What risk is associated with the use of Flucytosine?

Flucytosine is an antifungal medication that is particularly effective against certain fungal infections, such as those caused by Cryptococcus and Candida species. One of the known risks associated with its use is its toxicity to rapidly proliferating tissues. This is because flucytosine is converted to 5-fluorouracil in the body, a compound that inhibits DNA and RNA synthesis. As a result, it can selectively affect rapidly dividing cells, which include not only fungal cells but also human cells in tissues that proliferate quickly, such as bone marrow, gastrointestinal epithelium, and hair follicle cells. This can lead to side effects such as bone marrow suppression, leading to anemia, leukopenia, or thrombocytopenia.

While flucytosine may lead to some degree of liver enzyme elevation due to its metabolism, this is not its primary and most notable risk compared to the impact on rapidly proliferating tissues. Similarly, cardiovascular complications and respiratory distress are not commonly associated with flucytosine and do not represent the primary concerns when monitoring patients for adverse effects related to this medication. Therefore, the most significant risk with flucytosine is indeed its toxicity to rapidly dividing cells.