Caution is advised when consuming alcohol with Segal. Please consult your doctor.
CONSULT YOUR DOCTOR
Segal is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
SAFE IF PRESCRIBED
Segal is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.
Segal may cause side effects which could affect your ability to drive. Segal may cause dizziness or seizures. This may affect your ability to drive.
Segal is probably unsafe to use in patients with kidney disease and should be avoided. Please consult your doctor. Caution to be advised in patients with impaired renal function.
Segal should be used with caution in patients with liver disease. Dose adjustment of Segal may be needed. Please consult your doctor.
Segal belongs to a group of medicines called antifungals. It works by stopping the growth of fungus and is used to treat infections of the mouth, throat, vagina and other parts of the body including fingernails and toenails. It kills fungi by destroying the fungal cell membrane. Segal should be taken in the dose and duration as prescribed by your doctor. It should be swallowed whole and can be taken with or without food. The dosage and length of treatment will depend on the condition you are being treated for. Sometimes this will be in cycles of use and non-use. To get the most benefit, take this medicine at evenly spaced times and continue using it until your prescription is finished, even if your symptoms disappear after a few days. If you stop treatment too early, the infection may return and if you miss doses you can increase your risk of infections that are resistant to further treatment. Tell your doctor if the infection does not get better or if it gets worse. Avoid taking antacid treatments within one hour before or two hours after you take it. The most common side effects of this medicine include stomach pain, headache and feeling sick (nausea). You could ask your doctor about ways of preventing or reducing these effects. You should stop taking it straight away if you have any signs of an allergic reaction or of congestive heart failure. Signs of this include rash, swelling of the lips, throat or face, swallowing or breathing problems, feeling dizzy or faint and nausea. Do not take it if you are pregnant or could become pregnant unless your doctor has told you to. Talk to your doctor before taking it if you have ever had heart failure, a weak immune system (including HIV/AIDS), kidney problems or liver problems such as yellow skin (jaundice). This medicine may not be suitable for you. If your course of treatment is for more than a month, your doctor may want to check your liver by testing your blood. This medicine may make you dizzy or have blurred vision so do not drive or operate machines until it is safe.
Uses of Segal
- Fungal infections
Side effects of Segal
How to use Segal
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Segal may be taken with or without food, but it is better to take it at a fixed time.
How Segal works
Segal is an antifungal medication. It kills and stops the growth of the fungi by destroying its cell membrane, thereby treating your skin infection.
What if you forget to take Segal?
If you miss a dose of Segal, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
- Your doctor has prescribed Segal to cure your infection and improve symptoms.
- Do not skip any doses and finish the full course of treatment even if you feel better.
- Use a reliable method of contraception to prevent pregnancy while taking this medicine.
- Your doctor may check your liver function before starting treatment and regularly thereafter. Inform your doctor if you notice yellowing of eyes or skin, dark urine, or stomach pain.
- Inform your doctor if you develop severe skin rash like blistering of the skin along with fever.
Cryptococcal meningitis, Candidiasis, Tinea pedis, Tinea cruris, Tinea corporis, Vaginal candidiasis, Onychomycosis, Coccidioidomycosis, Cryptococcosis, Histoplasmosis, Mucosal candidiasis, Candidal balanitis, Dermatophytosis
May be taken with or without food Reconstitution: Powd for oral susp: Add 24 mL of distilled or purified water to the container labeled as containing 0.35 g or 1.4 g of fluconazole to provide a susp containing 50 mg or 200 mg per 5 mL, respectively. Shake vigorously to suspend the powd.
Oral Oropharyngeal Candidiasis 200 mg PO on Day 1, THEN 100 mg qDay Treatment should be continued for at least 2 weeks to decrease likelihood of relapse Esophageal Candidiasis 200 mg PO on Day 1, THEN 100 mg qDay; doses up to 400 mg/day may be used based on patient’s response Treat for a minimum of 3 weeks and for at least 2 weeks following resolution of symptoms Vaginal candidiasis; Candidal balanitis Uncomplicated: 150 mg PO as a single dose Complicated: 150 mg PO q72hr for 3 doses Recurrent: 150 mg PO qDay for 10-14 days followed by 150 mg once weekly for 6 months Cutaneous candidiasis; Dermatophytosis; Pityriasis versicolor Adult: 50 mg once daily for up to 6 wk. Systemic candidiasis ; Cryptococcal infections Adult: Initially, 400 mg, followed by 200-400 mg once daily. Treatment duration is based on clinical and mycological response, but is usually at least 6-8 wk in cryptococcal meningitis. To prevent relapse after a primary course of treatment for acute cryptococcal meningitis in AIDS patients: 100-200 mg daily. Prophylaxis of fungal infections in immunocompromised patients Adult: 50-400 mg daily. Prophylaxis in patients undergoing bone marrow transplantation: The recommended daily dosage is 400 mg, once daily. Patients who are anticipated to have severe granulocytopenia (less than 500 neutrophils per cu mm) should start Fluconazole Injection, USP prophylaxis several days before the anticipated onset of neutropenia, and continue for 7 days after the neutrophil count rises above 1000 cells per cu mm.
