Furazolidone

'Furazolidone is antibacterial agent, used in the treatment of bacterial diarrhea and gastro-enteritis. It may also be useful in treating traveler''s diarrhea, typhoid fever, cholera and salmonella infections.'


Adult Dose
Dose: 25 to 50 mg
Single Dose: 38 (37.5)
Frequency: 6 hourly
Route: PO
Instructions: For 7-10 Days
Neonatal
Paedriatic
Dose: 1.25 mg/kg
Single Dose: 1.2 (1.25)
Frequency: 6 hourly
Route: Oral
Instructions: For Paeds of all ages
Characteristics
. It is of Semi Synthetic origin and belongs to Polysaccharide. It belongs to Antibiotic (Prokaryote DNA) pharmacological group on the basis of mechanism of action and also classified in Antiviral Agents pharmacological group.The Molecular Weight of Furazolidone is 225.20.
Contraindications
Furazolidone is contraindicated in conditions like G6pd deficiency.
Effects
The severe or irreversible adverse effects of Furazolidone, which give rise to further complications include Hepatotoxicity, Agranulocytosis, Hepatotoxicity, Hacmolytic Anemia, Acute pulmonary reactions.The symptomatic adverse reactions produced by Furazolidone are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Drowsiness, Nausea, Vomiting, Fever, Skin rashes, Urticaria, Redness, Malaise, Hypotension, Arthralgia, Angioedema, Darkening of urine, Skin rashes, dizziness.
Indications
Furazolidone is primarily indicated in conditions like Bacillary dysentery, Cholera, Diarrhoea caused by e-coli, Diarrhoea caused by salmonella species, Diarrhoea caused by shigella species, Giardiasis, Intestinal infection caused by giardia lambia, Travelers diarrhoea, Typhoid.
Interactions
Furazolidone is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAdrenalineIncreased heart rate and blood pressure has been reported in some cases when adrenaline is used with furazolidne.Moderatemonitor patient heart rate and blood pressure on coadministration.AlbuterolShould not use concurrently without doctors prescription.AlcoholCocurrent use lead to disulfiram-like reactionsi.e.flushing,lacrimation and sweating due to inhibition of enzyme by furazolidone results in accumulation of acetaldehyde.ModerateAvoid alcohol while taking furazolidone or within four days of stopping therapy.Amitriptyline (HCl)CarbamazepineMarked adverse affects seen when carbmazepine given with furazolidone including nausea,vomiting,flushing,dizziness,tremor,hyperthermia,rigidity,autonomic instability,hypertensive crises,severe convulsive seizures,coma and death may also reported.MajorThis combination should be avoided or give a gap of atleast 2 weeks before or after use of any of these drugs.Dopamine (HCl)Both agents act synergistically effecting the sympathomimetic activity in this way that furazolidone enhances the storage of norepinephrine in adrenergic neuron and dopamine increases its liberation result in severe hypertension and hyperpyrexia.Majorboth agents should not be used in combination.if necessary 14 days discontinuation of furazolidone must take before initiastion of dopamine therapy.DoxapramBoth agents acts synergistically in inducing sympathomimetic effect. Furazolidone increases the storage of norepinephrine in adrenergic neurons and doxapram enhance liberation or reduce reuptake of catecholamines thus precipitate severe hypertension.MajorCoadministration is considered contraindicated. There should be gap of atleast 14 days between discontinuing of therapy with furazolidone and initiation of treatment with doxapram.EphedrineBoth agents act synergistically affecting the sympathomimetic activity in this way that furazolidone enhances the storage of norepinephrine in adrenergic neuron and ephedrine increases its liberation result in severe hypertension and hyperpyrexia.MajorBoth agents should not be used in combination.There should be gap of atleast 14 days before initiation of ephedrine therapy and discontinuation of therapy with furazolidone.LevodopaLevodopa precipitate severe hypertensive reactions when treated with furazolidone by availibility of catecholamine and increased synthesis of dopamine.MajorInsted of levodopa carbidopa has been prescribed and atleast 14 days gap should be given during other administration.Maprotiline (HCl)Coadministration enhances the excessive serotonergic activity in CNS i.e. serotonin syndrome and may produce adverse effects like tremor,dizziness,myoclonus,diaphoresis,hyperthermia and coma.MajorCoadministration in general must not be used. If necessary 14 days gap must be given and both drugs started at low doses.MetaraminolCoadministration results hypertension and hyperpyrexia by sympathomimetic effect due to increase norepinephrine storage in neurons and increased release of catecholamine.MajorCoadministration should not be given if necessary then 14 days gap should be given during the initiation of other therapy.MethylamphetamineCentrally-acting sympathomimetic agents (i.e., CNS stimulants), particularly the amphetamines and amphetamine derivatives, may precipitate severe hypertensive reactions and