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fluconazole

Pronunciation

Generic Name: fluconazole (floo KOE na zole)
Brand Name: Diflucan

What is fluconazole?

Fluconazole is an antifungal antibiotic.

Fluconazole is used to treat infections caused by fungus, which can invade any part of the body including the mouth, throat, esophagus, lungs, bladder, genital area, and the blood.

Fluconazole is also used to prevent fungal infection in people with weak immune systems caused by cancer treatment, bone marrow transplant, or diseases such as AIDS.

Fluconazole may also be used for purposes not listed in this medication guide.

What is the most important information I should know about fluconazole?

Do not use this medication if you are allergic to fluconazole, or similar drugs such as clotrimazole (Lotrimin), econazole (Spectazole), ketoconazole (Nizoral), miconazole (Monistat, Oravig), sertaconazole (Ertaczo), sulconazole (Exelderm), terconazole (Terazol), tioconazole (Vagistat-1), or voriconazole (Vfend).

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You should not use fluconazole if you are also taking cisapride (Propulsid).

Before taking fluconazole, tell your doctor if you have liver disease, kidney disease, a heart rhythm disorder, or a history of Long QT syndrome.

Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antifungal medication. Fluconazole will not treat a viral infection such as the common cold or flu.

What should I discuss with my healthcare provider before taking fluconazole?

Do not use this medication if you are allergic to fluconazole, or similar drugs such as clotrimazole (Lotrimin), econazole (Spectazole), ketoconazole (Nizoral), miconazole (Monistat, Oravig), sertaconazole (Ertaczo), sulconazole (Exelderm), terconazole (Terazol), tioconazole (Vagistat-1), or voriconazole (Vfend).

You should not use fluconazole if you are also taking cisapride (Propulsid).

To make sure you can safely take fluconazole, tell your doctor if you have any of these other conditions:

  • liver disease;

  • kidney disease;

  • a heart rhythm disorder; or

  • a personal or family history of Long QT syndrome.

FDA pregnancy category D. Do not take more than 1 dose of fluconazole if you are pregnant. Long-term use of fluconazole can harm an unborn baby or cause birth defects. Use effective birth control, and tell your doctor if you become pregnant during treatment.

A single dose of fluconazole taken to treat a vaginal yeast infection is not expected to harm an unborn baby.

Fluconazole can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take fluconazole?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your dose will depend on the infection you are treating. Vaginal infections are often treated with only one pill. For other infections, your first dose may be a double dose. Carefully follow your doctor's instructions. Tell your doctor if your symptoms do not improve.

Take this medicine with a full glass of water.

Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antifungal medication. Fluconazole will not treat a viral infection such as the common cold or flu.

Store fluconazole tablets at room temperature away from moisture and heat.

You may store liquid fluconazole in a refrigerator, but do not allow it to freeze. Throw away any leftover liquid medicine that is more than 2 weeks old.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include confusion or unusual thoughts or behavior.

What should I avoid while taking fluconazole?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Fluconazole side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • fever, chills, body aches, flu symptoms;

  • severe blistering, peeling, and red skin rash;

  • easy bruising or bleeding, unusual weakness; or

  • seizure (convulsions).

Less serious side effects may include:

  • mild stomach pain, diarrhea, upset stomach;

  • headache;

  • dizziness; or

  • unusual or unpleasant taste in your mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Fluconazole Dosing Information

Usual Adult Dose for Vaginal Candidiasis:

150 mg orally as a single dose

Usual Adult Dose for Oral Thrush:

200 mg on the first day followed by 100 mg orally or IV once a day
Therapy should be continued for at least 2 weeks to decrease the likelihood of relapse.

Dosages of 100 to 200 mg orally once a day have been recommended for long-term suppressive or maintenance therapy (secondary prophylaxis) to prevent recurrence or relapse of oropharyngeal candidiasis in HIV-infected patients who have experienced frequent or severe episodes.

Usual Adult Dose for Candidemia:

Systemic candidiasis: 400 mg on the first day followed by 200 mg IV or orally once a day

Optimal therapeutic dosage and therapy duration have not been established for systemic Candida infections (including candidemia, disseminated candidiasis, and pneumonia). Doses up to 400 mg/day have been used.

Therapy should be continued for at least 4 weeks and at least 2 weeks following resolution of symptoms.

