Reply To: Rx Antifungals

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dvjorge
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dvjorge;25615 wrote: Hi guys,
I thought to write some information about pharmaceutical grade antifungals because many people ask about them in the forums. Rx antifungal must be prescribed by a licensed MD.

Fungus are hard to kill because the few fungus specific targets and its ability to develop resistance. There are only a few antifungals if we compare it to antibiotics.

Most antifungals are FUNGISTATIC, meaning they only inhibit the fungus growth. In fact, most of them are FUNGICIDAL “in vitro” , but their toxicity to the human cells and organs don’t allow to rise the dosage to FUNGICIDAL levels “in vivo”.

There are a few antifungal categories, the Polyenes, the Azoles, the Allylamines, the Echinocandins, Chitin Inhibitors, and the Cerulenims.

The Polyenes.
These are NYSTATIN, AMP B, and NATAMYCIN.
Their mode of action is binding to ergosterol in the fungal cell wall.
The polyenes are very toxic to the liver and our cells since our cells are composed by cholesterol (very similar to ergosterol), and the polyenes may destroy our own cells. Only AMP B is used as a systemic IV antifungal. They are poorly absorbed by the gut lining allowing to use Nystatin as an oral non-systemic drug. There is also an oral non-systemic AMP B version. When taken orally, they aren’t toxic and are considered very safe drugs.
The polyenes are fungicidal/fungistatic against candida albicans. They kill it dose dependable, but there are candida species that are resistant to them. In the case of intestinal candidiasis, they are the most effective Rx antifungal available so far. A note, don’t take oral Nystatin solutions that pharmacies prepare loaded with sugar to kill its bitter test. It will do more damage than anything. The most effective for CRC is the refrigerated powder, and next, the tablets.

The Azoles.
These are Ketoconazole, Fluconazole, Itraconazole, Voriconazole, Posoconazole, etc. They inhibit the ergosterol synthesis path way of the fungal wall.
These are systemic drugs, meaning they pass to the bloodstream when taken orally. The azoles are mostly FUNGISTATIC in the dosage we can tolerate, with the exception of Voriconazole and Posoconazole that are fungicidal to some candida species and strains.
These drugs aren’t very effective treating an intestinal fungal overgrowth since they are absorbed in the upper intestinal tract passing to the blood. The azoles are considered safe drugs. There are reports of liver toxicity using them mostly with Ketconazole, but their toxicity have been boosted by the alternative natural field treating CRC. In reality, they are well tolerated when used to regular dosage. Liver enzymes should be monitored when using the azoles.

To treat this syndrome, well documented MDs use Fluconazole or another azole for several months in most cases. Don’t expect a short course of these drugs be enough to eradicate a persistent fungal overgrowth. To get a proper treatment for this syndrome using these drugs, you need to see a MD that understands and accepts this syndrome.

The allylamines.
Terbinafine ( Lamisil ) is an antifungal drug that inhibits squalence epoxidase of the candida cell wall. It is a systemic drug.
Terbinafine is FUNGISTATIC against candida species and considered having limited activity against candida albicans. However, Lamisil has been documented as offering synergistic effects when combined with one azole, specially Fluconazole and Itraconazole. Combining Lamisil with Diflucan have been effective treating resistant to the azoles candida infections. Lamisil has a moderate toxicity very similar to the azoles. Liver enzymes should be monitored during its use.

Chitin Inhibitors.
There are many chitin inhibitors. Chitin is an hormone the fungus generates to create a shield to protect its cell core.
The most mentioned by candida sufferers is Lufenuron since there are web myths staying it is effective treating candida.I can not say it is true since to my knowledge there aren’t studies demonstrating Lufenuron is effective against candida albicans. In fact it has almost no activity against candida species according to the research. Chitin inhibitors have shown synergistic activity when combined with the azoles and the echinocandins. Lufenuron hasn’t been used in those studies but other chitin inhibitors.

The Echinocandins.
Caspofungin, Micafungin, and Anidulafungin.
These are part of a new antifungal generation. They inhibit the Glucan synthesis of the fungus cell wall. They are only available in IV versions since they are poorly absorbed by the gut lining and there isn’t market for non-systemic antifungals. ( could be ideal for us some oral versions )
They are FUNGICIDAL against most candida species. They kill candida at regular dosage. They are low in toxicity since human cells don’t have Glucan.
These could be excellent drugs to treat chronic intestinal candidiasis if there were oral versions available. Unfortunately, the pharma industry don’t have market for oral versions because intestinal yeast overgrowth isn’t widely accepted by the mainstream medicine.Think about an oral Echinocandin fungicidal against most candida species, that don’t cross the gut epithelium keeping its effect inside the intestines ( where we need more ) and have almost not liver toxicity even used systemically. They could be the ideal drugs for CRC sufferers.

This post is a general information about the Rx antifungals in case that your Dr prescribe one of them and you want some information.

The standard or personalized doses have to be discussed with a MD.

Jorge.