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WINCH is one of a group of medicines called “antifungals”. The active substance is fluconazole. WINCH is used to treat infections caused by fungi and may also be used to stop you from getting a candidal infection. The most common cause of fungal infections is a yeast called Candida.

Active Substance: Fluconazole mg 150 Excipients: lactose monohydrate, maize starch, colloidal silica anhydrous, magnesium stearate and sodium laurilsulfate Capsule: gelatin, titanium dioxide (E171)

Adults You might be given this medicine by your doctor to treat the following types of fungal infections: Cryptococcal meningitis – a fungal infection in the brain Coccidioidomycosis – a disease of the bronchopulmonary system Infections caused by Candida and found in the blood stream, body organs (e.g. heart, lungs) or urinary tract Mucosal thrush - infection affecting the lining of the mouth, throat and denture sore mouth Genital thrush – infection of the vagina or penis Skin infections - e.g. athlete's foot, ringworm, jock itch, nail infection You might also be given WINCH to: stop cryptococcal meningitis from coming back stop mucosal thrush from coming back reduce recurrence of vaginal thrush stop you from getting an infection caused by Candida (if your immune system is weak and not working properly). Children and adolescents (0 to 17 years old) You might be given this medicine by your doctor to treat the following types of fungal infections: Mucosal thrush - infection affecting the lining of the mouth, throat Infections caused by Candida and found in the blood stream, body organs (e.g. heart, lungs) or urinary tract Cryptococcal meningitis – a fungal infection in the brain

If you are allergic (hypersensitive) to fluconazole, to other medicines you have taken to treat fungal infections or to any of the other ingredients of WINCH. The symptoms may include itching, reddening of the skin or difficulty in breathing if you are taking astemizole, terfenadine (antihistamine medicines for allergies) if you are taking cisapride (used for stomach upsets) if you are taking pimozide (used for treating mental illness) if you are taking quinidine (used for treating heart arrhythmia) if you are taking erythromycin (an antibiotic for treating infections)

Additionally, if any of the following side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. Common side effects which affect up to 1 in 10 people: headache; stomach discomfort, diarrhoea, feeling sick, vomiting; increases in blood tests of liver function; rash. Uncommon side effects which affect up to 1 in 100 people: reduction in red blood cells which can make skin pale and cause weakness or breathlessness; decreased appetite; inability to sleep, feeling drowsy fit, dizziness, sensation of spinning, tingling, pricking or numbness, changes in sense of taste; constipation, difficult digestion, wind, dry mouth;  muscle pain; liver damage and yellowing of the skin and eyes (jaundice); wheals, blistering (hives), itching, increased sweating; tiredness, general feeling of being unwell, fever. Rare side effects which affect up to 1 in 1000 people: lower than normal white blood cells that help defend against infections and blood cells that help to stop bleeding; red or purple discoloration of the skin which may be caused by low platelet count, other blood cell changes; blood chemistry changes (high blood levels of cholesterol, fats); low blood potassium; shaking; abnormal electrocardiogram (ECG), change in heart rate or rhythm; liver failure; allergic reactions (sometimes severe), including widespread blistering rash and skin peeling, severe skin reactions, swelling of the lips or face; hair loss

Tell your doctor immediately if you are taking astemizole, terfenadine (an antihistamine for treating allergies) or cisapride (used for stomach upsets) or pimozide (used for treating mental illness) or quinidine (used for treating heart arrhythmia) or erythromycin (an antibiotic for treating infections) as these should not be taken with Winch (see section: “Do not take Winch if you”). There are some medicines that may interact with WINCH. Make sure your doctor knows if you are taking any of the following medicines: rifampicin or rifabutin (antibiotics for infections) alfentanil, fentanyl (used as anaesthetic) amitriptyline, nortriptyline (used as anti-depressant) amphotericin B, voriconazole (anti-fungal) medicines that thin the blood to prevent blood clots (warfarin or similar medicines) benzodiazepines (midazolam, triazolam or similar medicines) used to help you sleep or for anxiety nifedipine, isradipine, amlodipine felodipine and losartan (for hypertension- high blood pressure) ciclosporin, everolimus , sirolimus or tacrolimus (to prevent transplant rejection) cyclophosphamide, vinca alkaloids (vincristine, vinblastine or similar medicines) used for treating cancer halofantrine (used for treating malaria)  statins (atorvastatin, simvastatin and fluvastatin or similar medicines) used for reducing high cholesterol levels methadone (used for pain) celecoxib, flurbiprofen, naproxen, ibuprofen, lornoxicam, meloxicam, diclofenac (Non-Steroidal Anti-Inflammatory Drugs (NSAID) oral contraceptives prednisone (steroid) zidovudine, also known as AZT; saquinavir (used in HIV-infected patients)] medicines for diabetes such as chlorpropamide, glibenclamide, glipizide or tolbutamide theophylline (used to control asthma) vitamin A (nutritional supplement)

Taking too many capsules at once may make you unwell. Contact your doctor or your nearest hospital casualty department at once. The symptoms of a possible overdose may include hearing, seeing, feeling and thinking things that are not real (hallucination and paranoid behaviour). Symptomatic treatment (with supportive measures and gastric lavage if necessary) may be adequate.

Always take your medicine exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Swallow the capsule whole with a glass of water. It is best to take your capsules at the same time each day.  The usual doses of this medicine for different infections are below:  To treat cryptococcal meningitis 400 mg on the first day then 200 mg to 400 mg once daily for 6 to 8 weeks or longer if needed. Sometimes doses are increased up to 800 mg  To stop cryptococcal meningitis from coming back 200 mg once daily until you are told to stop To treat coccidioidomycosis 200 mg to 400 mg once daily from 11 months for up to 24 months or longer if needed. Sometimes doses are increased up to 800 mg To treat internal fungal infections caused by Candida 800 mg on the first day then 400 mg once daily until you are told to stop  To treat mucosal infections affecting the lining of mouth, throat and denture sore mouth 200 mg to 400 mg on the first day then 100 mg to 200 mg until you are told to stop   To treat mucosal thrush – dose depends on where the infection is located 50 mg to 400 mg once daily for 7 to 30 days until you are told to stop  To stop mucosal infections affecting the lining of mouth, throat 100 mg to 200 mg once daily, or 200 mg 3 times a week, while you are at risk of getting an infection To treat genital thrush 150 mg as a single dose  To reduce recurrence of vaginal thrush 150 mg every third day for a total of 3 doses (day 1, 4 and 7) and then once a week for 6 months while you are at risk of getting an infection To treat fungal skin and nail infections Depending on the site of the infection 50 mg once daily, 150 mg once weekly, 300 to 400 mg once weekly for 1 to 4 weeks (Athlete’s foot may be up to 6 weeks, for nail infection treatment until infected nail is replaced)  To stop you from getting an infection caused by Candida (if your immune system is weak and not working properly) 200 mg to 400 mg once daily while you are at risk of getting an infection

Store below 30°C.