Brand Name: Diflucan
Generic Name: fluconazole
Drug Class: Antifungals, Systemic
What is fluconazole (Diflucan), and what is it used for?
Diflucan (fluconazole) is an anti-fungal medication related to clotrimazole (Lotrimin), ketoconazole (Nizoral), itraconazole (Sporanox), and miconazole (Micatin, Monistat). Fluconazole prevents the growth of fungi by preventing the production of the membranes that surround fungal cells.
- Diflucan is used for treating vaginal, oral, and esophageal fungal infections caused by Candida. It is used for treating uncomplicated, complicated, or recurrent vaginal Candida infections.
- Diflucan also may be effective in treating urinary tract infections, peritonitis, pneumonia, and disseminated infections caused by Candida.
- Diflucan is used for treating cryptococcal meningitis, and prevention of Candida infections in patients treated with chemotherapy or radiation after bone marrow transplantation.
What are the side effects of fluconazole?
Common side effects of fluconazole include:
- headache,
- nausea, and
- abdominal pain.
Other important side effects include:
Possible serious side effects include:
- seizures,
- reduced number of white blood cells,
- reduced number of blood platelets, and
- toxic epidermal necrolysis.
Rarely, serious allergic reactions, including angioedema (swelling of tissues), may also occur. Liver dysfunction (jaundice, hepatitis) and abnormal heartbeats have been associated with fluconazole. Stevens-Johnson syndrome has also been reported.
What is the dosage for fluconazole?
- 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.
SLIDESHOW
Bacterial Infections 101: Types, Symptoms, and Treatments See SlideshowWhich drugs interact with fluconazole?
- 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, Jantoven) 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 of the following drugs in the blood, and as a result, the risk of side effects of these drugs may increase. These drugs include:
- 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 the above drugs may increase.
- Combining fluconazole with amiodarone (Cordarone), pimozide (Orap), bepridil (Vascor), or other drugs that affect heart rhythm may increase the risk of abnormal heart rhythms.
Is fluconazole safe to use during pregnancy or while breastfeeding?
- There are no adequate studies of Diflucan in pregnant women. There are reports of harmful effects on the fetus when high-dose fluconazole was administered to pregnant women for a few months. The use of fluconazole during pregnancy is not recommended.
- Diflucan 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 the use of fluconazole during breastfeeding has little risk.
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Summary
Diflucan (fluconazole) is a drug prescribed to treat fungal infections caused by Candida, for example, vaginal, oral, esophageal, urinary tract, pneumonia, and peritonitis. Side effects include nausea, diarrhea, dizziness, rash, indigestion, and abdominal pain. Drug interactions, and pregnancy and breastfeeding safety information should be reviewed before taking this medication.
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