The best analogue of "Itraconazole": reviews. Visitor survey results
pharmachologic effect
Orungal – antifungal drug synthetic origin of the azoles group. Its action is to inhibit the key enzyme CYP 450. As a result, the formation of the main structural component of the fungal cell wall (ergosterol) stops.
Itraconazole ( active ingredient Orungala) is active against yeast-like fungi, dermatophytes, molds and yeasts. The drug has a fungistatic and fungicidal effect.
Indications for use
Orungal is used for fungal infections various localizations, which are provoked by sensitive fungal microflora. Use it for:
- onychomycosis;
- dermatomycosis;
- keratitis;
- aspergillosis;
- cryptococcosis;
- candidomycosis;
- sporotrichosis;
- trichophytosis;
- microsporia;
- epidermophytosis;
- mycoses of the eyes;
- tropical mycoses;
- deep organ mycoses;
- pityriasis versicolor;
- blastomycosis;
- histoplasmosis;
- paracoccidioidomycosis.
Separate indications for oral solution:
- candidiasis of the esophagus in immunodeficiency states, HIV;
- prevention of mycoses in the period after transplantation bone marrow, in oncological hematological patients.
Mode of application
The Orungal capsule is not opened or chewed. The capsule should only be consumed whole, with water, after meals. In case of immunodeficiency, neutropenia, AIDS, in the post-transplant period, dosages may be increased (due to possible violations bioavailability). The doctor decides to change treatment regimens depending on the effectiveness of taking Orung
Side effects
Side effects of Orungal capsules are as follows:
- anorexia;
- hepatitis;
- increased transaminase activity of the liver;
- epigastric pain;
- dyspepsia;
- toxic liver damage (sometimes fatal);
- headache;
- peripheral neuropathy;
- dizziness;
- anaphylaxis;
- angioedema;
- itching;
- urticaria;
- Stevens-Johnson syndrome;
- rash;
- alopecia;
- edema due to congestive heart failure;
- photosensitivity;
- pulmonary edema;
- hypokalemia;
- amenorrhea;
- dysmenorrhea.
Contraindications
Orungal is not prescribed for allergies to azoles, lactation, hypersensitivity to capsule components, with caution - for children, the elderly, women of childbearing age, for liver cirrhosis, CHF, renal failure. It is contraindicated to prescribe Orungal to patients taking astemizole, digoxin, levomethadone, cyclosporine, lovastatin, terfenadine, mizolastine, cisapride, quinidine, pimozide, dofetilide, sertindole.
Pregnancy
Orungal is prescribed during pregnancy as a last resort for systemic mycoses that threaten the patient’s life.
Drug interactions
The absorption of itraconazole is impaired by histamine receptor antagonists, didanosine, rifampicin, phenytoin, rifabutin, inducers of microsomal oxidation, and antacids. The drug prolongs the effect of calcium antagonists, vincristine, digoxin, prednisolone, midazolam, terbinafine, triazolam, quinidine, cisapride, vitamin K antagonists, antithrombic agents. Orungal reduces the effect of warfarin. Carbamazepine reduces the effect of the drug. When taken with lovastatin, the development of myopathies is possible. Indinavir, ritonavir, erythromycin, clarithromycin increase the bioavailability of Orungal. When taken with astemizole, death is possible.
Overdose
Cases of exceeding the dose have not been described. There is no antidote. Theoretically, in case of an overdose of Orungal, it is necessary to rinse the stomach and prescribe adsorbents. Hemodialysis is not effective.
Release form
Orungal is available in capsules (100 mg), oral solution (10 mg/ml). Packaging:
- 4 capsules;
- 14 capsules;
- 15 capsules;
- 28 capsules;
- 42 capsules;
- 60 capsules;
- 84 capsules;
- 150 ml bottle (plus measuring cap).
Storage conditions
Storage temperature for Orungal solution is up to 25, capsules – 15-30 degrees Celsius. After opening the bottle of oral solution, store for no more than a month. The shelf life of Orungal capsules is 3 years, the oral solution is 2 years.
Compound
1 capsule of Orungal contains 0.1 g of itraconazole. Auxiliary components: gelatin, hypromellose, sucrose, macrogol, titanium dioxide, indigo carmine, azorubine.
1 ml of Orungal solution contains 10 mg of itraconazole. Auxiliary components: hydroxypropyl-beta-cyclodextin, sorbitol, 1,2-propylene glycol, hydrochloric acid, cherry-vanilla flavor, sodium hydrochloride, prepared water.
Active substance: Itraconazole
Additionally
For any diseases of the heart, liver, lungs, kidneys, the risk/benefit ratio of taking Orungal should be weighed.
If signs of myocardial failure or peripheral neuropathy appear, the drug is discontinued.
The break between taking Orungal and antacids should be more than 2 hours.
Our body is a complex system that can protect itself very well from external influences. But there are many in the world pathogenic microorganisms and fungi that are looking for an opportunity to disrupt protective barriers body and use it for your own needs. Symptoms of infection with these protozoa are mycoses. The disease is not very dangerous, but it greatly reduces the quality of life, as it causes severe discomfort and many cosmetic problems.
