Forcan is known for its effective treatment of Candida infections in both children and adults. To use Forcan safely and achieve early improvement, you must strictly follow the treatment regimen prescribed by your doctor.
1. What is Forcan?
Forcan belongs to the group of drugs used to treat parasites, bacterial infections, fungal infections, and viral infections. It originates from India and is currently widely distributed in Vietnam.
Forcan contains the active ingredient Fluconazole at a dosage of 150 mg and is formulated as capsules. Each large box contains 5 smaller boxes, with each small box containing 1 blister pack of 1 capsule. Doctors primarily recommend Forcan for cases of vaginal/vulvovaginal Candida infections, fungal infections caused by Coccidioides immitis, or meningitis caused by Cryptococcus neoformans.
Fluconazole is a new synthetic antifungal drug from the Triazole group, capable of inhibiting the cytochrome P450-14-α-demethylase enzyme and preventing the synthesis of ergosterol in fungal cell membranes. This action alters the permeability of the fungal cell membrane, facilitating the release of substances such as potassium or amino acids while reducing the absorption of precursor molecules like pyrimidines or purines into the fungal cell.
2. Indication- Contraindication
2.1 Indication
Currently, Forcan is prescribed by doctors for the treatment of the following fungal infections:
- Treatment of vaginal or vulvovaginal Candida infections.
- Treatment of Candida infections in the esophagus, urinary tract, oropharynx, and peritoneum.
- Treatment of severe systemic Candida infections such as disseminated Candida, pulmonary Candida, or Candida septicemia.
- Treatment of meningitis caused by Cryptococcus neoformans.
- Treatment of fungal infections caused by Histoplasma, Coccidioides immitis, or Blastomyces.
- Prophylactic treatment of Candida infections in individuals with weakened immune systems, such as those undergoing bone marrow transplantation with radiation/chemotherapy, or patients with AIDS or cancer.
2.2 Contraindication
Do not use Forcan without consulting a specialist doctor for the following patients:
- Individuals with a history of hypersensitivity or allergic reactions to Fluconazole or any of the excipients in the drug.
- Contraindicated for patients who are sensitive to antifungal drugs in the Azole group, such as Miconazole, Ketoconazole, or Clotrimazole.
- Contraindicated for breastfeeding women, as Fluconazole is excreted into breast milk at concentrations similar to those in plasma, which may negatively affect the health of the nursing infant.
- Relatively contraindicated for pregnant women, as there are no specific studies proving its efficacy and safety in this group. Pregnant women should only use Forcan when absolutely necessary, and the benefits must significantly outweigh the potential risks.
3. Dosage and administration guidelines for Forcan.
Forcan is formulated as oral capsules. Patients should take Forcan with a glass of water (about 240ml) and avoid consuming it with stimulants, carbonated drinks, or soft drinks.
The dosage and duration of Forcan treatment are determined based on the type of fungal infection, the specific fungal strain, the patient’s age, kidney function, and drug response. Patients should continue taking Forcan until all clinical symptoms completely disappear, as inadequate treatment duration may lead to a recurrence of the infection.
For patients with Cryptococcus-induced meningitis or HIV, long-term maintenance therapy with Forcan is necessary to prevent disease recurrence. Below are the general dosage recommendations for different patient groups:
Forcan Dosage for Newborns:
- Infants (2 weeks old): 3–6 mg/kg per dose, administered every 72 hours.
- Infants (2–4 weeks old): 3–6 mg/kg per dose, administered every 48 hours.
Forcan Dosage for Children:
- Prophylactic dose: 3 mg/kg per day (for superficial fungal infections) and 6–12 mg/kg per day (for systemic fungal infections).
- Therapeutic dose: 6 mg/kg per day. For persistent fungal infections, the dose may be increased to 12 mg/kg per 24 hours, divided into two doses, but should not exceed 600 mg per day.
Forcan Dosage for Adults:
- Vaginal/Vulvovaginal Candida infection: Take 1 capsule once daily. To prevent recurrence, 1 capsule may be taken once a month for 4–12 months.
- Oropharyngeal Candida infection: Take 1 capsule once daily for 1–2 weeks.
- Esophageal Candida infection: Take 1 capsule once daily for at least 3 months, continuing for at least 2 weeks after symptoms resolve.
- Systemic Candida infection: Take an initial dose of 3 capsules, followed by 1 capsule per day for at least 4 weeks, with an additional minimum of 2 weeks after symptom resolution.
- Meningitis caused by Cryptococcus: Take an initial dose of 3 capsules, then continue with 1–3 capsules per day for at least 6–8 weeks after cerebrospinal fluid cultures confirm a negative result.
- For HIV patients: Long-term maintenance therapy with 1 capsule per day is recommended to prevent recurrence.
- Prophylactic antifungal treatment:
- Bone marrow transplant patients: 3 capsules per day to prevent Candida infection.
- Patients at high risk of severe neutropenia: Forcan can be taken a few days before neutropenia is expected and continued for an additional week after neutrophil counts exceed 1000/mm³.
Forcan Dosage for Patients with Kidney Impairment:
For patients with kidney dysfunction and Candida infections, the Forcan dosage may be adjusted based on creatinine clearance levels or as prescribed by a doctor.
4. What are the potential side effects of Forcan?
Reports indicate that approximately 5–30% of people using the antifungal drug Forcan experience side effects when taking it for more than 7 days. Additionally, the percentage of patients who discontinue the drug due to side effects is around 1–2.8%.
About 26–31% of women taking a single dose of Forcan for vulvovaginal Candida infections experience adverse effects. Research also shows that HIV-infected patients tend to have a higher incidence of side effects when using Forcan.
Potential Side Effects of Forcan:
- Common: Dizziness, headache, nausea, vomiting, diarrhea, or abdominal pain.
- Uncommon: Skin rash, itching, mild temporary increases in serum bilirubin and transaminase levels (1.5–3 times the normal limit).
- Rare:
- Anemia, eosinophilia, neutropenia, leukopenia, or thrombocytopenia.
- Severe elevations (up to 8 times) in serum transaminase levels.
- Skin peeling (mainly in cancer and AIDS patients).
- Stevens-Johnson syndrome, pleural effusion, fever, edema, hypotension, oliguria, anaphylactic shock, or hypokalemia.
Patients should inform their doctor immediately if they experience any side effects while taking Forcan.
5. Important precautions when using Forcan.
Before and during antifungal treatment with Forcan, consider the following recommendations:
- Use Forcan with caution in patients with arrhythmia, prolonged QT interval on ECG, or impaired liver/kidney function.
- Forcan may cause dizziness or headaches, so patients should be cautious when driving or operating machinery while taking the medication.
- Check the expiration date of Forcan before use to avoid taking expired medication.
- If the capsule shows signs of moisture, mold, or discoloration, discontinue use and dispose of it properly as instructed.
- Avoid taking Forcan simultaneously with certain medications, including:
- Sulfonylurea-class diabetes medications
- Antihistamines (e.g., Astemizole)
- Epilepsy medications (e.g., Phenytoin)
- Coumarin-class anticoagulants
- Antiviral drugs (e.g., Zidovudine)
- Tacrolimus
- Cisapride
- Ciclosporin
The information above provides key details about Forcan. Patients should carefully read the instructions before use and consult a specialist doctor for optimal treatment results.
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