|
Special Clinical Concerns |  |
|
Side Effects and Toxicity: |
| Flucytosine is often well tolerated over long periods, but toxic effects may be seen when serum levels are high (>100 µg/mL). These include GI signs (nausea, vomiting, diarrhea) and reversible hepatic and hematologic effects (increased liver enzymes, anemia, neutropenia, thrombocytopenia). In dogs, erythemic and alopecic dermatitis may be seen but subsides when the drug is discontinued. |
|  |
|
Interactions: |
| There is synergistic antifungal activity between amphotericin B and ketoconazole, and the combination may retard the emergence of strains resistant to flucytosine. The renal effects of amphotericin B prolong elimination of flucytosine. If flucytosine is used together with immunosuppressive drugs, severe depression of bone marrow function is possible. |
| |
|
Effects on Laboratory Tests: |
| Alkaline phosphatase, AST, ALT, and other liver leakage enzymes increase. RBC, WBC, and platelet counts decrease. |
| |