Usual Adult Dose for Fungal Pneumonia:

Systemic candidiasis: 400 mg on the first day followed by 200 mg IV or orally once a day

Optimal therapeutic dosage and therapy duration have not been established for systemic Candida infections (including candidemia, disseminated candidiasis, and pneumonia). Doses up to 400 mg/day have been used.

Therapy should be continued for at least 4 weeks and at least 2 weeks following resolution of symptoms.

Usual Adult Dose for Fungal Infection -- Disseminated:

Systemic candidiasis: 400 mg on the first day followed by 200 mg IV or orally once a day

Optimal therapeutic dosage and therapy duration have not been established for systemic Candida infections (including candidemia, disseminated candidiasis, and pneumonia). Doses up to 400 mg/day have been used.

Therapy should be continued for at least 4 weeks and at least 2 weeks following resolution of symptoms.

Usual Adult Dose for Esophageal Candidiasis:

200 mg on the first day followed by 100 mg orally or IV once a day; doses up to 400 mg/day may be used, based on medical judgment of patient's response to therapy

Therapy should be continued for at least 3 weeks and for at least 2 weeks following resolution of symptoms.

Dosages of 100 to 200 mg orally once a day have been recommended for long-term suppressive or maintenance therapy (secondary prophylaxis) to prevent recurrence or relapse of esophageal candidiasis in HIV-infected patients who have experienced frequent or severe episodes.

Usual Adult Dose for Candida Urinary Tract Infection:

50 to 200 mg orally or IV once a day

Usual Adult Dose for Fungal Peritonitis:

Candida peritonitis: 50 to 200 mg orally or IV once a day

Usual Adult Dose for Cryptococcal Meningitis -- Immunocompetent Host:

Acute: 400 mg on the first day followed by 200 to 400 mg IV or orally once a day, based on medical judgment of patient's response to therapy

Therapy should be continued for 10 to 12 weeks after cerebrospinal fluid culture is negative. Patients should be monitored for at least 1 year for relapse.

Usual Adult Dose for Cryptococcal Meningitis -- Immunosuppressed Host:

Acute: 400 mg on the first day followed by 200 to 400 mg IV or orally once a day, based on medical judgment of patient's response to therapy

Therapy should be continued for 10 to 12 weeks after cerebrospinal fluid culture is negative. Patients should be monitored for at least 1 year for relapse.

Suppression of relapse in patients with AIDS: 200 mg once a day

Usual Adult Dose for Fungal Infection Prophylaxis:

Prevention of candidiasis in bone marrow transplantation patients: 400 mg orally or IV once a day

Patients who are anticipated to have severe granulocytopenia (less than 500 neutrophils/mm3) should start fluconazole prophylaxis several days before the anticipated onset of neutropenia, and continue for 7 days after the neutrophil count rises above 1000 cells/mm3.

Usual Adult Dose for Coccidioidomycosis -- Meningitis:

200 to 800 mg IV or orally once a day

Dosages of 400 to 800 mg IV or orally once a day have been recommended in patients with AIDS.

Therapy should be continued for 1 year after normalization of the cerebrospinal fluid to prevent relapse. Many experts recommend that fluconazole therapy be continued for the lifetime of the patient.

Usual Adult Dose for Coccidioidomycosis:

400 mg orally or IV once a day

Therapy ranges from many months to years in duration. Relapse is common. Lifetime therapy is recommended for HIV positive or AIDS patients.

Usual Adult Dose for Cryptococcosis:

400 mg orally or IV once a day

The duration of therapy should be about 8 weeks. Patients should be monitored for at least 1 year for relapse. Fluconazole 200 mg orally once a day may be used for suppression of relapse. Lifelong therapy is required for HIV positive or AIDS patients.

Usual Adult Dose for Histoplasmosis:

400 to 800 mg IV or orally once a day

The duration of therapy should be 6 to 12 months in patients without meningitis or endocarditis, which require more prolonged therapy.

Usual Adult Dose for Chronic Mucocutaneous Candidiasis:

100 to 200 mg orally or IV once a day
Generally requires long term maintenance therapy.

Usual Adult Dose for Blastomycosis:

400 to 800 mg orally once a day
Therapy should be continued for at least 6 months.

Usual Adult Dose for Onychomycosis -- Fingernail:

150 to 300 mg orally once a week
Therapy should be continued for 3 to 6 months.

Usual Adult Dose for Onychomycosis -- Toenail:

150 to 300 mg orally once a week
Therapy should be continued for 6 to 12 months.

