Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: fluconazole
BRAND NAME: Diflucan
DRUG CLASS AND MECHANISM: Fluconazole is an anti-fungal medication
related to clotrimazole (Lotrimin), ketoconazole (Nizoral), itraconazole
(Sporanox), and miconazole (Micatin, Monistat). It prevents growth of fungi by
preventing production of the membranes that surround fungal cells. The Food and
Drug Administration approved fluconazole in January 1990.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: Tablets: 50, 100, 150, 200 mg. Oral Suspension: 10 mg/ml
and 40 mg/ml. Injection: 2 mg/ml
STORAGE: Store tablets and dry powder below 86 F (30 C). Store
injection and reconstituted suspension between 5-30 C (41-86 F). Discard unused
portion of the reconstituted suspension after 2 weeks. Protect from freezing.
PRESCRIBED FOR: Fluconazole is used for treating
vaginal,
oral, and
esophageal fungal infections caused by Candida. It may also be effective in
treating urinary tract infections,
peritonitis, pneumonia and disseminated
infections caused by Candida. Fluconazole is also used for treating cryptococcal
meningitis, and prevention of
Candida infections in patients treated with
chemotherapy or
radiation after bone marrow transplantation.
DOSING: The usual adult dose is 50-400 mg daily depending on the type
of infection. Although symptoms of oral candida infections may subside in a few
days treatment is continued for 2 weeks. Esophageal Candida infections are
treated for 3 weeks or longer. Treatment of cryptococcal meningitis may last for
10-12 weeks after cerebrospinal fluid cultures become negative.
DRUG INTERACTIONS: Hydrochlorothiazide significantly increases the
blood concentration of oral fluconazole by reducing the elimination of
fluconazole by the kidneys. This interaction may increase the side effects of
fluconazole. Rifampin (Rifadin, Rimactane,
Rifadin,
Rifater,
Rifamate) reduces the blood concentration of oral fluconazole,
probably by reducing the metabolism of fluconazole in the liver; therefore,
reducing the effectiveness of fluconazole. Fluconazole may increase the
concentration of warfarin
(Coumadin) in blood by reducing the metabolism of warfarin.
Therefore, the effect of warfarin may increase, leading to increased tendency to
bleed. Fluconazole also increases the concentration of phenytoin
(Dilantin), cyclosporine,
zidovudine (Retrovir),
theophylline (Theo-Dur,
Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin), tolbutamide,
glyburide
(Micronase, Diabeta, Glynase), glipizide, triazolam
(Glucotrol), and midazolam
(Versed).
PREGNANCY: There are no adequate studies in
pregnant women. There are
reports of harmful effects to the fetus when high dose fluconazole was
administered to pregnant women for a few months. Use of fluconazole during
pregnancy is not usually recommended.
NURSING MOTHERS: Fluconazole is secreted in
breast milk. Use of
fluconazole by nursing mothers is not recommended.
SIDE EFFECTS: Common side effects include headache, nausea, and
abdominal pain. Other side effects included diarrhea, dyspepsia, dizziness,
rash, and taste disturbance. Rarely, serious allergic reactions, including
angioedema (swelling of tissues), may also occur. Liver dysfunction (jaundice,
hepatitis) has also been associated with fluconazole.
Reference: FDA Prescribing Information
Last Editorial Review: 10/21/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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