsia,
    feeling of fullness in the stomach, nausea, loss of appetite, pain in
    stomach, diarrhea. Dermatological reactions: skin reactions,
    psoriasis-like skin rash. Musculoskeletal system:
    arthralgia, myalgia.
  • Цена: Тербизил 14 шт 1000 руб, 28 шт 1800 руб.
    Ламизил 14 шт 1800 руб. Terbinox
    14 pcs 580 rubles. Тербинафин 14 PC. 480-560 rub.

Terbinafin inside is taken regardless of the meal, it
it is necessary to drink enough water. In the treatment of
any oral antifungal drugs use
Alcohol is contraindicated.

Antifungal agents of other groups:

Griseofulvin is one of the very first natural antimycotics, he
possesses a narrow spectrum of activity, therefore it is applied only in
cases of ringworm caused by dermatomycete fungi.

Гризеофульвин – противогрибковый препарат в
tablets, which are used only for heavy fungal
lesions. It is not used to treat fungal infections.
flowing in a mild degree and easily eliminated by local
treatment. It is an antibiotic effective against fungi of the genus.
Epydermophyton, Trichophyton, Microsporum, Achorionum.

  • Indications for use: Mycosis of hair, skin, nails, microsporia
    волосистой части, Гризеофульвинтрихофития, микроспория гладкой кожи,
    athlete Smooth Skin, Onychomycosis, Beard Dermatomycosis and
    whiskers, athlete’s groin.
  • Contraindications: Children under 2 years old, lactation period and
    pregnancy, hypersensitivity, porphyria, lupus-like
    syndrome, malignant neoplasms, systemic diseases
    blood, organic diseases of the liver and kidneys.
  • Побочное действие: Nervous система: слабость, повышенная
    fatigue, headache, dizziness, insomnia, disturbances
    motor coordination, peripheral neuropathy, disorientation,
    confusion, paresthesia of the limbs. Digestive
    system: gastralgia, nausea, vomiting, candidal stomatitis, diarrhea,
    hepatitis. Organs кроветворения: агранулоцитоз, лейкопения
    granulocytopenia. Allergic reactions: angioedema,
    itchy urticaria, skin rash, photosensitization, multiforme
    exudative erythema, lupus-like syndrome, toxic
    epidermal necrolysis.
  • Цена: Гризеофульвин 20 табл. 240 rub.

Griseofulvin is taken orally immediately after a meal or during
food intake. If the patient is on a low diet
fat, then the use of griseofulvina should be with one article. with a spoon
vegetable oil.

Автор: Мельникова Светлана Георгиевна врач-дерматолог

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