In the article, we consider the instructions for use, reviews and analogues to the drug "Orungal". It is a derivative of triazole, an antifungal agent with a systemic type of exposure. According to the instructions to Orungal, each capsule of the drug contains itraconazole as an active substance. The dosage of the capsule is 100 mg. Excipients are dyes, gelatin, macrogol 20,000, sucrose and hypromellose.
Pharmacological forms of this drug
As indicated in the instructions for use, Orungal is available in capsule form. There is also a solution.
The capsules of the drug are gelatinous, have a transparent body with a blue cap. The capsule contains cream-colored pellets. The drug is packaged in blisters as follows:
- A blister containing 4 capsules. Each cardboard box holds 1 blister.
- A blister containing 5 capsules. Each cardboard box holds 3 blisters.
- A blister containing 6 capsules. Each cardboard box holds 1 blister.
- A blister containing 14 capsules. Each cardboard box can hold 1, 2, 3, 6 blisters.
Pharmacological effects and indications for the use of a medication
According to the instructions, Orungal is an antifungal medication. The drug is indicated for use in the treatment of the following pathological conditions:
- Pityriasis versicolor.
- Onychomycosis.
- Candidamycosis affecting the dermis and mucous membranes.
- Deep types of visceral type.
- Systemic mycoses: blastomycoses, sporotrichoses, cryptococcoses, histoplasmoses, aspergillosis, paracoccidoidomycoses, candidiasis, tropical mycoses.
- Fungal keratitis.
- Dermatomycosis.
Contraindications to the use of the drug
What else can you learn from the instructions for Orungal? It should not be prescribed to patients in the following cases:
- The presence of allergic reactions to any component of a medical device.
- Parallel administration of ergot alkaloids (methylergometrine, ergometrine, dihydroergotamine, ergometrine).
- Parallel use of metabolizable CYP3A4 enzymes HMG-CoA reductase blockers (lovastatin, simvastatin).
- The simultaneous use of oral forms of triazolam and midazolam.
- The parallel use of drugs that are metabolized in the presence of the CYP3A4 enzyme and increase the QT interval on the electrocardiogram (astemizole, quinidine, terfenadine).
Caution should be exercised when prescribing "Orungal" to patients suffering from cirrhosis of the liver, chronic forms of heart and kidney failure, who are hypersensitive to azole derivatives, to persons 18 or older than 65 years of age.
Negative effects from the use of the drug
In the instructions to “Orungal” it is reported that, against the background of the use of the drug, the following negative reactions from various organs and systems may develop:
- Gastrointestinal tract: acute liver failure, a temporary increase in the concentration of liver enzymes in the blood, hepatitis, impaired appetite, diarrhea, nausea, constipation, vomiting and other manifestations of dyspepsia, abdominal pain.
- Nervous system: peripheral neuropathy, headaches, dizziness.
- Skin manifestations: photosensitivity, alopecia.
- Allergic reactions: Stevens-Johnson syndrome, rash, urticaria, pruritus, anaphylaxis, angioedema.
- Blood circulation: peripheral puffiness, congestive heart failure, pulmonary edema.
- Other: menstrual irregularities, hypokalemia.
If the described negative manifestations occur, the patient is advised to consult a doctor. A dose adjustment or refusal to use Orungal tablets is likely to be required. The instruction confirms this.
Use of medication
Capsules should be swallowed whole, not allowing them to be crushed or crushed. Reception is best done after a meal.
With vulvovaginal candidiasis, it is indicated to take 1 capsule twice a day for one day, or once a day for three days.
For the treatment of skin dermatomycosis or pityriasis versicolor, 1 capsule should be taken once a day. The course takes one week.
In the treatment of fungal infections of the feet and hands, it is indicated to take 2 capsules twice a day (one week), or once a day once a day (for a month).
With fungal keratitis , 2 capsules should be taken once a day for 21 days. In order to treat oral candidiasis, it is indicated for two weeks to take 1 capsule once a day.
