Fluconazole

💊 What is Fluconazole used for?

• •Vaginal yeast infections (vaginal candidiasis) caused by Candida
• •Oropharyngeal candidiasis (yeast infection of the mouth and throat)
• •Esophageal candidiasis (yeast infection of the food pipe)
• •Cryptococcal meningitis (a fungal infection around the brain and spinal cord)
• •Decreasing the chance of candidiasis in patients having bone marrow transplants who receive chemotherapy and/or radiation therapy
• •The label also mentions use for Candida urinary tract infections, peritonitis, and systemic Candida infections in small studies

How it works

The label describes fluconazole as a synthetic triazole antifungal. The patient leaflet says it helps stop too much yeast from growing so the yeast infection goes away.

How it is usually taken

• •The label says to take fluconazole exactly as your healthcare provider tells you. It is taken by mouth, with or without food. Follow the instructions from your prescriber or pharmacist about how long to keep taking it.

Comes as

• •Tablets: 50 mg, 100 mg, 150 mg, and 200 mg

⚠️ Fluconazole side effects

🛑 Who should not take Fluconazole, and who should be careful

The label says not to take it if

• 🚨You take quinidine, erythromycin, or pimozide. The label lists these as medicines you should not take with fluconazole.
• 🚨You are allergic to fluconazole or to any of the ingredients in fluconazole tablets.

Tell your doctor before taking it if

• •Tell your healthcare provider if you have liver problems.
• •Tell your healthcare provider if you have kidney problems.
• •Tell your healthcare provider if you have heart problems, including heart arrhythmias (irregular heartbeats).
• •Tell your healthcare provider if you have low potassium (hypokalemia).
• •Tell your healthcare provider if you are pregnant or plan to become pregnant.
• •Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
• •Tell your healthcare provider about all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
• •The label says fluconazole can cause dizziness and seizures, so do not drive or operate machinery until you know how it affects you.

🔀 Fluconazole with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Diabetes medicines such as glyburide, tolbutamide, and glipizide
• •Blood pressure medicines such as hydrochlorothiazide, losartan, amlodipine, verapamil, nifedipine, or felodipine
• •Blood thinners such as warfarin
• •Cyclosporine, tacrolimus, or sirolimus (used to prevent organ transplant rejection)
• •Rifampin or rifabutin (used for tuberculosis)
• •Phenytoin or carbamazepine (used for seizures)
• •Theophylline (used for asthma)
• •Quinidine, amiodarone, or pimozide (used for heart rhythm or psychiatric conditions)
• •Amitriptyline or nortriptyline (used for depression)
• •Amphotericin B or voriconazole (used for fungal infections)
• •Erythromycin (used for bacterial infections)
• •Olaparib, cyclophosphamide, or vinca alkaloids such as vincristine or vinblastine (used for cancer)
• •Fentanyl, alfentanil, or methadone (used for chronic pain)
• •Ibrutinib (used for blood cancer)

Alcohol and food

The label says fluconazole can be taken with or without food. The label excerpt provided does not mention alcohol.

🤰 Fluconazole in pregnancy and breastfeeding

Pregnancy

The label says use in pregnancy should be avoided except in patients with severe or potentially life-threatening fungal infections, when the expected benefit is judged to outweigh the possible risk to the fetus. Case reports describe a pattern of birth defects in babies whose mothers took high doses (400 to 800 mg per day) during most or all of the first trimester. Studies also suggest a possible risk of miscarriage and birth defects with the 150 mg single or repeated dose, but the label says these studies have limitations. The label says that if you may become pregnant, you should use effective birth control during treatment and for about 1 week after the final dose. Tell your provider right away if you become pregnant while taking fluconazole.

Breastfeeding

The label says fluconazole was present in low levels in breast milk after a single 150 mg dose. It says there are no data on milk levels after repeated use or high-dose fluconazole. Fluconazole can pass into breast milk, so talk to your healthcare provider about the best way to feed your baby.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20 to 25 degrees C (68 to 77 degrees F). Short excursions to 15 to 30 degrees C (59 to 86 degrees F) are permitted.

If a dose is missed

The label does not say.

If too much is taken

The label reports that overdose has been accompanied by hallucinations and paranoid behavior. If you take too much, the label says to call your healthcare provider or go to the nearest emergency room right away. The label says treatment is symptomatic with supportive measures, and that about 50% of plasma levels are removed by a 3-hour hemodialysis session.

🗒️ Questions to ask about Fluconazole

• What is the exact treatment plan for my infection, and how long should I keep taking fluconazole?
• Are any of my current medicines or supplements on the list of medicines that can interact with fluconazole?
• Given my heart, liver, or kidney history, what should I watch for while taking fluconazole?
• If I could become pregnant, what birth control method should I use during treatment and afterward?
• Is it safe for me to drive while taking this medicine, and what should I do if I feel dizzy?
• What should I do if I think I have taken too much fluconazole?

❓ Fluconazole: frequently asked questions