griseofulvin: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
griseofulvin: clinical details
Prescribing considerations
- Confirm a dermatophyte infection and that systemic treatment is justified because topical treatment is unsuitable or unsuccessful.
- Review pregnancy intentions, paternal conception plans, breastfeeding, hormonal contraception and interacting medicines.
- Counsel about photosensitivity, possible drowsiness and enhanced alcohol effects.
- Absorption is variable and incomplete but improves after food.
Contraindications and cautions
- Pregnancy or planned pregnancy within one month after stopping
- Severe liver disease
- Porphyria
- Systemic lupus erythematosus
- Hypersensitivity to griseofulvin or an excipient
- Prophylactic use without active infection
Monitoring
- Assess liver function when clinically indicated, particularly if hepatic symptoms or significant abnormalities develop.
- Consider a full blood count if fever, mouth ulcers or recurrent infection suggests leucopenia or neutropenia.
- Monitor anticoagulant response, ciclosporin exposure or clinical effect when relevant.
- Review response and reconsider the diagnosis if the infection does not improve.
Clinical pharmacology
Griseofulvin inhibits fungal mitosis by disrupting polymerised microtubules and the mitotic spindle. Gastrointestinal absorption is variable; it is deposited in newly formed keratin and metabolised mainly to 6-desmethylgriseofulvin before urinary excretion.
Formulation and product differences
- The selected product is an oral tablet intended to be swallowed whole after food.
- The tablet contains propylene glycol and is described as essentially sodium-free.
griseofulvin preparations and strengths
Tablet
Route: Oral
Strengths: 125 mg, 500 mg
griseofulvin interactions
Tell the prescriber or pharmacist about all medicines, contraception and alcohol use. Important examples include:
Oral hormonal contraceptives
Griseofulvin can reduce contraceptive effectiveness; additional precautions are required during treatment and for one month afterwards.
Coumarin anticoagulants, including warfarin
Their anticoagulant effect may be reduced, requiring closer monitoring and possible adjustment.
Ciclosporin
Griseofulvin may lower ciclosporin exposure and effectiveness, so clinical or concentration monitoring may be needed.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.