Generic Name

Griseofulvin

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Classification

FDA Approved Indications

• Dermatophyte infections of the skin, hair, and nails

Mechanism of Action

Griseofulvin binds to fungal microtubules, disrupting mitosis and inhibiting fungal cell division, thereby exerting antifungal effects.

Dosage and Administration

Adult: Typically 500 mg to 1000 mg daily in divided doses; duration varies based on infection severity and site.

Pediatric: Dosage generally 6-12 mg/kg/day divided into 1-2 doses, depending on age and weight.

Geriatric: Use with caution; dosage adjustments may be necessary due to potential hepatic impairment.

Renal Impairment: Use with caution; dose adjustment may be required.

Hepatic Impairment: Use with caution; hepatic function should be monitored.

Pharmacokinetics

Absorption: Absorption is variable; food increases absorption.

Distribution: Widely distributed in body tissues, especially keratin-containing tissues.

Metabolism: Metabolized in the liver, primarily via hydroxylation.

Excretion: Excreted mainly in feces as unchanged drug and metabolites.

Half Life: Approximately 9-25 hours, but can be prolonged in hepatic impairment.

Contraindications

• Hypersensitivity to griseofulvin or any component of the formulation.
• Active liver disease.

Precautions

• Use cautiously in patients with hepatic impairment, alcoholism, or in pregnant women due to potential teratogenicity.

Adverse Reactions - Common

• Headache (Common)
• Dizziness (Common)
• Gastrointestinal upset (nausea, vomiting, diarrhea) (Common)
• Rash or hypersensitivity reactions (Common)

Adverse Reactions - Serious

• Hepatotoxicity (Rare)
• Leukopenia, eosinophilia, or other hematologic abnormalities (Rare)
• Severe hypersensitivity reactions (Rare)

Drug-Drug Interactions

• Cyclosporine (may increase levels)
• Hepatotoxic drugs (caution)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication with food for better absorption.
• Complete the full course of therapy.
• Report symptoms of hepatotoxicity (jaundice, dark urine), rash, or severe dizziness.
• Avoid alcohol and hepatotoxic substances during therapy.

Special Considerations

Black Box Warnings:

• Potential teratogenicity—avoid during pregnancy.
• Hepatotoxicity—monitor liver enzymes.

Genetic Factors: None specific.

Lab Test Interference: May cause elevated liver enzymes, which should be interpreted with caution.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, allergic reactions.

Treatment: Supportive care; no specific antidote. Seek immediate medical attention.

Storage and Handling

Storage: Store at room temperature, 15-30°C (59-86°F).

Stability: Stable under recommended conditions.