Flucytosine Cytarabine

CYTARABINE ANTIFUNGALS- FLUCYTOSINE 1 flucytosine levels Uncertain Watch for poor response to flucytosine... 

Flucytosin i.v., 0. ind. systemic mycoses, given in combination with amphotericin B resistance when used as monotherapy bone marrow toxicity, nephrotoxicity, hepatotoxicity avoid other nephrotoxic drugs cytarabin as antagonist... 

The suggested interaction of cytarabine with flucytosine, in which there is competitive inhibition of antifungal activity, has not been confirmed (28). 

Wingfield HJ. Absence of fungistatic antagonism between flucytosine and cytarabine in vitro and in vivo. J Antimicrob Chemother 1987 20(4) 523-7. 

A man with Hodgkin s disease treated for cryptococcal meningitis with flucytosine 100 mg/kg daily had reduced flucytosine serum and CSF levels, from a range of 30 to 40 mg/L down to undetectable levels, when given cytarabine intravenously. When the cytarabine was replaced by procarbazine, the flucytosine levels returned to their former values. In vitro tests found that cytarabine 1 mg/L completely abolished the activity of up to 50 mg/L of flucytosine against the patient s strain of Cryptococcus, whereas procarbazine did not. In another study in a patient with acute myeloid leukaemia, the predose flucytosine level fell from 65 to 42 mg/L and... 

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