Ancobon (flucytosine), an antifungal agent, is available as 250-mg and 500-mg capsules for oral administration.
Ancobon is indicated only in the treatment of serious infections caused by susceptible strains of Candida and/or Cryptococcus.
Septicemia, endocarditis and urinary system infections have been effectively treated with flucytosine. Limited trials in pulmonary infections justify the use of flucytosine.
Meningitis and pulmonary infections have been treated effectively. Studies in septicemias and urinary tract infections are limited, but good responses have been reported.
With the exception of urinary tract infection, Ancobon should be used in combination with amphotericin B for the treatment of systemic candidiasis and cryptococcosis because of rapid emergence of resistance to Ancobon in Candida and Cryptococcus isolates in patients receiving Ancobon alone.
Published Studies Related to Ancobon (Flucytosine)
Combination flucytosine and high-dose fluconazole compared with fluconazole monotherapy for the treatment of cryptococcal meningitis: a randomized trial in Malawi. [2010.02.01]
BACKGROUND: Cryptococcal meningitis is a major cause of human immunodeficiency virus (HIV)-associated morbidity and mortality in Africa. Improved oral treatment regimens are needed because amphotericin B is neither available nor feasible in many centers. Fluconazole at a dosage of 1200 mg per day is more fungicidal than at a dosage of 800 mg per day, but mortality rates remain unacceptably high. Therefore, we examined the effect of adding oral flucytosine to fluconazole... CONCLUSIONS: The results suggest that optimal oral treatment for cryptococcal meningitis is high-dose fluconazole with flucytosine. Efforts are needed to increase availability of flucytosine in Africa. Clinical trials registration. isrctn.org Identifier: ISRCTN02725351.
High-dose amphotericin B with flucytosine for the treatment of cryptococcal meningitis in HIV-infected patients: a randomized trial. [2008.07.01]
BACKGROUND: The standard therapy for human immunodeficiency virus (HIV)-associated cryptococcal meningitis of amphotericin B (AmB; 0.7 mg/kg per day) plus flucytosine frequently takes >2 weeks to sterilize the cerebral spinal fluid, and acute mortality remains high. A dosage range for AmB of 0.7-1 mg/kg per day is noted in current guidelines, but there are no data comparing 0.7 mg/kg per day with 1 mg/kg per day... CONCLUSIONS: AmB, 1 mg/kg per day, plus flucytosine is more rapidly fungicidal than is standard-dose AmB plus flucytosine. Because of its size, this study provides limited data on any difference in toxicity between the regimens, but toxicities were manageable and reversible. CLINICAL TRIALS REGISTRATION NUMBER: ISRCTN68133435 (http://www.controlled-trials.com).
Oral versus intravenous flucytosine in patients with human immunodeficiency virus-associated cryptococcal meningitis. [2007.03]
In a randomized controlled trial of amphotericin B-based therapy for human immunodeficiency virus (HIV)-associated cryptococcal meningitis in Thailand, we also compared the mycological efficacy, toxicity, and pharmacokinetics of oral versus intravenous flucytosine at 100 mg/kg of body weight/day for the initial 2 weeks...
Oral versus intravenous flucytosine in patients with HIV-associated cryptococcal meningitis. [2006.12.28]
In a randomized controlled trial of amphotericin B based therapy for HIV-associated cryptococcal meningitis in Thailand, we also compared the mycological efficacy, toxicity, and pharmacokinetics of oral versus intravenous flucytosine at 100 mg/kg/d for the initial 2 weeks... Concentrations of flucytosine with intravenous formulation at 100 mg/kg/d may be in excess of those required for maximal fungicidal activity.
Early empiric antifungal therapy of infections in neutropenic patients comparing fluconazole with amphotericin B/flucytosine. 
We compared the efficacy and tolerability of fluconazole (FCA) with amphotericin B/flucytosine (ABF) in neutropenic patients with haematological malignancies. Antifungal therapy started on day 4 when fever was unresponsive to antibiotics or on day 1 together with the antibiotics, if there was evidence of mycosis...
Clinical Trials Related to Ancobon (Flucytosine)
A Pilot Feasibility Study of Oral 5-Fluorocytosine and Genetically-Modified Neural Stem Cells Expressing E.Coli Cytosine Deaminase for Treatment of Recurrent High Grade Gliomas [Recruiting]
Study Evaluating Efficiency and Tolerance of High-dose Fluconazole Associated With Flucytosine as Induction Therapy for Cryptococcal Meningitis Associated With HIV in Burundi [Recruiting]
The aim of the trial is to demonstrate that in a sub-Saharan African country, Burundi, the
1. Oral treatment : high dose of fluconazole (1600mg/d) associated with flucytosine (100
mg/kg/j) as induction therapy
2. lumbar punctures to control intracranial pressure
3. early introduction of HAART (highly active antiretroviral therapy ) (at day 15 after
can decrease mortality rate below 40% at 10 weeks.
This is a non randomized open label pilot study, with standardized management of
cryptococcoses meningitis and follow-up in Burundi. A total of 61 patients will be
Safety Study of Fluconazole in Combination With Flucytosine for the Treatment of Early Cryptococcal Infection [Not yet recruiting]
The purpose of this study is to determine if treatment with two medicines in combination
(fluconazole and flucytosine) is safe as compared with one medicine alone (fluconazole) for
the treatment of an early infection with a fungus called cryptococcus.
Phase I/II Study of APS001F With Flucytosine and Maltose in Solid Tumors [Recruiting]
The purpose of this study is to test the safety and efficacy of an investigational drug
called APS001F when given with flucytosine (5-FC) for treatment of solid tumors. APS001F is
a recombinant Bifidobacterium longum (a live bacteria normally found in the digestive tract)
that has been modified to produce an enzyme, cytosine deaminase (CD). The patient will
first receive an injection of APS001F followed by oral 5-FC. APS001F is expected to go to
the site of the tumor(s) where the agent will produce CD enzyme. CD enzyme will convert the
5-FC into 5-fluorouracil (5-FU) which is a standard chemotherapy drug for several types of
cancer. Additionally, some patients will also receive 10% maltose injection, a sugar that
has been shown to enhance the growth and effectiveness of APS001F in animals. This is the
first study where APS001F is being used in humans.
Trial of TG4023 Combined With Flucytosine in Liver Tumors [Recruiting]
This trial is a phase I, open-label, dose-escalating study of the safety or percutaneous
intra-tumoral injection of TG4023 (MVA-FCU1) combined with systemic administration of
5-fluorocytosine in patients with primary or secondary hepatic tumors.