What are mycoses? This includes nails, hair and internal organs humans, the causative agent of which is fungi belonging to opportunistic microflora. A drug such as Irunin protects health. We will consider analogues, cost and spectrum of action today.
What is the drug "Irunin"
It is primarily a broad-spectrum antifungal agent. Basics active substance- itraconazole - disrupts the integrity and prevents their reproduction. At the same time, there are microorganisms that are more or less sensitive to this substance. It is most effective against dermatomycetes, molds, and yeasts such as Candida. However, there is not only Irunin on the market. Analogues provide a wide choice and the ability to regulate treatment costs. Below we will take a closer look at the price range of these medicines.
Pharmacological properties
Let's look at the mechanism of action of the drug "Irunin". Instructions for use (the price of this medicine does not at all indicate poor quality) presents it to us as a broad-spectrum antimycotic drug. The active substance violates life cycle fungi, preventing the production of ergosterol by the membrane of their cells. The drug effectively destroys dozens of different types of fungi. The maximum concentration in the blood is reached after approximately 4 hours. Decomposition products are completely eliminated from the body approximately 7 days after stopping the course of treatment. At the same time, the therapeutic concentration remains in the epidermis for about another month. In nail keratin, the drug will retain its healing power approximately another 200 days after the end of the 90-day course of treatment.
Indications
Where is Irunin (analogs) primarily used? This is dermatology (it is most often prescribed for cutting and lichen versicolor), as well as gynecology. The very first problem with which women seek advice is candidiasis (or thrush). The drug is especially effective for candidiasis affecting the mucous membranes and skin, onychomycosis, vulvovaginal thrush. In this case, “Irunin” is most often prescribed. Analogues are not much inferior to it in terms of effectiveness, but are less widely used products.
Contraindications
However, not in all cases the drug “Irunin” can be prescribed. Its use in childhood is strictly prohibited; it is also prohibited in the first trimester of pregnancy. From the 4th month of pregnancy, this drug can only be prescribed if the expected benefit to the mother is greater than possible risk for the fetus. The doctor should exercise great caution when prescribing the drug to people suffering from heart failure, chronic diseases lungs and respiratory system, serious liver damage.
Side effects
They are quite serious, so you should carefully study their list before deciding to take the drug. Antifungal tablets, due to their wide spectrum of action, not only can provoke various side effects, but also touch almost everything vital important systems. Each of them can react various manifestations. So, digestive system often responds to the effects of the drug with various disorders and extremely rarely with intoxication and liver damage. Central nervous system often responds with migraine attacks, drowsiness and dizziness. Women may experience problems menstrual cycle. Meet allergic reactions as skin rashes, possible pulmonary edema.
It should be noted that most often antifungal tablets are well tolerated, but any side effects may appear with varying degrees of probability. Therefore, do not self-medicate, but consult a doctor who will select the most suitable remedy for you.
Release forms and method of application
The most popular antifungal agent is Irunin tablets. The instructions for use tell us that the drug is yellow round tablets that should be used according to the specified scheme. At - 0.2 g twice a day; for lichen versicolor, the dosage can be halved. The same dose (0.2 g once a day) is maintained in the treatment of fungal keratitis and dermatomycosis. In some cases, it is recommended to reduce the dosage to 0.1 g per day. This is for diseases such as fungal infections skin.
The second dosage form is Irunin suppositories. They are prescribed for thrush. The method of application is classic: every day before bed you need to insert one suppository deep into the vagina. The duration of treatment is usually no more than two weeks. If you are already desperate to find a solution sensitive issue, ask your doctor about the possibility of using the drug "Irunin". Vaginal suppositories very effective in combating diseases such as candidiasis.
Overdose
To date, there have never been any reports of overdose. However, you need to remember that you cannot violate the regimen prescribed by your doctor, as well as increase the dosage. If you suspect that you have taken a large dose of the drug, you should rinse the stomach and give the person Activated carbon. There is no antidote, since taking a high dose of the drug is not life-threatening. Despite this, it is necessary to carry out restorative therapy.
How much does Irunin cost?
Against the backdrop of the advertised "Diflucan" and him similar drugs, the price of "Irunin" is quite moderate. The cost of a package of 0.1 mg capsules is 330 rubles. One package includes 14 capsules. In this case, candidiasis is treated by taking 0.2 g capsules twice (morning and evening) or for three days, one 0.2 mg capsule per day. As you can see, the drug “Irunin” is very accessible and economical. The price of a tablet does not exceed 30 rubles.
During treatment pityriasis versicolor The scheme changes slightly, 200 mg is prescribed once a day, treatment lasts up to 7 days. The most difficult to treat diseases, such as aspergillosis, cryptococcosis, histoplasmosis, sporotrichosis, require a long course of two months to a year. In this case, the patient should not take more than 200 mg of the drug daily. But even in this case, treatment with the drug “Irunin” is quite accessible. The price of the tablet is almost 10 times lower than Flucanozol capsules, which is also often prescribed for thrush and other problems.
