Mechanisms of action Two major mechanisms of action have been elucidated: *<unk>  is intrafungally converted into the cytostatic fluorouracil which undergoes further steps of activation and finally interacts as 5-fluorouridinetriphosphate with RNA biosynthesis thus disturbing the building of certain essential proteins. *<unk>  also undergoes conversion into 5-fluorodeoxyuridinemonophosphate which inhibits fungal DNA synthesis. Spectrum of susceptible fungi and resistance<unk>  is active in vitro as well as in vivo against some strains of Candida and Cryptococcus. Limited studies demonstrate that<unk>  may be of value against infections with Sporothrix, Aspergillus, Cladosporium, Exophiala, and Phialophora. Resistance is quite commonly seen as well in treatment-naive patients and under current treatment with<unk> . In different strains of Candida resistance has been noted to occur in 1 to 50% of all specimens obtained from patients. Pharmacokinetic data<unk>  is well absorbed (75 to 90%) from the gastrointestinal tract. Intake with meals slows the absorption, but does not decrease the amount absorbed. Following an oral dose of 2 grams peak serum levels are reached after approximately 6 hours. The time to peak level decreases with continued therapy. After 4 days peak levels are measured after 2 hours. The drug is eliminated renally. In normal patients<unk>  has reportedly a half-life of 2.5 to 6 hours. In patients with impaired renal function higher serum levels are seen and the drug tends to accumulate. The drug is mainly excreted unchanged in the urine (90% of an oral dose) and only traces are metabolized and excreted in the feces. Therapeutic serum levels range from 25 to 100 μg/ml. Serum levels in excess of 100 μg are associated with a higher incidence of side effects. Periodic measurements of serum levels are recommended for all patients and are a must in patients with renal damage.
Flucytosine
Micafungin
Caspofungin
Miconazole
Fluconazole
Fosravuconazole
Anidulafungin
Ganciclovir