Griseofulvin

A to Z Drug Facts

Griseofulvin

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(griss-ee-oh-FULL-vin)

Microsize

Fulvicin U/F, Grifulvin V, Grisactin 500, Grisactin 250, Grisovin-FP

Ultrasize

Fulvicin P/G, Gris-PEG, Grisactin Ultra

Class: Anti-infective/Antifungal

Action Deposited preferentially into infected skin, which gradually sloughs off and is replaced by noninfected tissue; binds tightly to new keratin, which becomes highly resistant to fungal invasions.

Indications Treatment of ringworm infections of skin, hair, and nails caused by susceptible fungi.

Contraindications Porphyria; hepatic disease.

Route/Dosage

ADULTS: PO 500 to 1000 mg microsize (330 to 750 mg ultramicrosize) in single or divided doses. May need to give for several weeks. CHILDREN: PO 11 mg microsize kg/day (125 to 500 mg) or 7.3 mg ultramicrosize/kg/day (82.5 to 330 mg).

Interactions

Alcohol: Effects of alcohol may be potentiated with tachycardia and flushing. Anticoagulants: Anticoagulant effect may be decreased. Barbiturates: May depress griseofulvin serum levels. Oral contraceptives: May cause loss of contraceptive effectiveness.

Lab Test Interferences False elevation of vanillylmandelic acid test assayed by photometric tests but not with gas or thin layer chromatography method.

Adverse Reactions

CNS: Headache; fatigue; dizziness; insomnia; confusion; paresthesias. DERM: Rash; urticaria. EENT: Oral thrush. GI: Nausea; vomiting; epigastric distress; diarrhea; GI bleeding. GU: Proteinuria. HEMA: Leukopenia; granulocytopenia. HEPA: Hepatic toxicity. META: Interferes with porphyrin metabolism. OTHER: Angioneurotic edema.

Precautions

Pregnancy: Category C. Lactation: Undetermined. Hypersensitivity: Drug may need to be discontinued. Also, penicillin cross-sensitivity is possible, although some penicillin-sensitive patients have used without difficulty. Lupus: May exacerbate lupus or lupus-like syndrome.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Administer with or after meals, particularly with fatty foods if not contraindicated.
Generally administered in conjunction with topical agent.
Do not interchange griseofulvin microsize with ultramicrosize because dosage is different.
Store at room temperature in tightly closed containers.

Assessment/Interventions

Evaluate skin condition prior to and throughout therapy.
Institute general supportive measures to maintain skin integrity.
Observe for signs of infection or reinfection.
Institute safety precautions if dizziness or other neurologic alterations occur.

Patient/Family Education

Advise patient to inspect skin for signs of improvement of infection or re-infection.
Explain importance of good hygiene, particularly to affected areas.
Inform patient that beneficial effects of drug may not be observable for weeks to months.
Emphasize importance of continued follow-up examinations.
Instruct patient to report these symptoms to health care provider: Fever, sore throat, or skin rash.
Caution patient to avoid intake of alcoholic beverages or other CNS depressants.
Advise patient that drug may cause dizziness and to use caution while driving or performing other tasks requiring mental alertness.
Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.