The drug "Orungal"
This is an original drug, on the basis of which they later began to produce various generics, that is, drugs that were created on the basis of clinical studies of their original progenitor. Not having to invest time and money in lengthy development allows manufacturers to maintain a more attractive price. We have already talked about how much “Irunin” costs. Now, for comparison, let's look at the average prices for Orungal. For the same 14 capsules you will pay no less than 2,500 rubles, that is, at least five times more expensive.
It should be noted that there are three original ones on the market. These are “Orungal”, which specializes in the treatment of skin fungus covered with hair (this can be the head, chest or back); "Lamisil" - specializes in the treatment of nail fungus and is absolutely useless for therapy and internal organs - this is the field of activity of "Diflucan". In turn, “Orungal” is also used to treat fungal infections oral cavity, vagina, intestines and bronchi.
Other analogues
Among all those presented on the market, the most popular is “Irunin”. Instructions for use, reviews from doctors and patients - everything confirms high efficiency and drug reliability. It is very difficult to find such a good combination of price and quality on the market. In addition to the analogues listed above, doctors can offer you the drug “Itrazol”; it is very close in cost and will cost about 400 rubles per pack.
Another popular analogue is “Orungamin”. The cost is approximately the same, as is the spectrum of action. The most reliable is the antifungal drug "Orungal", this is not the cheapest treatment option, but clinical studies confirm its highest effectiveness.
Drug interactions
How safe is it to start a course of treatment with other drugs if you are taking Irunin? The instructions (the price of this brand is the most attractive, so we pay more attention to it) says that in some cases it will be necessary to interrupt the course if there is an urgent need to take other drugs. This applies to drugs such as rifampicin, rifabutin, diphenin. Moreover, the point is not that the interaction of these drugs with Irunin has harmful effects on the body. These drugs activate liver enzymes, which in turn reduces the effectiveness of itraconazole.
There are also drugs that, on the contrary, enhance the effectiveness of the active substance “Irunin”. These are drugs such as erythromycin and ritonavir. In combination with antifungal drugs, you cannot take drugs such as terfenadine and astemizole, chalcion and flormidal, quinidine, oral, zocor, lovastine, mizolastine, cizaparide.
Pregnancy and lactation
During pregnancy, the risk of Candida infection doubles. But it was during this period that treatment with the drug “Irunin” is strictly prohibited. They can not only negatively affect the fetus, but also cause severe developmental defects. That's why to the expectant mother offer maintenance therapy with folk remedies. During lactation, the child’s body also receives all the medications that the mother takes. Therefore, you should not take any medications without serious reasons. All women should remember this reproductive age. If you are prescribed long-term treatment so serious drug, then it is imperative to protect yourself with reliable means to avoid accidental pregnancy. After completing the course of treatment, at least three months must pass before planning a pregnancy.
This page provides a list of all Orungal analogues by composition and indication for use. A list of cheap analogues, and you can also compare prices in pharmacies.
- Most cheap analogue Orungal:
- The most popular analogue of Orungal:
- ATC classification: Itraconazole
- Active ingredients/composition: itraconazole
Cheap analogues of Orungal
When calculating the cost cheap analogs of Orungal the minimum price was taken into account, which was found in the price lists provided by pharmacies
Popular analogues of Orungal
The list of drug analogues based on statistics of the most requested drugs
All analogues of Orungal
Analogues in composition and indications for use
| Name | Price in Russia | Price in Ukraine |
|---|---|---|
| itraconazole | 67 RUR | -- |
| -- | 7 UAH | |
| -- | -- | |
| itraconazole | -- | 61 UAH |
| itraconazole | -- | 7 UAH |
| itraconazole | -- | 7 UAH |
| 146 RUR | 1550 UAH | |
| itraconazole | 26 rub. | 839 UAH |
| itraconazole | 13 rub. | 355 UAH |
| itraconazole | 44 rub. | 20 UAH |
| itraconazole | -- | 7 UAH |
| -- | -- | |
| itraconazole | -- | 20 UAH |
The above list of drug analogues, which indicates Orungal substitutes, is the most suitable because they have the same composition of active ingredients and coincide in indications for use
Analogues by indication and method of use
| Name | Price in Russia | Price in Ukraine |
|---|---|---|
| fluconazole | 83 RUR | 7 UAH |
| fluconazole | -- | 7 UAH |
| fluconazole | 10 rub | 7 UAH |
| fluconazole | -- | 7 UAH |
| fluconazole | 128 rub. | 7 UAH |
| fluconazole, sodium chloride | -- | -- |
| fluconazole | -- | 7 UAH |
| fluconazole | 8 rub | 6 UAH |
| fluconazole | -- | 18 UAH |