Child: PO 3–12 mg/kg/day, max 600 mg/day q24h Max 800–1,000 mg/day may be used for some CNS fungal infections Age Average Weight Dose/Day 1 year: 9 kg - ½ spoonful 1-2 years: 12 kg- 1 spoonful 2-3 years: 14 kg- 1½ spoonful 3-4 years: 16 kg- 2 spoonful
Renal impairment: Haemodialysis patients: Usual dose given after each session. CrCl (ml/min) Dosage Recommendation <50 and not receiving dialysis 50% of the usual dose. >50 Usual dose.
Mode of Action
Fluconazole decreases ergosterol synthesis by interfering w/ cytochrome P450 activity, thus inhibiting cell membrane formation of susceptible fungi including B. dermatitidis, Candida spp., C. immitis, C. neoformans, Epidermophyton spp., H. capsulatum, Micosporum spp., Trichophyton spp.
Renal or hepatic impairment. May prolong QT interval. Pregnancy, lactation. CDC guidelines recommend only using topical antifungal products to treat pregnant women with vulvovaginal yeast infections, including for longer periods than usual if these infections persist or recur. Lactation Enters breast milk; use caution
>10% Headache (2-13%) 1-10% Nausea (2-7%),Abdominal pain (2-6%),Diarrhea (2-3%),Rash (2%),Vomiting (2-5%) Frequency Not Defined QT prolongation,Torsades de pointes,Alopecia,Anaphylactic reactions,Angioedema,Cholestasis,Dizziness,Dyspnea,Hepatic failure,Hepatitis,Hypertriglyceridemia,Hypokalemia,Increased alkaline phosphatase,Increased ALT/AST,Jaundice,Leukopenia,Pallor,Seizures,Stevens-Johnson syndrome,Taste perversion,Thrombocytopenia,Toxic epidermal necrolysis Potentially Fatal: Hepatotoxicity; rarely anaphylaxis; Stevens-Johnson syndrome.
Pregnancy Category Note
Pregnancy Single maternal PO dose of 150 mg for vaginal candidiasis Results of a Danish study concludes there is a possible increased risk of miscarriage; women who are pregnant or actively trying to get pregnant should ask their physician about alternative treatments Spontaneous abortion between 7 and 22 weeks' gestation occurred significantly more often in women exposed to oral fluconazole than unexposed pregnancies (4.43% vs. 4.25%; hazard ratio, 1.48); fluconazole was also compared with intravaginal azole antifungals to account for confounding by candidiasis, again, the oral drug was associated with significantly increased risk for spontaneous abortion - JAMA. 2016;315(1):58-67 CDC guidelines recommend only using topical antifungal products to treat pregnant women with vulvovaginal yeast infections, including for longer periods than usual if these infections persist or recur All other indications Use in pregnancy should be avoided except in patients with severe or potentially life-threatening fungal infections in whom fluconazole may be used if the anticipated benefit outweighs the possible risk to the fetus A few published case reports describe a rare pattern of distinct congenital anomalies in infants exposed in-utero to high dose maternal fluconazole (400-800 mg/day) during most or all of the first trimester Effective contraceptive measures should be considered in women of child-bearing potential who are being treated with 400-800 mg/day and should continue throughout the treatment period and for approximately 1 week (5 to 6 half-lives) after the final dose Reported anomalies are similar to those seen in animal studies and consist of brachycephaly, abnormal facies, abnormal calvarial development, cleft palate, femoral bowing, thin ribs and long bones, arthrogryposis, and congenital heart disease Lactation Secreted in human milk at concentrations similar to maternal plasma concentrations; use caution (AAP Committee states "compatible with nursing")
May increase plasma concentrations of oral hypoglycaemics (e.g. tolbutamide, glyburide, glipizide), phenytoin, theophylline, tofacitinib, rifabutin. May increase prothrombin time w/ anticoagulants. May cause significant increase in ciclosporin levels in renal transplant patients w/ or w/o renal impairment. Rifampicin reduces fluconazole levels. May increase risk of nephrotoxicity w/ tacrolimus. May increase the effect of short-acting benzodiazepines (e.g. midazolam). Potentially Fatal: Increased risk of cardiac arrhythmias or QT prolongation w/ terfenadine, cisapride, astemizole, pimozide, quinidine, halofantrine and erythromycin.
The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.