If the patient has immunity disorders (for example, neutropenia, after an organ transplant operation, in patients with AIDS), then the oral bioavailability of the drug is reduced. In such cases, the doctor may recommend a double dosage increase.
For the treatment of onychomycosis, the use of pulse therapy is indicated, in which certain schemes should be adhered to:
- If the nails of the feet are affected (with or without the nails of the hands), 2 capsules should be taken once a day at the first, fifth and ninth weeks of therapy. In other weeks, the use of the medicine should be suspended.
- If the nails of the hands are affected, it is necessary to take 2 capsules once a day in the first and fifth weeks of therapy. In the remaining weeks, the use of the drug is suspended.
The result of therapy is determined after the end of therapy, as the nail regrowth.
Pulse therapy can be replaced by continuous use of the drug. In this case, you should take 3 capsules once a day for three months.
The optimal mycological result is observed approximately one month after completion of the course of therapy, if skin diseases are treated, and 9 months later, with the treatment of nails.
In order to treat systemic mycoses, Orungal is prescribed in the following dosages:
- Aspergillosis - 2 capsules once a day. The course of therapy takes up to 5 months.
- Candidiasis - once a day, up to 2 capsules. The course of therapy takes up to 7 months.
- Cryptococcosis - once a day, 2 capsules. The course lasts up to a year.
- Blastomycosis - twice a day for 1 capsule. The course is up to 6 months.
- Histoplasmosis - twice a day, 2 capsules. The course is 8 months.
- Cryptococcal meningitis - 2 capsules twice daily. The course is up to 1 year.
- Sporotrichosis - once a day, 1 capsule. The course is 3 months.
- Chromomycosis, paracoccidiomycosis - once a day, 1 capsule. The course is up to six months.
It is important to remember that the dosage of the drug should be determined by the doctor only after finding out the exact diagnosis.
Instructions for use with Orungal tablets do not end there.
Overdose
In case of accidental overdose, the patient should wash the stomach for an hour and prescribe the use of enterosorbents. Hemodialysis in this case is ineffective, an antidote does not currently exist.
Interaction with other medicines
The effectiveness of the drug and its bioavailability are reduced when combined with Phenytoin, Rifampicin, Rifabutin and other microsomal oxidation stimulants.
Similar effects occur with parallel use with "Phenobarbital", "Isoniazid", "Carbamazepine".
The bioavailability of Itraconazole increases significantly when used concomitantly with Erythromycin, Ritonavir, Clarithromycin, Indinavir).
Orungal should not be combined with Levometadone, Pimozide, Sertindole, Cisapride, Misolastine, Astemizole, Dofetilide, Terfenadine, Quinidine.
In the instructions for use analogues of "Orungal" are not indicated.
Analogs
If necessary, it can be replaced by one of the drugs, the composition or therapeutic effect of which is similar. The most popular analogs of Orungal are: Fluconazole, Mikosist, Diflucan, Diflazone, Diaflu, Vfend, Trioxad, Orunzol, Izol, Rumikoz, Orungamine ”,“ Canditral ”,“ Itrazol ”,“ Irunin ”.
It is important to remember that each of these medicines has its own list of contraindications and is able to provoke various negative reactions. Therefore, any replacement of the medication should be agreed with a specialist.
Cost
The average cost of a package containing 14 capsules in Russian pharmacies is at the level of 3150 rubles. This information is also not in the instructions.
Reviews about Orungal
The medication has established itself well, and not only among specialists, but also among patients. The drug is actually effective in the treatment of various lesions of fungal nature. However, patients often mention the ability of the drug to cause dyspepsia and other negative reactions from the gastrointestinal tract. A negative characteristic of the drug is also considered its rather high price. The drug has quite a few analogues, the cost of which is much lower, and the effectiveness is not inferior.
It is important to remember that the appointment of the drug should be done by the doctor. Only in this case, the therapy will be effective, and the risk of negative reactions and complications will be minimized.
We reviewed the drug "Orungal" instructions for use and reviews.