| fluconazole | -- | 7 UAH |
| 37 rub. | 135 UAH | |
| fluconazole | -- | 7 UAH |
| fluconazole | -- | -- |
| fluconazole | 46 RUR | 7 UAH |
| fluconazole | -- | 7 UAH |
| fluconazole | -- | -- |
| fluconazole | -- | 14 UAH |
| fluconazole | -- | 11 UAH |
| fluconazole | -- | 22 UAH |
| fluconazole | -- | -- |
| fluconazole | -- | 38 UAH |
| fluconazole | -- | 7 UAH |
| fluconazole | -- | 42 UAH |
| fluconazole | -- | 7 UAH |
| fluconazole | 23 rub. | -- |
| fluconazole | -- | -- |
| fluconazole | -- | -- |
| fluconazole | 61 RUR | -- |
| fluconazole | -- | -- |
| voriconazole | 1249 RUR | 7 UAH |
| -- | 1112 UAH | |
| voriconazole, pregelatinized corn starch, croscarmellose sodium, mannitol, magnesium stearate, microcrystalline cellulose | 15200 rub. | -- |
| voriconazole | -- | 23225 UAH |
| voriconazole | -- | -- |
| posaconazole | 22000 rub. | 5000 UAH |
Different composition, may have the same indication and method of use
| Name | Price in Russia | Price in Ukraine |
|---|---|---|
| RUB 3,745 | -- | |
| -- | -- | |
| ketoconazole | 108 rub. | 180 UAH |
| ketoconazole | -- | -- |
| caspofungin | -- | 10880 UAH |
| caspofungin | 7445 RUR | 4560 UAH |
| caspofungin | -- | -- |
| micafungin | 24 rub. | 4800 UAH |
| anidulafungin | 21 rub. | 10998 UAH |
To compile a list of cheap analogues of expensive drugs, we use prices that are provided to us by more than 10,000 pharmacies throughout Russia. The database of drugs and their analogues is updated daily, so the information provided on our website is always up to date as of the current day. If you have not found the analogue you are interested in, please use the search above and select the medicine you are interested in from the list. On the page of each of them you will find everything possible options analogues of the sought-after medicine, as well as prices and addresses of pharmacies where it is available.
How to find a cheap analogue of an expensive medicine?
To find inexpensive analogue medicine, generic or synonym, first of all we recommend paying attention to the composition, namely the same active ingredients and indications for use. The same active ingredients of a drug will indicate that the drug is a synonym for the drug, pharmaceutically equivalent or a pharmaceutical alternative. However, do not forget about inactive components similar drugs, which may have an impact on safety and effectiveness. Do not forget about the instructions of doctors; self-medication can harm your health, so before consuming any medical product Always consult your doctor.Orungal price
On the websites below you can find prices for Orungal and find out about availability at a pharmacy near youOrungal instructions
INSTRUCTIONS
on the use of the drug
Orungal
pharmachologic effect
Orungal is an antifungal drug of synthetic origin from the azole group. Its action is to inhibit the key enzyme CYP 450. As a result, the formation of the main structural component of the fungal cell wall (ergosterol) stops.
Itraconazole (the active component of Orungal) is active against yeast-like fungi, dermatophytes, molds and yeasts. The drug has a fungistatic and fungicidal effect.
Indications for use
Orungal is used for fungal infections of various localizations, which are provoked by sensitive fungal microflora. Use it for:
- onychomycosis;
- dermatomycosis;
- keratitis;
- aspergillosis;
- cryptococcosis;
- candidomycosis;
- sporotrichosis;
- trichophytosis;
- microsporia;
- epidermophytosis;
- mycoses of the eyes;
- tropical mycoses;
- deep organ mycoses;
- pityriasis versicolor;
- blastomycosis;
- histoplasmosis;
- paracoccidioidomycosis.
Selected indications for oral solution:
- candidiasis of the esophagus in immunodeficiency states, HIV;
- prevention of mycoses in the period after bone marrow transplantation in hematological cancer patients.
Mode of application
The Orungal capsule is not opened or chewed. The capsule should only be consumed whole, with water, after meals. In case of immunodeficiency, neutropenia, AIDS, in the post-transplant period, dosages may be increased (due to possible disturbances in bioavailability). The doctor decides to change treatment regimens depending on the effectiveness of taking Orung
Side effects
Side effects of Orungal capsules are as follows:
- anorexia;
- hepatitis;
- increased transaminase activity of the liver;
- epigastric pain;
- dyspepsia;
- toxic liver damage (sometimes fatal);
- headache;
- peripheral neuropathy;
- dizziness;
- anaphylaxis;
- angioedema;
- itching;
- urticaria;
- Stevens-Johnson syndrome;
- rash;
- alopecia;
- edema due to congestive heart failure;
- photosensitivity;
- pulmonary edema;
- hypokalemia;
- amenorrhea;
- dysmenorrhea.
Contraindications
Orungal is not prescribed for allergies to azoles, lactation, hypersensitivity to capsule components, with caution - for children, the elderly, women of childbearing age, for liver cirrhosis, CHF, renal failure. It is contraindicated to prescribe Orungal to patients taking astemizole, digoxin, levomethadone, cyclosporine, lovastatin, terfenadine, mizolastine, cisapride, quinidine, pimozide, dofetilide, sertindole.
