Composition

Actions
Like systemic fungal infections the incidence of ophthalmic fungal infections has risen with the growing number of immunocompromised hosts. Of the various ophthalmic fungal infections the common clinical conditions known are keratomycosis, fungal keratitis, scleritis,endogenous fungal endophthalmitis post operative endopthalmitis, canaliculitis. Topical ophthalmic solution of fluconazole is reported to be safe and effective antifungal agent, and can be used as an additional choice for the treatment of severe ocular fungal infections. In addition to its proven effectiveness and safety in patients with various mycoses, the pharmacokinetic profile of fluconazole confers many advantages including diffusions into ocular tissue. In single dose application of ophthalmic floconazole solution the aqueous humor concentrations after 15 minutes were found to be higher than MICs of C.albicans and C.parapsilosis, and with multiple dose the same is even higher than MICs of C.tropicalis and hence could be good alternative to Amphotericin B for the treatment of Candida Keratitis.

Fluconazole is fungistatic in action. Although the exact mechanism of action of fluconazole has not been fully determined, the drug inhibits cytochrome P-450 14-alfa demethylase  in susceptible fungi which leads to accumulation of lanostarol and decreased concentration of ergosterol thereby altering cellular membrane resulting in increased membrane permeability, leakage of essential elements and impaired uptake of precursor molecules to DNA.

Indications
For the treatment of fungal corneal ulcers/ keratitis.

Precautions & Contraindictions
The drug is contraindicated in patients with hypersensitivity to azoles. No adequate and well controlled studies in pregnant women are available; may be used only when the potential benefit outweigh the possible risk to the foetus. Nursing mother should not be given. Use of fluconazole may result in overgrouth of non-susceptible strain of candida other than C.albicans.

Adverse Reaction
The drug is generally well tolerated. Eosinophillia has been reported in some patients.

Drug Interactions
Fluconazole can alter pharmacokinetics of certain drugs undergoing heptic metabolism. Potential serious adverse cardiovascular effects should be considered during concomitant admonistration of astemozole/terfenadine with fuconazole.

Dose & Administration
Fluconazole can alter pharmacokinetics of certain drugs undergoing heptic metabolism. Potential serious adverse cardiovascular effects should be considered during concomitant admonistration of astemozole/terfenadine with fuconazole.

Duration of Treatment