What is Neofomiral
Neofomiral is an antifungal medication used to treat various fungal infections, including yeast infections (such as vaginal, oral, and esophageal candidiasis) and systemic fungal infections.
It contains Fluconazole as its active ingredient. In addition, it contains nonactive ingredients called excipients in sufficient quantities.
Neofomiral works by inhibiting the growth of fungi, preventing them from reproducing and causing further infection.
It’s available in different dosage forms and strengths, including oral tablets, liquid suspension, cream, shampoo, and intravenous solution.
Uses of Neofomiral
- Systemic mycoses including histoplasmosis, non-meningeal coccidioido-mycosis, paracoccidioidomycosis and blastomycosis
- Treatment and Prevention of fungal infections in immuno-compromised patients in AIDS and other immunosuppressed patients, prophylaxis of cryptococcal meningitis
- Oesophageal and oropharyngeal candidosis, vaginal candidosis and systemic candidosis
Dosage of Neofomiral
- Systemic mycoses, by mouth or by IV infusion, 200 mg daily for at least 6 months
- Cryptococcal meningitis (following amphotericin B induction therapy), by mouth or by IV infusion, 800 mg daily for 2 days, then 400 mg daily for 8 weeks
- Prevention of relapse of cryptococcal meningitis in AIDS patients after completion of primary therapy, by mouth, 200 mg daily or by IV infusion, 100-200 mg daily.
- Systemic candidosis (in patients unable to tolerate amphotericin B), by mouth or by IV infusion, 400 mg as initial dose, then 200 mg daily for at least 4 weeks
- Oesophageal and oropharyngeal candidosis, by mouth or by IV infusion, 200 mg as an initial dose, then 100 mg daily until symptoms resolved; up to 400 mg daily in very resistant infections;
- Vaginal candidosis, by mouth, 150 mg as a single dose.
- Prevention of fungal infections in immunocompromised patients, by mouth or by IV infusion, 50-400 mg daily adjusted according to risk; commence treatment before anticipated onset of neutropenia and continue for 7 days after neutrophil count in desirable range
Systemic mycoses, by mouth or by IV infusion,
- Child over 2 years 3-6 mg/kg daily for at least 6 months.
Cryptococcal meningitis (following amphotericin B induction therapy), by mouth or by IV infusion,
- Child 6-12 mg/kg daily (every 72 hours in neonates up to 2 weeks old, and every 48 hours in neonates 2-4 weeks old)
Systemic candidosis (in patients unable to tolerate amphotericin B), by mouth or by IV infusion
- Child 6-12 mg/kg daily (every 72 hours in NEONATES up to 2 weeks old, and every 48 hours in neonates 2-4 weeks old).
Oesophageal and oropharyngeal Candidiasis, by mouth or by IV infusion,
- Child 3-6 mg/kg on the first day, then 3 mg/kg daily (every 72 hours in neonates up to 2 weeks old, and every 48 hours in neonates 2-4 weeks old).
Prevention of fungal infections in immunocompromised patients, by mouth or by IV infusion
- Child according to extent and duration of neutropenia, 3-12 mg/kg daily (every 72 hours in neonate up to 2 weeks old, and every 48 hours in neonate 2-4 weeks old); max. 400 mg daily
Side effects of Neofomiral
- Abdominal pain
- Taste disturbance
- Hepatic disorders
- Rash (withdraw treatment);
- Bullous lesions
- Toxic epidermal necrolysis and erythema multiforme (Stevens-Johnson syndrome) reported (severe skin reactions more common in AIDS)
Nursing action to take during the use of Neofomiral
- Oral bioavailability of Neofomiral is greater than 90% and is unaffected by gastric pH; dosage is the same for oral or IV use.
- Administer Fluconazole with food to reduce gastrointestinal upset
- Shake oral suspension before each use to allow for uniform dosing
- IV fluconazole may be administered by continuous infusion at a rate not exceeding 200 mg/hour; do not connect in series with other infusions to prevent air embolism; do not add any other drugs to the solution.
- Advise patient that prolonged treatment may be needed to control infection and prevent relapse, even if symptoms abate in first few days of therapy.
- Dosage should be adjusted in renal failure as the drug is excreted unchanged by the kidneys
When to observe precautions when using Neofomiral
Observe precautions in:
- Renal impairment
- Monitor liver function-discontinue if signs or symptoms of hepatic disease (risk of hepatic necrosis); Susceptibility to QT interval prolongation; interactions.
Is Neofomiral safe in pregnancy?
The FDA stated that taking a lot of the Neofomiral every day (400-800 mg/day) might lead to unusual birth defects in babies if their moms took the drug during the first 3 months of pregnancy.
However, the equally stated that taking a smaller dose (150 mg) for a yeast infection is safe.
Read more about FDA statement on the use of Fluconazole during pregnancy here.
The use of Neofomiral by breastfeeding women
Neofomiral is safe for nursing mothers, as the excreted amounts in breast milk are lower than neonatal dosage. It’s considered compatible with breastfeeding, and monitoring the baby for GI symptoms is usually enough, given typical treatment.