Pregnancy
Orungal is prescribed during pregnancy as a last resort for systemic mycoses that threaten the patient’s life.
Drug interactions
The absorption of itraconazole is impaired by histamine receptor antagonists, didanosine, rifampicin, phenytoin, rifabutin, inducers of microsomal oxidation, and antacids. The drug prolongs the effect of calcium antagonists, vincristine, digoxin, prednisolone, midazolam, terbinafine, triazolam, quinidine, cisapride, vitamin K antagonists, antithrombic agents. Orungal reduces the effect of warfarin. Carbamazepine reduces the effect of the drug. When taken with lovastatin, the development of myopathies is possible. Indinavir, ritonavir, erythromycin, clarithromycin increase the bioavailability of Orungal. When taken with astemizole, death is possible.
Overdose
Cases of exceeding the dose have not been described. There is no antidote. Theoretically, in case of an overdose of Orungal, it is necessary to rinse the stomach and prescribe adsorbents. Hemodialysis is not effective.
Release form
Orungal is available in capsules (100 mg), oral solution (10 mg/ml). Packaging:
- 4 capsules;
- 14 capsules;
- 15 capsules;
- 28 capsules;
- 42 capsules;
- 60 capsules;
- 84 capsules;
- 150 ml bottle (plus measuring cap).
Storage conditions
Storage temperature for Orungal solution is up to 25, capsules – 15-30 degrees Celsius. After opening the bottle of oral solution, store for no more than a month. The shelf life of Orungal capsules is 3 years, the oral solution is 2 years.
Compound
1 capsule of Orungal contains 0.1 g of itraconazole. Auxiliary components: gelatin, hypromellose, sucrose, macrogol, titanium dioxide, indigo carmine, azorubine.
1 ml of Orungal solution contains 10 mg of itraconazole. Auxiliary components: hydroxypropyl-beta-cyclodextin, sorbitol, 1,2-propylene glycol, hydrochloric acid, cherry-vanilla flavor, sodium hydrochloride, prepared water.
Active substance: Itraconazole
Additionally
For any diseases of the heart, liver, lungs, kidneys, the risk/benefit ratio of taking Orungal should be weighed.
If signs of myocardial failure or peripheral neuropathy appear, the drug is discontinued.
The break between taking Orungal and antacids should be more than 2 hours.
In this article you can find instructions for use medicinal product Orungal. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of Orungal in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Orungal in the presence of existing structural analogues. Use for the treatment of mycoses, candidiasis or thrush in adults, children, as well as during pregnancy and breastfeeding.
Orungal- a broad-spectrum antifungal drug, a triazole derivative. Inhibits ergosterol synthesis cell membrane mushrooms, which determines the antifungal effect of the drug.
Itraconazole is active against infections caused by dermatophytes (Trichophyton spp., Microsporum spp., Epidermophyton floccosum); yeast-like and yeast fungi (Candida spp. (candida), including Candida albicans, Candida glabrata and Candida krusei, Cryptococcus neoformans, Pityrosporum spp., Trichosporon spp., Geotrichum spp.); Aspergillus spp.; Histoplasma spp.; Paracoccidioides brasiliensis; Sporothrix schenckii; Fonsecaea spp.; Cladosporium spp.; Blastomyces dermatitidis; Pseudoallescheria boydii; Penicillium marneffei and others.
Candida glabrata and Candida tropicalis are the least susceptible Candida species to itraconazole.
The main types of fungi that are not inhibited by itraconazole are Zygomycetes (Rhizopus spp., Rhizomucor spp., Mucor spp., Absidia spp.), Fusarium spp., Scedosporium spp., Scopulariopsis spp.
Compound
Itraconazole + excipients.
Pharmacokinetics
After oral administration it is well absorbed. The absolute bioavailability of itraconazole when taken with food is about 55%; when taken on an empty stomach, the bioavailability increases by 30%. Most of itraconazole in plasma is bound to proteins (99.8%), mainly to albumin (for the metabolite of itraconazole - hydroxy-itraconazole, protein binding is 99.6%). The affinity of itraconazole for lipids has also been noted. Only 0.2% of itraconazole in plasma is present in unbound form.
Itraconazole penetrates well into tissues, concentrations in the lungs, kidneys, liver, bones, stomach, spleen and muscles are 2-3 times higher than the corresponding concentrations in plasma. The ratio of itraconazole concentrations in brain tissue and plasma is approximately the same. The concentration of the drug in keratin tissues, especially in the skin, is approximately 4 times higher than the concentration in plasma.
Itraconazole is biotransformed in the liver to form large quantity metabolites. One of the metabolites, hydroxy-itraconazole, has antifungal effect, comparable to the effect of itraconazole. Plasma concentrations of hydroxy-itraconazole are almost 2 times higher than the corresponding concentrations of itraconazole.
From 3 to 18% of the administered dose is excreted unchanged in the feces. Less than 0.03% is excreted unchanged in the urine. About 35% of the dose is excreted as inactive metabolites in the urine and about 54% in the feces.
