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Antifungal agents and the kidney: pharmacokinetics, clinical nephrotoxicity, and interactions
Published in Expert Opinion on Drug Safety, 2021
Athanasios Tragiannidis, Anastasia Gkampeta, Maria Vousvouki, Eleni Vasileiou, Andreas H. Groll
Flucytosine is taken up by a fungal-specific enzyme, converted intracellularly to 5-fluorouracil, and then processed into 5-fluorouridine triphosphate, which is incorporated into fungal RNA resulting in miscoding during translation, or transformed to 5-fluorodeoxyuridylate, which blocks DNA synthesis [10]. The compound is available in both oral and intravenous formulations, given in three to four daily doses, and penetrates well into most body sites because it is highly water-soluble and minimally protein bound.