Buy Grifulvin Online

Griseofulvin (griseofulvin)

OTHER BRAND NAMES

Grifulvin V

THERAPEUTIC CLASS

Penicillium-derived antifungal

DEA CLASS

RX

INDICATIONS

Treatment of dermatophyte infections of the skin not adequately treated by topical therapy, hair and nails, namely: tinea corporis, tinea pedis, tinea cruris, tinea barbae, tinea capitis; and tinea unguium caused by Epidermophyton floccosum, Microsporum audouinii, M. canis, M. gypseum, Trichophyton crateriform, T. gallinae, T. interdigitalis, T. megnini, T. mentagrophytes, T. rubrum, T. schoenleini, T. sulphureum, T. tonsurans, and T. verrucosum.

ADULT DOSAGE

Tinea Infections

Treatment of dermatophyte infections of the skin not adequately treated by topical therapy, hair and nails, namely: tinea corporis, tinea pedis, tinea cruris, tinea barbae, tinea capitis; and tinea unguium caused by Epidermophyton floccosum, Microsporum audouinii, M. canis, M. gypseum, Trichophyton crateriform, T. gallinae, T. interdigitalis, T. megnini, T. mentagrophytes, T. rubrum, T. schoenleini, T. sulphureum, T. tonsurans, and T. verrucosum

Sus/Tab:
500mg/day (125mg qid, 250mg bid, or 500mg/day)

Widespread Lesions:
Tab:
Initial:
0.75-1g/day; may reduce gradually to ≤0.5g after a response has been noted

Infections Difficult to Eradicate (eg, Tinea Pedis/Tinea Unguium):
Sus:
1g/day

Treatment Duration

Tinea Capitis:
4-6 weeks
Tinea Corporis:
2-4 weeks
Tinea Pedis:
4-8 weeks
Tinea Unguium:
≥4 months (fingernails) or ≥6 months (toenails), depending on rate of growth

PEDIATRIC DOSAGE

Tinea Infections

Treatment of dermatophyte infections of the skin not adequately treated by topical therapy, hair and nails, namely: tinea corporis, tinea pedis, tinea cruris, tinea barbae, tinea capitis; and tinea unguium caused by Epidermophyton floccosum, Microsporum audouinii, M. canis, M. gypseum, Trichophyton crateriform, T. gallinae, T. interdigitalis, T. megnini, T. mentagrophytes, T. rubrum, T. schoenleini, T. sulphureum, T. tonsurans, and T. verrucosum

>2 Years:
10mg/kg/day (approx 5mg/lb/day)
30-50 lbs:
125-250mg/day
>50 lbs:
250-500mg/day in divided doses

ADMINISTRATION

Oral route

HOW SUPPLIED

Sus: 125mg/5mL [120mL]; Tab: (Grifulvin V) 500mg* *scored

CONTRAINDICATIONS

Porphyria, hepatocellular failure, women who are or may become pregnant.

WARNINGS/PRECAUTIONS

Serious skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis) and erythema multiforme reported; d/c if these occur. Elevations in AST, ALT, bilirubin, and jaundice reported; monitor for hepatic adverse events and consider discontinuation if warranted. Possibility of cross-sensitivity with penicillin (PCN) exists. Lupus erythematosus, lupus-like syndromes or exacerbation of existing lupus erythematosus reported. Photosensitivity reactions reported; avoid exposure to intense or prolonged natural/artificial sunlight. D/C if granulocytopenia occurs. Male patients should wait at least 6 months after completing therapy before fathering a child. Concomitant use of appropriate topical agents is usually required (particularly in tinea pedis).

ADVERSE REACTIONS

Skin rash, urticaria.

DRUG INTERACTIONS

Decreases activity of warfarin-type anticoagulants; may require dosage adjustment of the anticoagulant during and after therapy. May reduce the effectiveness of estrogen-containing oral contraceptives and cause menstrual irregularities; an alternate or 2nd form of birth control may be indicated during periods of concurrent use. May reduce cyclosporine and serum salicylate levels. Barbiturates may decrease plasma levels; coadministration may require dosage adjustment of the antifungal agent. N/V, flushing, tachycardia, and severe hypotension reported following alcohol ingestion during therapy.

PREGNANCY AND LACTATION

Category X, not for use in nursing.

MECHANISM OF ACTION

Penicillium-derived antifungal; binds to microtubular proteins, which are required for mitosis.

PHARMACOKINETICS

Absorption: Primarily absorbed in the duodenum. (Fasted, 0.5g dose) Cmax=0.5-2mcg/mL; Tmax=4 hrs. Metabolism: Liver via glucuronidation; 6-desmethylgriseofulvin (metabolite). Elimination: Feces (1/3 of dose within 5 days), urine (30% within 24 hrs, 50% within 5 days, <1% unchanged), perspiration; T1/2=9-24 hrs.

ASSESSMENT

Assess for porphyria, hepatocellular failure, lupus erythematosus, PCN sensitivity, history of hypersensitivity to the drug, pregnancy/nursing status, and possible drug interactions. Obtain specimens for lab testing (potassium hydroxide preparation, fungal culture, or nail biopsy) to confirm diagnosis. Obtain baseline LFTs.

MONITORING

Monitor for photosensitivity reactions, lupus erythematosus or exacerbation of lupus erythematosus, lupus-like syndrome, granulocytopenia, serious skin reactions, jaundice, and other adverse reactions. Periodically monitor renal, hepatic, and hematopoietic functions with prolonged therapy.

PATIENT COUNSELING

Inform of benefits and risks of therapy. Instruct to avoid exposure to intense or prolonged natural/artificial sunlight. Instruct to inform physician if pregnant, intending to become pregnant, or planning to breastfeed. Counsel male patients to wait at least 6 months after completing therapy before fathering a child. Instruct to contact physician if any adverse reactions occur.

STORAGE

20-25°C (68-77°F).

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