Indications
Treatment of mycoses caused by pathogens sensitive to the drug, including:
- dermatomycosis;
- fungal keratitis;
- onychomycosis caused by dermatophytes and/or yeast and mold fungi;
- systemic mycoses: systemic aspergillosis and candidiasis, cryptococcosis (including cryptococcal meningitis; in patients with immunodeficiency and in all patients with cryptoccosis of the central nervous system, Orungal should be prescribed only in cases where first-line treatment drugs are not applicable in in this case or ineffective), histoplasmosis, sporotrichosis, paracoccidioidomycosis, blastomycosis and other systemic and tropical mycoses;
- candidomycosis with damage to the skin and mucous membranes (including vulvovaginal candidiasis);
- deep visceral candidiasis;
- pityriasis versicolor;
- prevention of systemic fungal infections in patients with malignant diseases blood or in patients undergoing bone marrow transplantation with high probability neutropenia (less than 500 cells/μl).
Release forms
Oral solution (sometimes mistakenly called syrup).
100 mg capsules (sometimes mistakenly called tablets).
Others dosage forms, whether ointment or cream for external use, does not exist.
Instructions for use and dosage regimen
Solution
When treating candidiasis of the oral cavity and/or esophagus, Orungal is prescribed 200 mg (2 measuring cups) per day in 1 or 2 doses for 1 week. With absence positive effect after 1 week, the course of treatment should also be continued for another 1 week.
When treating candidiasis of the oral cavity and/or esophagus, with resistance to fluconazole, 200-400 mg (2-4 measuring cups) per day in 1-2 doses is prescribed for 2 weeks. If there is no positive effect after 2 weeks, treatment should be continued for another 2 weeks.
To prevent systemic fungal infections, the drug is prescribed at a dose of 5 mg/kg body weight per day in 2 divided doses. Taking the drug begins 1 week before the start of treatment with cytostatics or a week after bone marrow transplant and continues until the number of neutrophils is restored (at least 1000 cells/μl).
The solution should be taken orally on an empty stomach. Rinse your mouth with the solution and then swallow it. After this, you should not rinse your mouth with water.
Capsules
Capsules should be taken immediately after meals, swallowed whole.
The oral bioavailability of itraconazole may be reduced in some immunocompromised patients, such as neutropenic patients, patients with AIDS, or organ transplant recipients. Therefore, a doubling of the dose may be required.
One course of pulse therapy consists of taking 2 capsules of Orungal daily 2 times a day (200 mg 2 times a day) for 1 week.
For the treatment of fungal infections of the nail plates of the hands, 2 courses are recommended. For the treatment of fungal infections of the nail plates of the feet, 3 courses are recommended. The interval between courses during which you do not need to take the drug is 3 weeks.
Clinical results will become obvious after the end of treatment as the nail grows back.
In addition to pulse therapy, a continuous course is possible. The drug is prescribed 2 capsules per day (200 mg once a day) for 3 months.
The removal of Orungal from the skin and nail tissue is slower than from plasma. Thus, optimal clinical and mycological effects are achieved 2-4 weeks after the end of treatment for skin infections and 6-9 months after the end of treatment for nail infections.
Side effect
- dyspepsia (nausea, vomiting, constipation, diarrhea, loss of appetite);
- stomach ache;
- hepatitis;
- toxic liver damage (including cases of acute liver failure with fatal outcome);
- headache;
- dizziness;
- peripheral neuropathy;
- skin itching;
- rash;
- hives;
- angioedema;
- Stevens-Johnson syndrome;
- anaphylactic and anaphylactoid reactions;
- alopecia;
- photosensitivity;
- swelling;
- congestive heart failure and pulmonary edema;
- menstrual irregularities;
- hypokalemia.
Contraindications
- simultaneous use of drugs that are metabolized with the participation of the CYP3A4 enzyme and can increase the QT interval, incl. terfenadine, astemizole, mizolastine, cisapride, dofetilide, quinidine, pimozide, sertindole, levomethadone;
- simultaneous use of midazolam for oral administration and triazolam;
- simultaneous use of HMG-CoA reductase inhibitors metabolized by the CYP3A4 enzyme, such as simvastatin and lovastatin;
- simultaneous intake of ergot alkaloids such as dihydroergotamine, ergometrine, ergotamine and methylergometrine;
- hypersensitivity to itraconazole and other components of the drug.
Use during pregnancy and breastfeeding
Orungal should be prescribed during pregnancy only when life-threatening systemic mycoses, when the expected benefit to the woman outweighs the potential risk to the fetus.
Since itraconazole is released from breast milk, if necessary, its use during lactation breast-feeding should be stopped.
Women of childbearing age while taking the drug must use adequate methods of contraception throughout the entire course of treatment until the onset of the first menstruation after its completion.
Use in elderly patients
Use with caution in elderly patients.
Use in children
Since there is insufficient clinical data on the use of Orungal in children, it is not recommended to prescribe it to children, except in cases where the expected benefit outweighs the possible risk.
special instructions
When studying the dosage form of the drug Orungal for intravenous administration conducted on healthy volunteers, a transient asymptomatic decrease in left ventricular ejection fraction was noted, which returned to normal until the next infusion of the drug. Clinical relevance The data obtained for oral dosage forms is unknown.
