Fluconazole
Brand name Diflucan
Used in the following combined preparations None
General Information
Fluconazole is an antifungal drug that is used to treat systemic Candida infection as well as local Candida infections (“thrush”) affecting the vagina, mouth, and skin. This drug is also used to treat some more unusual fungal infections, including cryptococcal meningitis. It may also be used to prevent fungal infections in patients with defective immunity. The dosage and length of course will depend on the condition being treated.
The drug is generally well tolerated, although side effects such as nausea and vomiting, diarrhoea, and abdominal discomfort are common.
Information for Users
Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.
How taken
Capsules, liquid, injection.
Frequency and timing of doses
Once daily.
Adult dosage range
50-400mg daily.
Onset of effect
It begins to work within a few hours but full beneficial effects may take several days.
Duration of action
Up to 24 hours.
Diet advice
None.
Storage
Keep in a closed container in a cool, dry place out of the reach of children. Store liquid in a refrigerator (do not freeze) for no longer than 14 days.
Missed dose
Take as soon as you remember. If your next dose is due within 6 hours, take a single dose now and skip the next.
Stopping the drug
Take the full course. Even if you feel better, the original infection may still be present and may recur if treatment is stopped too soon.
Exceeding the dose
An occasional unintentional extra dose is unlikely to be a cause for concern. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.
Possible Adverse Effects
Fluconazole is generally well tolerated. Most side effects affect the gastrointestinal tract.
Rarely, a rash may occur and should be reported to your doctor.
Interactions
Anticoagulant drugs
Fluconazole may increase the effect of oral anticoagulants, such as warfarin.
Oral antidiabetic drugs
Fluconazole may increase the risk of hypoglycaemia with oral sulphonylureas, such as gliclazide, glibenclamide, chlorpropamide, and tolbutamide.
Phenytoin
Fluconazole may increase the blood level of phenytoin.
Theophylline/aminophylline
Fluconazole may increase the blood level of this drug.
Cyclosporin
Fluconazole may increase the blood level of cyclosporin.
Rifampicin
The effect of fluconazole may be reduced by rifampicin.
Terfenadine and astemizole
There is an increased risk of these antihistamines causing adverse effects on the heart.
Quick Reference
Drug group Antifungal drug.
Overdose danger rating Medium
Dependence rating Low
Prescription needed Yes (except for vaginal infection preparations)
Available as generic No
Special Precautions
Be sure to tell your doctor if:
You have long-term liver or kidney problems.
You have previously had an allergic reaction to antifungal drugs.
You are taking other medications.
Pregnancy
Safety in pregnancy not established. Discuss with your doctor.
Breast-feeding
Not recommended. The drug passes into the breast milk. Discuss with your doctor.
Infants and children
Not recommended. Dosage reduction required for children and infants, in whom fluconazole is used only if there is no alternative.
Over 60
Normal dose used as long as kidney function is not impaired.
Driving and hazardous work
No known problems.
Alcohol
No known problems.
Prolonged Use
Fluconazole is usually given for short courses of treatment. However, for prevention of relapse of cryptococcal meningitis in patients with defective immunity, it may be administered indefinitely.
