This medication is used to treat serious infections caused by cryptococcus neoformans. Often, it is used to treat cryptococcal meningitis in immunocompromised patients.
Flucytosine is used to treat serious infections caused by candida. It can also be used in minor candida infections, such as candidal cystitis.
Due to its weak antifungal effects and susceptibility to resistance, flucytosine shoud be used in combination with amphotericin B or azole antifungals.
Flucytosine works to inhibit and disrupt DNA and RNA biosynthesis in the fungal cell.
The way that flucytosine inhibits fungal DNA and RNA synthesis is by being converted to 5-FU, which is an antimetabolite medication. Within the fungal cell, cytosine deaminase converts flucytosine into 5-FU, which blocks the synthesis of thymidine (a building block of DNA).
Flucytosine leads to antiproliferative actions on bone marrow, leading to suppression. Patients develop anemia, leukopenia, pancytopenia, and even agranulocytosis. This toxicity can be irreversible and can lead to death, notably in immunocompromised patients.
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