Name: Griseofulvin indications and dosage in dermatology | Dermatology Games
Published: 2020-09-20T21:26:07+00:00

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Indications

Dermatophyte infections of the skin, scalp, and nails.
Tinea pedis (moccasin type)/tinea manuum(adults): 750–1000 mg/day (microsize) or 500–750 mg/day (ultramicrosize) × 4 weeks.
Tinea pedis (moccasin type)/tinea manuum(children):15–20 mg/kg/day (microsize suspension) × 4 weeks.
Tinea unguium (adults):1–2 g/day (microsize) or 750 mg/day (ultramicrosize) until nails are normal.
Tinea unguium (children) :20 mg/kg/day (microsize suspension) until nails are normal.
Tinea corporis (extensive, adults) :500–1000 mg/day (microsize) or 375–500 mg/day (ultramicrosize) × 2–4 weeks.
Tinea corporis (extensive, children):15–20 mg/kg/day (microsize suspension) × 2–4 weeks.
Tinea capitis (adults):10–15 mg/kg/day (ultramicrosize; usually maximum 750 mg/day) ×6–8 weeks.
Tinea capitis (children):20–25 mg/kg/day (microsize suspension) × 6–8 weeks.
Tinea imbricata :500 mg twice daily for 4–6 weeks.
Tinea barbae :Micronized or ultramicronized griseofulvin,500–1000 mg/day or 500–750 mg/day po,respectively, for 4–6 weeks.
Majocchi granuloma.

others

Follow Up Monitoring

COMMON
- Urticaria.
- Nausea, headache, confusion, vomiting, diarrhea, flatulence, increased thirst.
- Candidiasis.
- Photosensitivity.
- Lupus-like reaction.
- Estrogenic effects.
- Paresthesias.
- Dizziness, fatigue, insomnia,proteinuria.

RARE
- Fixed drug eruptions.
- Granulocytopenia.
- Hepatotoxicity.
- Neutropenia.
- Nephrotoxicity.
- Erythema multiforme.
- Angioedema.
- Mental confusion.

Fungistatic and anti-inﬂammatory agent that deposits in the keratinocytes, which are gradually exfoliated and replaced by new, uninfected cells.
It disrupts mitotic spindle by interacting with microtubules, thereby inhibiting mitosis in dermatophytes.

Decreased levels of: alfentanil, amiodarone, aprepitant, aripiprazole, bortezomib, bosentan, buprenorphine, benzodiazepines, carbamazepine, calcium channel blockers, clarithromycin, oral contraceptives, cyclosporin, delavirdine, disopyramide, efavirenz, erythromycins, fentanyl, geftinib, itraconazole, ketoconazole, levonorgestrel, paclitaxel, protease inhibitors, repaglinide, sirolimus, statins, tacrolimus, voriconazole, warfarin,salicylates, zonisamide.

Pregnancy category x.
Rare cases of conjoined twins have been reported in women taking griseofulvin in the frst trimester of pregnancy.
Excretion in milk is unknown, avoid use because of potential tumorigenicity.

Patients should avoid pregnancy for at least 1 month after discontinuing griseofulvin.
Severe skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis) and erythema multiforme reported, some resulting in hospitalization or death; discontinue if severe skin reaction occurs.
Elevations in AST, ALT, bilirubin, and jaundice reported, some resulting in hospitalization or death; discontinue if jaundice occurs.
During prolonged griseofulvin therapy, periodic assessment of renal, hepatic, and hematopoietic functions should be performed.
It may increase estrogen metabolizing liver enzymes, which may make oral contraceptives less effective or cause menstrual irregularities.

The duration of therapy depends on the organism (e.g., T. tonsurans infections may require prolonged treatment schedules) but varies between 8 and 10 weeks.
Shorter courses may lead to higher relapse rates.
Griseofulvin is not effective in the treatment of pityriasis (tinea) versicolor, bacterial infections, candidiasis (moniliasis), or deep mycotic infections.
Resistance to griseofulvin among dermatophytes is rare.
Absorption of griseofulvin is improved when given with whole milk or ice cream.
Drug particle size reduction through micronization and ultra-micronization has signifcantly enhanced oral absorption.

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