Introduction
Tericin is an antifungal medication. It is used in the treatment of severe fungal infections and kala-azar. It kills the infection causing fungi and thus, treats the infection.
Tericin is administered as an injection by a healthcare professional. Kindly do not self administer. Before you take this medicine, inform your doctor if you suffer from diabetes, liver/kidney problems or are on dialysis or have low potassium level in blood.
It may lead to a few common side effects like headache, vomiting, nausea, stomach cramps and fever. You may also notice some injection site reactions like pain, swelling or redness. Inform your doctor if these side effects persist for a longer duration. Please consult your doctor if you are pregnant, planning to conceive or breastfeeding.
Uses of Tericin
- Severe fungal infections
- Kala-azar
Side effects of Tericin
Common
- Headache
- Vomiting
- Nausea
- Stomach cramp
- Fever
- Anemia (low number of red blood cells)
- Heartburn
- Hyperventilation (rapid breathing)
How to use Tericin
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Tericin works
Tericin is an antifungal medication. It kills fungi by destroying the fungal cell membrane.
What if you forget to take Tericin?
If you miss a dose of Tericin, please consult your doctor.
Indication
Adult: Dosing regimens are applicable to amphotericin B (conventional). PO Oral candidiasis Per loz contains amphotericin B 10 mg: Suck 1 loz 4 times/day, up to 8 loz/day if needed.
IV Systemic Fungal Infections
Test dose: 1 mg IV x1 infused over 20-30 min
Load: 0.25-0.5 mg/kg IV infused over 2-6 hr
Maintenance: 0.25-1 mg/kg IV qDay OR up to 1.5 mg/kg IV qOD (may increase gradually by 0.25 mg-increments/day)
Administration
Increased toxicity with flucytosine. Drug induced renal toxicity enhanced in presence of other nephrotoxic medications. Antagonises effects of azole antifungals.
Potentially Fatal: Potentiates K loss by corticosteroids. Avoid diuretics. Enhances digitalis toxicity and neuromuscular blocker effects.
Adult Dose
Renal and hepatic impairment; pregnancy; monitor renal and liver function changes.
Lactation: Excretion in milk is unknown; due to the potential for serious adverse reactions in breast-fed infants, a decision should be made whether to discontinue nursing or whether to discontinue the drug, taking into account the importance of the drug to the mother
Renal Dose
Amphotericin B is a polyene antifungal antibiotic which alters cell membrane permeability by binding to ergosterol, thus causing leakage of cell components and subsequent cell death. It is active against Absidia spp, Aspergillus spp, Basidiobolus spp, B. dermatitidis, Candida spp, C. immitis, Conidobolus spp, C. neoformans, H. capsulatum, Mucor spp, P. brasiliensis, Rhizopus spp, Rodotorula spp. and S. schenckii.
Contraindication
Systemic Fungal Infections
Test dose: 0.1 mg/kg IV, not to exceed 1 mg; administer over 20-60 min
Initial dose: 0.25 mg/kg/dose IV qDay/qOD
Maintenance: Increase by 0.25 mg/day increments as tolerated to 1-1.5 mg/kg/day
Mode of Action
IV Administration
Use promptly after dilution. Infuse over 2-6 hr
Reconstitution: For conventional amphotericin B: Reconstitute with sterile water for inj (without preservatives), then further dilute with glucose inj 5% (with a pH>4.2) to a final concentration not exceeding 0.1 mg/ml for peripheral infusion or 0.25 mg/ml for central infusion.
Precaution
Endocarditis, Systemic fungal infections, Visceral leishmaniasis, Primary amoebic meningoencephalitis, Thrush, Cryptococcal meningitis, Candidiasis, Aspergillosis, Candidal cystitis
Side Effect
Renal Impairment
CrCl <10 mL/min: 0.5-0.7 mg/kg IV q24-48hr
Consider other antifungal agents that may be less nephrotoxic
Intermittent hemodialysis: 0.5-1 mg/kg IV q24hr after dialysis session
Continuous renal replacement therapy: 0.5-1 mg/kg IV q24hr
Pregnancy Category Note
>10%
Anorexia,Chills,Diarrhea,Fever,Headache,Hypokalemia,Hypomagnesemia,Hypotension,Malaise,Nausea,Pain (generalized),Pain at injection site,Renal function abnormalities,Tachypnea,Vomiting
1-10%
Arachnoiditis,Delerium,Flushing,Hypertension,Leukocytosis,Lumbar nerve pain,Paresthesia,Urinary retention
<1%
Agranulocytosis,Anuria,Bone marrow suppression,Cardiac arrest,Coagulation defects,Convulsions,Dyspnea,Hearing loss,Leukopenia,Maculopapular rash,Renal failure,Thrombocytopenia,Vision changes
Potentially Fatal: Anaphylactic reaction; leucoencephalopathy. Overdosage can result in cardio-respiratory arrest.
Interaction
Hypersensitivity; lactation; do not give to patients receiving antineoplastics.