Griseofulvin (Fulvicin P/G, Fulvicin U/F, Gris-Peg, Grisactin)

Category:

Antifungal

Description:

Systemic antifungal

Indications:

Fungal infections of the skin, hair, and nails caused by susceptible organisms.
Antifungal spectrum usually includes: Trichophyton rubrum, T. tonsurans, T. mentagropytes, T. interdigitalis, T. verrucosum, T. megninii, T. gallinae, T. crateriform, T. sulphureum, T. schoenleinii, Microsporum audouinii, M. canis, M. gypseum, Epidermophyton floccosum

Contraindications:

Porphyria
Hepatocellular failure

Precautions:

Pregnancy category C; avoid use during pregnancy; use caution in nursing mothers
Penicillin allergy (possible cross-sensitivity)
Lupus erythematosus

Adverse Reactions (Side Effects):

CNS: dizziness, fatigue, headache, insomnia, mental confusion, paresthesias
GI: diarrhea, epigastric distress, BI bleeding, hepatic toxicity, nausea, oral thrush, vomiting
GU: menstrual irregularities, proteinuria
HEME: granulocytopenia, leukopenia
SKIN: angioneurotic edema, photosensitivity, rash, urticaria

Dosage:

Administered orally (microsize tablets, ultramicrosize tablets, suspension)

Adult: (microsize) PO 500-1000mg daily in single or divided doses; (ultramicrosize) 330-375mg daily in single or divided doses, max 750mg daily
Child: > or = 2 years: PO (microsize) 10-15 mg/kg/day in single or divided doses; (ultramicrosize) 5.5-7.3 mg/kg/day in single or divided dose

Duration of Treatment:

Condition	Duration
Tinea corporis	2-4 weeks
Tinea capitis	at least 4-6 weeks
Tinea pedis	4-8 weeks
Tinea unguium	3-6 months

Drug interactions:

Reduces the response of : Aspirin, Cyclosporine, Oral Contraceptives, Tacrolimus, and Warfarin
Phenobarbital: reduces plasma griseofulvin level

Special considerations:

Prior to therapy, the type of fungus responsible for infection should be identified
Response to therapy may not be apparent for some time; complete entire course of therapy
Avoid prolonged exposure to sunlight
Clinician should be notified if sore throat or skin rash occurs
Store suspension at room temperature in light-resistant container

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300