Itraconazole has been found to have a negative inotropic effect. Cases of congestive heart failure associated with the use of Orungal have been reported, and therefore the drug should not be taken by patients with chronic heart failure or with a history of this disease, unless possible benefit significantly exceeds the potential risk. When individually assessing the balance of benefit and risk, factors such as the severity of the indication, dosage regimen and individual factors risk of congestive heart failure. Risk factors include the presence of heart disease, such as coronary artery disease or heart valve disease; serious illnesses lungs, such as obstructive pulmonary lesions; renal failure or other diseases accompanied by edema. Such patients should be informed of the signs and symptoms of congestive heart failure. Treatment should be carried out with caution, and the patient should be monitored for symptoms of congestive heart failure. When they appear, taking Orungal must be stopped.
At simultaneous administration itraconazole and calcium channel blockers should be used with caution.
At low acidity gastric juice absorption of itraconazole is impaired. For patients taking antacids(for example, aluminum hydroxide), it is recommended to use them no earlier than 2 hours after taking Orungal. Patients with achlorhydria or using histamine H2 receptor blockers or proton pump inhibitors are recommended to take the capsules with cola.
Very in rare cases When using Orungal, severe toxic damage to the liver developed, incl. cases of acute liver failure with fatal outcome. In most cases, this was observed in patients who already had liver disease, or were receiving itraconazole therapy for systemic indications, or had other serious illnesses, as well as in patients receiving other drugs that have hepatotoxic effects. Some patients had no obvious risk factors for liver damage. Several such cases occurred in the first month of therapy, and some in the first week of treatment. In this regard, it is recommended to regularly monitor liver function in patients receiving Orungal. Patients should be warned to immediately inform their physician if symptoms suggestive of hepatitis (anorexia, nausea, vomiting, weakness, abdominal pain, and dark urine) occur. If such symptoms occur, you should immediately stop therapy and conduct a liver function test. Patients with increased levels liver enzymes or liver disease in active phase, or when transferred toxic damage liver when taking other drugs, treatment with Orungal should not be prescribed, except in cases where the expected benefit justifies the risk of liver damage. In these cases, it is necessary to monitor the level of liver enzymes during treatment.
In patients with impaired liver and/or renal function, the drug is used under the control of plasma itraconazole levels and, if necessary, the dose of Orungal is adjusted.
Due to pharmacokinetic characteristics, it is not recommended to prescribe Orungal in capsule form to begin treatment of systemic mycoses that pose a threat to the life of patients.
The treating physician should evaluate the need for maintenance therapy in patients with AIDS who have previously been treated for systemic fungal infections, such as sporotrichosis, blastomycosis, histoplasmosis, or cryptococcosis (both meningeal and nonmeningeal), and who are at risk of relapse.
If peripheral neuropathy occurs, if it is caused by taking Orungal, the drug is discontinued.
There is no evidence of cross-hypersensitivity to itraconazole and other azole antifungals.
Impact on the ability to drive vehicles and operate machinery
Taking Orungal does not affect the ability to drive a car or operate machinery.
Drug interactions
Medicines that affect the absorption of itraconazole
Medicines that reduce the acidity of gastric contents reduce the absorption of itraconazole, which is associated with the solubility of the capsule shells.
Medicines that affect the metabolism of itraconazole
Studies have found that when Orungal interacts with rifampicin, rifabutin and phenytoin, the bioavailability of itraconazole and hydroxy-itraconazole is significantly reduced, which leads to a significant decrease in the effectiveness of the drug. The simultaneous use of itraconazole with these drugs, which are potential inducers of liver enzymes, is not recommended. Interaction studies with other hepatic enzyme inducers such as carbamazepine, phenobarbital and isoniazid have not been conducted, but similar results can be expected.
Since itraconazole is primarily metabolized by CYP3A4, potential inhibitors of this enzyme (ritonavir, indinavir, clarithromycin and erythromycin) may increase the bioavailability of itraconazole.
Effect of itraconazole on the metabolism of other drugs
Itraconazole may inhibit the metabolism of drugs metabolized by the CYP3A4 isoenzyme. The result of this may be an increase or prolongation of their action (including side effects). Before starting to take concomitant medications, you should consult your doctor about metabolic pathways this drug specified in the instructions for medical use. After discontinuation of treatment, itraconazole plasma concentrations decrease gradually depending on the dose and duration of treatment. This should be taken into account when assessing the inhibitory effect of itraconazole on the metabolism of concomitantly prescribed drugs.
