PREPARATIONS: Tablets: 50, 100, 150 and 200 mg. Oral Suspension: 10 mg/ml and 40 mg/ml. Injection: 2 mg/ml
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),
- zidovudine (Retrovir),
- saquinavir (Invirase),
- theophylline (Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin),
- glyburide (Micronase, Diabeta, Glynase),
- 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.
PREGNANCY AND BREASTFEEDING SAFETY: 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 recommended.
Fluconazole is secreted in breast milk at concentrations similar to the mother's blood level. However, fluconazole is used for treating neonates with fungal infections and for treating lactation associated Candida infections. Available evidence suggests that use of fluconazole during breastfeeding has little risk.
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.
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 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.
Medically reviewed by Eni Williams, PharmD
Reference: FDA Prescribing Information
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