hyperpyrexia in patients treated with monoamine oxidase inhibitors (MAOIs). Death has occurred in some reported cases. The mechanism involves a synergistic sympathomimetic effect due to enhanced norepinephrine storage in adrenergic neurons (MAOI activity) and increased liberation or decreased reuptake of catecholamines (central sympathomimetic activity). MAOIs also slow amphetamine metabolism, which may potentiate amphetamine effect on the release of norepinephrine and other monoamines from adrenergic nerve endings. In general, CNS stimulants should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with CNS stimulants. MajorMethyldopaCoadministration results in alteration in blood pressure,hyperexcitability and hallucinations.MajorCoadministration is considered contraindicated.OxymorphoneThe coadministration of narcotic analgesics and monoamine oxidase inhibitors (MAOIs) may rarely result in hypotension, respiratory depression, or coma. The mechanism is unknown but may be related to additive CNS and respiratory depressant effects. Rare case reports of severe hypotensive reactions have included propoxyphene (with multiple medications), morphine, and methadone, although others have reported the safe use of MAOIs with narcotic analgesics including methadone and morphine.MajorSome manufacturers consider the administration of narcotics and MAOIs within 2 weeks of each other to be contraindicated. However, morphine has been safely used in MAOI patients who previously had an adverse reaction with meperidine and is generally suggested as an alternative to meperidine in anesthesia, as long as vital signs are closely monitored. Other recommendations include giving patients small initial test doses of narcotics and monitoring vital signs for adverse reactions.ParoxetinePhenylpropanolamine (HCl)Coadministration results hypertension and hyperpyrexia by sympathomimetic effect due to increase norepinephrine storage in neurons and increased release of catecholamine.MajorCoadministration should not be given if necessary then 14 days gap should be given during the initiation of other therapy.Pseudoephedrine (HCl)Both agents act synergistically affecting the sympathomimetic activity in this way that furazolidone enhances the storage of norepinephrine in adrenergic neuron and pseudoephedrine increases its liberation result in severe hypertension and hyperpyrexia.MajorBoth agents should not be used in combination.There should be gap of atleast 14 days before initiation of pseudoephedrine therapy and discontinuation of therapy with furazolidone.RizatriptanRizatriptan should not be used within 2 weeks of having used Furazolidone.Sertraline (HCl)Risk of serotonin syndrome i.e inhibition of serotonin metabolism by furazolidine due to additive effect which may be fatal because of hyperstimulation of 5HT1 A receptor results in enhance sertraline pharmacologic activity. MajorThis combination should be avoided or give a gap of atleast 2 weeks before or after use of any of these drugs.SulfapyridineConcurrent use with sulfapyridine may increase the potential for toxic side effectsSumatriptanFurazolidone inhibit metabolic clearance and elevate plasma concnetrationn of sumatriptan result in high risk of coronary artery vasospasm,peripheral vascular ischemia and colonic ischemia.MajorThis combination should be avoided or give a gap of atleast 2 weeks before or after use of any of these drugs. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Pregnant Mothers, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store in a well closed container, Between 15°C-30°C. Protect from Sunlight. Syrup Store at room temperature, Between 15°C-30°C. Do not Freeze. Protect from Sunlight.
Warnings
Furazolidone should be used with caution in patients with medical history, especially of blood disorders, glucose-6-phosphate dehydrogenase (G6PD) deficiency or allergies, especially of drug allergies. Avoid intake of alcohol during therapy and for 4 days after taking this medication. The following are among the foods and beverages to be avoided while taking this medication and for 2 weeks after stop. These foods interact with monoamino oxidase (MAO) inhibitors causing severe headache and increased blood pressure and could lead to a medical emergency, so use with caution while taking meat, fish, pickled herring, liver, dry sausage, meats prepared with tenderizer, yogurt, sour cream, cheese, beverages, avoid excessive amounts of caffeine containing colas, coffee and tea, fruits or vegetables, bananas, figs, raisins, broad beans, yeast extract, soya sauce, large amounts of chocolate. This medication should be used only if clearly needed during pregnancy or lactation. Infants less than one month old should not receive this drug.The drug also inhibit some enzymes including monoamine oxidase. The urine of the patient on furazolidone may be coloured a dark yellow or brown ; this results from the presence of metabolites and is not harmful.
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