Indications
Ravuconazole is an antifungal medicine of the triazole group. It is taken by mouth, usually in the form of a prodrug (fosravuconazole) that the body converts to Ravuconazole, mainly to treat fungal infection of the nails (onychomycosis). It has also been studied for other deep fungal infections such as eumycetoma.
How It Works
Fungi need a substance called ergosterol to build their cell membranes. Ravuconazole blocks an enzyme (lanosterol 14-alpha-demethylase) that the fungus uses to make ergosterol. Without it, the fungal cell membrane becomes weak and leaky and the fungus stops growing and dies. The medicine collects in nail tissue, which helps it act on nail infections.
Dosage and Administration
Take as prescribed by your doctor. For nail fungus it is usually taken once a day for about 12 weeks. Swallow the capsule whole with water. The nail takes many months to grow out clear even after the course ends, so do not stop early just because you see no change. Your doctor may check liver tests during treatment.
Interactions
Ravuconazole can slow the breakdown of medicines handled by the liver enzyme CYP3A4, raising their levels. Take care with Simvastatin and other statins, Midazolam and Triazolam, Ciclosporin, Tacrolimus, some calcium channel blockers and Warfarin. Tell your doctor about all medicines and herbal products you take; some may need to be stopped or their doses changed.
Contraindications
- Allergy to Ravuconazole, fosravuconazole or other azole antifungals
- Pregnancy or possible pregnancy
- Use with certain medicines that interact strongly, as advised by your doctor
Side Effects
Possible side effects include raised liver enzymes on blood tests, stomach discomfort, nausea, diarrhoea, headache, tiredness and rash. Serious liver problems are uncommon.
Get urgent medical help if you notice yellowing of the skin or eyes, dark urine, pale stools, severe tummy pain, a severe rash with blistering or peeling, or signs of a severe allergic reaction such as swelling of the face or difficulty breathing.
Pregnancy and Lactation
Animal studies suggest it may harm an unborn baby, so it must not be used in pregnancy. Women who could become pregnant should use effective contraception during treatment and for the period advised afterwards. Breastfeeding is not recommended during treatment.
Precautions and Warnings
Tell your doctor if you have liver disease or drink alcohol heavily. Liver function may be checked before and during treatment. Nail fungus should be confirmed by a test before a long course of treatment. Keep feet and nails clean and dry to help prevent reinfection.
Overdose
Overdose may increase side effects, especially on the liver. Seek medical advice; treatment is supportive.
Therapeutic Class
Triazole antifungal (systemic)
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.