Usual Pediatric Dose for Esophageal Candidiasis:

2 weeks or younger (gestational age 26 to 29 weeks): 3 to 12 mg/kg orally or IV every 72 hours

Greater than 2 weeks: 6 mg/kg on the first day followed by 3 mg/kg orally or IV once a day; doses up to 12 mg/kg/day may be used, based on medical judgment of patient's response to therapy

Treatment should continue for at least 3 weeks and for at least 2 weeks following the resolution of symptoms.

Usual Pediatric Dose for Oral Thrush:

2 weeks or younger (gestational age 26 to 29 weeks): 3 mg/kg orally or IV every 72 hours
Greater than 2 weeks: 6 mg/kg on the first day followed by 3 mg/kg orally or IV once a day

Treatment should continue for at least 2 weeks to decrease the likelihood of relapse.

Usual Pediatric Dose for Candidemia:

Systemic Candida infections:
2 weeks or younger (gestational age 26 to 29 weeks): 6 to 12 mg/kg IV or orally every 72 hours
Greater than 2 weeks: 6 to 12 mg/kg/day, IV or orally

Usual Pediatric Dose for Fungal Infection -- Disseminated:

Systemic Candida infections:
2 weeks or younger (gestational age 26 to 29 weeks): 6 to 12 mg/kg IV or orally every 72 hours
Greater than 2 weeks: 6 to 12 mg/kg/day, IV or orally

Usual Pediatric Dose for Cryptococcal Meningitis -- Immunocompetent Host:

Acute:
2 weeks or younger (gestational age 26 to 29 weeks): 6 to 12 mg/kg IV or orally every 72 hours

Greater than 2 weeks: 12 mg/kg on the first day followed by 6 to 12 mg/kg IV or orally once a day, based on medical judgment of patient's response to therapy

Therapy should be continued for 10 to 12 weeks after cerebrospinal fluid culture is negative.

Usual Pediatric Dose for Cryptococcal Meningitis -- Immunosuppressed Host:

Acute:
2 weeks or younger (gestational age 26 to 29 weeks): 6 to 12 mg/kg IV or orally every 72 hours

Greater than 2 weeks: 12 mg/kg on the first day followed by 6 to 12 mg/kg IV or orally once a day, based on medical judgment of patient's response to therapy

Therapy should be continued for 10 to 12 weeks after cerebrospinal fluid culture is negative.

For suppression of relapse in children with AIDS: 6 mg/kg once a day

What other drugs will affect fluconazole?

Tell your doctor about all other medicines you use, especially:

  • a blood thinner such as warfarin (Coumadin, Jantoven);

  • alfentanil (Alfenta), fentanyl (Abstral, Actiq, Fentora, Duragesic, Ionsys, Lazanda, Onsolis);

  • clopidogrel (Plavix);

  • cyclophosphamide (Cytoxan, Neosar);

  • cyclosporine (Gengraf, Sandimmune, Neoral);

  • methadone (Diskets, Dolophine, Methadose);

  • pimozide (Orap);

  • prednisone (Deltasone, Sterapred);

  • saquinavir (Invirase) or zidovudine (Retrovir, Trizivir);

  • sirolimus (Rapamune) or tacrolimus (Prograf);

  • theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl, others);

  • voriconazole (Vfend);

  • an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol) or nortriptyline (Pamelor);

  • cancer medicine such as vinorelbine (Navelbine), vincristine (Oncovin, Vincasar), or vinblastine (Velban);

  • cholesterol lowering medicines such as atorvastatin (Lipitor, Caduet), fluvastatin (Lescol), lovastatin (Mevacor, Altoprev, Advicor), pravastatin (Pravachol), rosuvastatin (Crestor), or simvastatin (Zocor, Simcor, Vytorin);

  • heart or blood pressure medicine such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), felodipine (Plendil), isradipine (Dynacirc), losartan (Cozaar, Hyzaar), or nifedipine (Nifedical, Procardia);

  • NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;

  • oral diabetes medication such as glipizide (Glucotrol), glyburide (Diabeta, Micronase, Glynase), tolbutamide (Orinase), tolazamide (Tolinase), chlorpropamide (Diabinese), and others;

  • rifabutin (Mycobutin) or rifampin (Rifadin, Rifater, Rifamate, Rimactane);

  • a sedative such as diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), midazolam (Versed), or triazolam (Halcion); or

  • seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin) or valproic acid (Depakene).

This list is not complete and other drugs may interact with fluconazole. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about fluconazole.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 8.01. Revision Date: 2011-08-14, 11:54:11 PM.

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