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Forcan is known for its effective treatment of Candida infections in both children and adults. To use Forcan safely and improve your disease early, you need to strictly follow the treatment regimen prescribed by your doctor.
1. What is Forcan?
Forcan belongs to the group of antiparasitic, anti-infective, antifungal and antiviral drugs. Forcan medicine originated from India and is now widely circulated in Vietnam.
Forcan contains the main active ingredient is Fluconazole 150mg, is made in the form of capsules, in each big box includes 5 small boxes x 1 blister x 1 tablet. Forcan is recommended by doctors mainly for vaginal/vulvar candidiasis, Coccidioides immititis or Cryptococcus neoformans meningitis. The active ingredient Fluconazole belongs to a new group of synthetic antifungal drugs called Triazol, capable of inhibiting cytochrome P450-14-α-demethylase enzymes and blocking the synthesis of ergosterol in fungal cell membranes. This helps to change the permeability of the fungal cell membranes, while also assisting in the release of substances such as potassium or amino acids and reducing the absorption of precursor molecules such as pyrimidines or purines into the fungal cells.
2. Indications – Contraindications to the use of Forcan
2.1 Indications for the use of Forcan medicine Currently, Forcan is used by doctor's prescription to treat the following fungal infections:
Treatment of Candida infections in the vagina or vulva. Treatment of candidiasis in the esophagus, urinary tract, mouth - pharynx, peritoneum. Treatment of serious systemic candidiasis such as disseminated candidiasis, pulmonary candidiasis, or candidemia. Treatment of meningitis caused by Cryptococcus neoformans. Treatment of fungal infections caused by Histoplasma, Coccidioides immitis or Blastomyces. Prophylaxis of Candida infections in immunocompromised patients, bone marrow transplant recipients undergoing radiation/chemotherapy, AIDS or cancer. 2.2 Contraindication to the use of Forcan drug Do not arbitrarily use Forcan for the following patients without consulting a specialist:
Patients with a history of hypersensitivity or allergic reaction to Fluconazole or any auxiliary excipients contained in the drug. Forcan is contraindicated in patients with hypersensitivity to anti-fungal drugs of the Azol group such as Miconazole, Ketoconazole or Clotrimazole. Forcan is contraindicated in nursing women, because fluconazole is secreted into breast milk at concentrations similar to those in plasma, which may adversely affect the health of the nursing infant. Relatively contraindicated Forcan for pregnant women because there are no specific studies proving that the drug is effective and safe for this subject. Pregnant women should take Forcan only when absolutely necessary and the benefits should outweigh the risks.
3. Instructions on dosage and usage of Forcan
Forcan is in the form of capsules for oral use. Patients should take Forcan with a glass of water about 240ml, avoid sharing with stimulants, carbonated drinks or soft drinks.
Dosage and duration of Forcan use will be determined specifically based on the fungal infection status, the type of fungus causing the disease, age, kidney function and the patient's ability to respond to the drug. In addition, patients should take Forcan continuously when treating fungal diseases until the complete disappearance of clinical symptoms. Inadequate treatment can cause the fungal infection to return.
For cases of meningitis caused by Cryptococcus strains or people with HIV need long-term maintenance treatment with Forcan drug to prevent the risk of disease recurrence. Below is the dose of Forcan for each patient according to the general recommendation of the doctor:
Forcan dose for infants:
2 weeks old: Use a dose of 3 - 6mg / kg body weight / time, each time 72 hours apart. Children from 2 to 4 weeks old: Use a dose of 3-6mg/kg body weight/time, 48 hours apart. Forcan dose for children:
Prophylactic dose: Use 3mg / kg body weight / day (treatment of superficial fungal infections) and from 6-12mg / kg body weight / day (treatment of systemic fungal infections). Therapeutic dose: Use a dose of 6mg/kg body weight/day. For children with persistent fungal infections, the dose should be 12mg/kg/24 hours, divided into 2 times and not more than 600mg/day. Forcan dose for adults:
Treatment of vaginal candidiasis - vulva: Take only 1 tablet / time / day. Can take 1 tablet / time / month for 4 - 12 months to prevent the risk of recurrence. Treatment of oropharyngeal candidiasis: Take 1 tablet / time / day for 1-2 weeks. Treatment of esophageal candidiasis: Take 1 tablet once a day continuously for at least 3 months and for a minimum of 2 more weeks after symptoms disappear. Treatment of systemic candidal infections: Take the starting dose of 3 tablets / time, the following days can take 1 tablet / time / day for at least 4 weeks and should be taken for at least 2 more weeks after the symptoms disappear. pass away. Treatment of meningitis caused by Cryptococcus strains: Take the starting dose of 3 tablets / time, the next days can take 1 - 3 tablets / time / day for at least 6-8 weeks after completing the culture of cerebrospinal fluid. marrow and gave negative results. In case of HIV-infected patients, the dose of 1 tablet / time / day can be used for a long time to avoid relapse. Prophylactic treatment of fungal infections: For bone marrow transplant recipients, a dose of 3 tablets / time / day should be used to prevent Candida infections. For those who have been predicted to be at risk of severe agranulocytosis, Forcan can be used prophylactically for a few days before and continue to take the drug for the next 1 week when the neutrophil count is greater than 1000/mm3. Forcan dose for patients with renal impairment:
People with impaired kidney function with Candida infection can adjust the dose of Forcan based on creatinine clearance or as directed by the doctor.
4. What side effects does Forcan have?
It is reported that about 5 - 30% of people using Forcan antifungal drugs experience side effects when taking more than 7 days or longer. In addition, the percentage of patients who had to stop taking the drug due to side effects was about 1-2.8%.
About 26-31% of women taking a single dose of Forcan for vulvovaginal candidiasis experience adverse events. In addition, research also shows that people with HIV who take Forcan often have a higher rate of side effects.
The following are the possible side effects that appear during the patient's use of Forcan:
Common: Dizziness, headache, nausea, vomiting, diarrhea or abdominal pain. Uncommon: Rash, pruritus, transient elevation of serum bilirubin and transaminase levels to 1.5-3 times the upper limit of normal. Rare: Anemia, eosinophilia, neutropenia, leukopenia or thrombocytopenia, 8-fold elevation in serum transaminase levels, scaly skin (mainly in cancer and AIDS patients), Stevens-Johnson syndrome, pleural effusion, fever, edema, hypotension, oligouria, anaphylaxis or hypokalemia. Patients should inform their doctor immediately if they experience any side effects during their treatment with Forcan.
5. Important notes when using Forcan
Before and during the treatment of fungal diseases with Forcan, you need to note the following recommendations:
Use caution when using Forcan for people with cardiac arrhythmias, prolonged QT interval on electrocardiogram. or impaired liver/kidney function. Forcan can cause symptoms such as dizziness or headache, so patients need to be careful when using this medicine while driving or operating machinery. Check the Forcan's expiry date before taking it to avoid taking expired medicine. If the tablet shows signs of watery, moldy or changes color, you need to stop using and discard the medicine as directed. Avoid taking Forcan at the same time with medicines such as sulfonylurea antidiabetics, antihistamines (Astemizol), epilepsy drugs (Phenytoin), coumarin anticoagulants, antivirals (Zidovudine), tacrolimus drugs, Cisapride or Ciclosporin. Above is important information about Forcan, patients should carefully read the instructions for use before using and consult a qualified doctor to get the best treatment results.