During a course of treatment with Orungal, the following should not be prescribed:
- terfenadine, astemizole, mizolastine, cisapride, dofetilide, quinidine, pimozide, sertindole, levomethadone, the use of which together with Orungal can lead to an increase in the concentration of these substances in plasma, which in turn can cause an increase in the QT interval and, in rare cases, paroxysmal ventricular tachycardia"pirouette" type (torsade de pointes);
- oral midazolam and triazolam;
- HMG-CoA reductase inhibitors metabolized by the CYP3A4 enzyme, such as simvastatin and lovastatin;
- ergot alkaloid preparations such as dihydroergotamine, ergometrine, ergotamine and methylergometrine;
- calcium channel blockers - in addition to the possible pharmacokinetic interaction associated with in a common way metabolism involving the enzyme CYP3A4, calcium channel blockers have a negative inotropic effect, which may enhance a similar effect of itraconazole.
At simultaneous administration with Orungal, monitor plasma levels, effects, side effects oral anticoagulants; HIV protease inhibitors (such as ritonavir, indinavir, saquinavir); some anticancer drugs (such as rose vinca alkaloids, busulfan, docetaxel, trimetrexate); calcium channel blockers metabolized by the CYP3A4 isoenzyme (dihydropyridine and verapamil); some immunosuppressive drugs (such as cyclosporine, tacrolimus, sirolimus); some HMG-CoA reductase inhibitors metabolized by the CYP3A4 enzyme, such as atorvastatin; some corticosteroids, such as budesonide, dexamethasone and methylprednisolone; as well as digoxin, carbamazepine, buspirone, alfentanil, alprazolam, brotizolam, midazolam (iv), rifabutin, methylprednisolone, ebastine, reboxetine, repaglinide, disopyramide, cilostazol, eletriptan, halofantrine. When used simultaneously with Orungal, the dose of the above listed drugs should be reduced, if necessary.
No interaction was found between itraconazole and zidovudine and fluvastatin.
There was no effect of itraconazole on the metabolism of ethinyl estradiol and norethisetron.
Effect on protein binding
Studies have demonstrated that there is no interaction due to competition for plasma protein binding between itraconazole and drugs such as imipramine, propranolol, diazepam, cimetidine, indomethacin, tolbutamide and sulfamethazine.
Analogues of the drug Orungal
Structural analogues of the active substance:
- Irunin;
- Itrazole;
- Itraconazole;
- Itramikol;
- Candithral;
- Myconihol;
- Orungamin;
- Orunite;
- Rumicosis;
- Tecnazole.
Analogues therapeutic effect(medicines for the treatment of mycosis of nails):
- Amphotericin B;
- Atifin;
- Batrafen;
- Binafin;
- Bifonazole;
- Griseofulvin;
- Dactanol;
- Diflazon;
- Diflucan;
- Lamisil;
- Lamican;
- Loceryl;
- Mycozolon;
- Mycozoral;
- Mycomax;
- Mycosporus;
- Mycoflucan;
- Nizoral;
- Nofung;
- Terbizil;
- Thermikon;
- Trozide;
- Fluconazole;
- Flucostat;
- Fungolon;
- Fungoterbin;
- Exifin;
- Exoderil.
If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.
Today, every second prescription from a dermatologist prescribing treatment against fungal disease skin, there are drugs Orungal and Irunin. Both products are considered universal, as they have wide range actions, but one of them is original production, and the other is generic. So which is better, Orungal or Irunin? Is it worth saving and not overpaying just for the country of origin?
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The main differences between Orungal and Irunin
Almost all the drugs we compare have one feature - the same active ingredient. In this case it is Itraconazole. Orungal and Irunin have nothing in common anymore, but the differences are small, but still there:
- Manufacturer. Orgunal is released Italian company"Janssen-Silag". Irunin is produced in Russia by the Veropharm company;
- Excipients. According to many dermatologists, minor changes in the composition of excipients are unlikely to have any effect Negative influence on the effectiveness of the active substance.
- Price. Here the differences are simply impossible to notice. The price of “Orungala” starts from 3,000 rubles or 1,000 hryvnia, while “Irunin” will cost around 400 rubles. or 300 UAH.
If you compare both instructions supplied by manufacturers to their drugs, you will not find significant differences in pharmacological properties.
Comparison of "Orungal" and "Irunin"
You need to understand that Orungal and Irunin are considered systemic drugs which are prescribed for the following diseases:
Very often, drugs based on Itraconazole are prescribed for the treatment of trichophytosis and. Available in the form of tablets of 10 and 14 pieces in one package.
Most often, Irunin and Orungal are used for treatment running forms nail fungus and mycoses of the feet. The doctor can prescribe from 2 to 5 pulse therapies. One pulse therapy involves taking 2 capsules (200 mg) of Irunin or Orungal daily for one week. The number of pulse therapies will depend on the number of affected nails and the degree of deformation of the nail plate.
Orungal and Irunin – reviews from patients and doctors
Reviews from patients, as in the situation with other drugs, are very contradictory. Some claim that Irunin did not help them get rid of their problem, others complain about the lack of effect after taking Orungal. But if you believe clinical research, both drugs are effective antifungal agents when used correctly.
A qualified dermatologist will undoubtedly recommend Orungal, since it is an original drug. But he must also warn that Irunin is a generic version of Orungal, contains the same active ingredient and successfully treats the same diseases. Buy the original for 3,000 rubles or choose a generic for 400 rubles. It's up to you to decide!