fluconazole, Diflucan

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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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 FDA approved fluconazole in January 1990.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 50, 100, 150 and 200 mg. Oral Suspension: 10 mg/ml and 40 mg/ml. Injection: 2 mg/ml

STORAGE: Tablets and dry powder should be stored below 86 F (30 C). Injection and reconstituted suspension should be stored between 5 C to 30 C (41 F to 86 F). Unused portions of the reconstituted suspension should be protected from freezing and discarded after 2 weeks.

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 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 increases the blood concentration of fluconazole by 40%. However, dosage modification is not recommended when both drugs are combined.

Rifampin (Rifadin, Rimactane, Rifadin, Rifater, Rifamate) reduces the blood concentration of oral fluconazole, probably by increasing the elimination of fluconazole in the liver; therefore, reducing the effectiveness of fluconazole.

Fluconazole may increase the concentration of warfarin (Coumadin) in blood by reducing the elimination of warfarin. Therefore, the effect of warfarin may increase, leading to an increased tendency to bleed. Fluconazole also increases the concentration in the blood of phenytoin (Dilantin), cyclosporine, zidovudine (Retrovir), saquinavir (Invirase), (theophylline (Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin), tolbutamide, glyburide (Micronase, Diabeta, Glynase), glipizide, triazolam (Glucotrol), midazolam (Versed), celecoxib (Celebrex), fentanyl (Sublimaze), atorvastatin (Lipitor), simvastatin (Zocor), and lovastatin (Mevacor). As a result, the risk of side effects from these drugs may increase.

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. Need help identifying pills and medications? Use the pill identifier tool on RxList.