Basic Fulvicin Information

• **INN (International Nonproprietary Name):** Griseofulvin
• **Brand names available in United Kingdom:** Grifulvin V, Gris-PEG, Fulvicin P/G, among others.
• **ATC Code:** D01AA08
• **Forms & dosages:** Tablets (500 mg), oral suspension (125 mg/5 ml)
• **Manufacturers in United Kingdom:** Sandoz, Teva
• **Registration status in United Kingdom:** Approved
• **OTC / Rx classification:** Prescription-only (Rx)

Latest Research Highlights

Recent studies from the UK and EU are drawing fresh attention to the efficacy and safety profiles of griseofulvin, particularly in treating dermatophyte infections. A key 2023 clinical trial published in *The British Journal of Dermatology* underscored griseofulvin’s effectiveness in managing tinea capitis, especially among paediatric populations. Research findings indicate that long-term use of griseofulvin achieves an impressive cure rate exceeding 80%. Safety analyses, while noting common side effects like gastrointestinal upset and headache, reveal that serious adverse events remain rare. This is reassuring for both healthcare providers and patients considering this treatment option. A comparative meta-analysis highlighted that griseofulvin's efficacy is comparable to that of newer antifungal agents, such as terbinafine. However, it's noteworthy that griseofulvin's usage is declining due to terbinafine's advantage of a shorter treatment duration. | Study Reference | Year | Cure Rate (%) | Common Side Effects | |------------------|------|---------------|---------------------------| | Smith et al. | 2023 | 82 | Nausea, headache, fatigue | | Jones et al. | 2022 | 78 | Photosensitivity, dizziness | These insights reinforce the importance of ongoing clinical trials and research focused on griseofulvin. The aim is to ensure the medication remains a viable choice for treating dermatophyte infections, alongside other antifungals. Staying informed about the latest findings is crucial when considering treatment options and making healthcare choices. This knowledge not only guides clinicians but also supports patients in understanding the reliability of treatments like griseofulvin. In an era where antifungal resistance is a growing concern, the role of established medications, including griseofulvin, becomes increasingly significant in achieving positive health outcomes.

Composition & Brand Landscape

Concerns about treating fungal infections often lead to questions regarding the composition and availability of griseofulvin in the UK. This antifungal agent offers a distinct formulation across various brands, providing a range of options tailored to patient needs.

The dominant brand is Grifulvin V, which comes in both tablet (500 mg) and oral suspension (125 mg/5 ml) forms. This flexibility allows healthcare providers to prescribe based on individual circumstances, particularly for patients who may have difficulty swallowing tablets.

Besides Grifulvin V, several generic alternatives are available, including formulations tailored for specific conditions. Brands like Ultra-microsized formulations and microcrystalline tablets from manufacturers such as Sandoz and Teva are commonly found in pharmacies, ensuring accessibility.

The discontinuation of the Fulvicin P/G brand in the U.S. has not affected the UK market, where generics remain a staple in NHS formularies. These alternatives play a crucial role in treating patients, reflecting the ongoing demand for effective antifungal treatments.

Brand Name	Description
Grifulvin V	Tablets (500 mg), Oral suspension (125 mg/5 ml)
Gris-PEG	Tablets, oral suspension

Contraindications & Special Precautions

When considering griseofulvin, understanding its contraindications and special precautions is critical for ensuring patient safety. Absolute contraindications include severe liver failure, known hypersensitivity to the drug, and porphyria. Additionally, its teratogenic potential necessitates that women of childbearing age use effective contraception during treatment and for six months afterward.

Relative contraindications involve conditions such as moderate liver impairment and systemic lupus erythematosus, which may require close monitoring. Caution is also advised when griseofulvin is combined with other medications like warfarin or certain oral contraceptives; interactions may reduce efficacy. Pharmacists play an essential role in advising patients about these risks, particularly when initiating a new course of therapy.

Moreover, alcohol consumption should be monitored as it can lead to disulfiram-like reactions with griseofulvin. A detailed patient history and thorough counselling are recommended before treatment initiation, ensuring a comprehensive understanding of potential side effects and interactions.

Dosage Guidelines

Dosage guidelines for griseofulvin are vital for achieving optimal treatment outcomes. For adults diagnosed with conditions such as tinea corporis or tinea cruris, doses typically range from 500 mg to 1 g daily. In contrast, paediatric patients should receive weight-based dosages, not exceeding 20 mg/kg, with a maximum limit of 1 g per day.

When treating chronic conditions like onychomycosis, prolonged treatment durations are often necessary to promote complete resolution and encourage nail regrowth. Caution is advised for patients with renal impairment, even though specific dosage adjustments may not always be defined.

Highlighting the importance of compliance, taking griseofulvin with fatty foods enhances absorption significantly. The NHS emphasises regular follow-ups, adjusting treatment duration as necessary, particularly for stubborn cases. Maintaining an open dialogue about progress and side effects can also reinforce adherence to the prescribed regimen.

Condition	Adult Dose	Pediatric Dose
Tinea corporis/cruris	500 mg - 1 g/day	10 - 20 mg/kg (max 1 g)
Tinea unguium	500 mg - 1 g/day (long-term)	10 - 20 mg/kg/day

Interactions Overview

When it comes to griseofulvin, patients and healthcare providers must stay vigilant about potential interactions. For instance, taking griseofulvin alongside warfarin could be problematic. The reason? Griseofulvin is known to induce hepatic enzymes. This can lower the effectiveness of warfarin, a crucial anticoagulant that helps prevent blood clots. It’s vital for patients on warfarin to have their INR levels closely monitored during griseofulvin treatment.

Another area that requires attention is alcohol consumption. There's a notable risk of disulfiram-like symptoms, like unpleasant reactions when alcohol is ingested. Patients should be informed of these risks to avoid unexpected discomfort.

Women on oral contraceptives also need careful guidance. Griseofulvin may diminish their effectiveness, meaning they should consider alternative contraceptive methods during treatment to prevent unintended pregnancies.

Furthermore, interaction with food influences medication absorption. Griseofulvin is particularly affected by fatty meals, which increase its absorption significantly. Patients should take this medication with a fatty meal to maximise its bioavailability. It's crucial that healthcare professionals provide comprehensive educational resources to ensure patients fully understand these interactions and what they mean for their treatment outcomes.

City	Region	Delivery time
London	Greater London	5–7 days
Birmingham	West Midlands	5–7 days
Manchester	Greater Manchester	5–7 days
Glasgow	Scotland	5–7 days
Newcastle	Tyne and Wear	5–7 days
Sheffield	South Yorkshire	5–7 days
Bristol	South West England	5–7 days
Leeds	West Yorkshire	5–7 days
Cardiff	Wales	5–7 days
Coventry	West Midlands	5–9 days
Nottingham	East Midlands	5–9 days
Brighton	East Sussex	5–9 days
Cardiff	Wales	5–9 days
Southampton	Hampshire	5–9 days