Fluconazole is a drug to treat diseases caused by fungal infections , including Candida yeast infections (candidiasis). Fluconazole can be used for fungal infections of the skin, vagina, mouth, throat, esophagus, stomach, lungs , urinary tract, or bloodstream.

Fluconazole works by interfering with the formation of ergosterol. Ergosterol is an important component of the fungal cell wall. With the inhibition of this component, the fungal cells will die. Fluconazole can also inhibit the growth of new fungi.

In addition to treating candidiasis, fluconazole can also be used to treat meningitis caused by the fungus Cryptococcus ( cryptococcal meningitis ) and prevent fungal infections in people with weak immune systems, such as people with HIV/AIDS or chemotherapy recipients .

Fluconazole trademarks: Candipar, Cryptal, Diflucan, FCZ, Fluconazole, Flucoral, Fludis, Fluxar, Govazol, Kifluzol, Quazol, and Zemyc.

What is Fluconazole

class Prescription drug
Category Azole type antifungal
Benefit Overcome Candida fungal infections ( candidiasis ) and Cryp tococcus
Used by Adults and children
Fluconazole for pregnant and lactating women Category C: Studies in experimental animals show adverse effects on the fetus in the use of fluconazole at a dose of 150 mg (to treat candidiasis infection in the vagina). However, there have been no controlled studies in pregnant women. The drug should only be used if the expected benefit outweighs the risk to the fetus.

Category D: There is evidence that fluconazole poses a risk to the human fetus in use other than above. However, the benefits may outweigh the risks, for example in dealing with a life-threatening situation.

Fluconazole is absorbed into breast milk. For nursing mothers, do not use this drug without consulting a doctor first.

Drug form Tablets, capsules, infusions and injections

Warning Before Using Fluconazole

Fluconazole should not be used carelessly. There are several things you need to pay attention to before using this drug, including:

  • Tell your doctor about any history of allergies you have. Fluconazole should not be used in people who are allergic to it, or to other azole class antifungal drugs, such as ketoconazole .
  • Tell your doctor if you have or are currently having kidney disease, liver disease, cancer, HIV/AIDS , heart disease, heart rhythm disturbances (arrhythmias), lactose or sucrose intolerance, hypocalcemia, hypokalemia , hypomagnesemia, or porphyria .
  • Tell your doctor that you are using fluconazole before having surgery, including dental surgery.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy. Use contraception to prevent pregnancy while on treatment with fluconazole.
  • Tell your doctor if you are taking other medications, including supplements and herbal products, in case of unwanted drug interactions.
  • Do not immediately engage in activities that require alertness, such as driving a vehicle, after taking fluconazole, because this drug can cause dizziness.
  • Immediately consult a doctor if you have an allergic drug reaction, serious side effects, or overdose after using fluconazole.

Dosage and Rules for Use of Fluconazole

The dose of fluconazole prescribed by a doctor can be different for each patient. The following are common doses for using fluconazole based on their intended use:

Purpose: Treating vaginal candidiasis and penile candidiasis ( candal balanitis)

  • Adult: 150 mg as a single dose.

Purpose: Treat recurrent vaginal candidiasis (≥4 times a year)

  • Adult: 150 mg once every 3 days for a total of 3 doses (days 1, 4 and 7). Followed by a maintenance dose of 150 mg once weekly for 6 months.

Purpose: Treating oropharyngeal candidiasis

  • Adult: Initially 200–400 mg on day 1, followed by 100–200 mg once daily for 7–21 days.
  • Children 0–14 days: Initially 6 mg/kg, followed by 3 mg/kg every 72 hours. Maximum dose of 12 mg/kg every 72 hours.
  • Children 15 – 27 days old: Initially 6 mg/kg, followed by 3 mg/kg every 48 hours. The maximum dose is 12 mg/kg every 48 hours.
  • Children 28 days–11 years: Initially 6 mg/kg, followed by 3 mg/kg once daily.

Objective: To prevent recurrence of oropharyngeal candidiasis in HIV patients

  • Adult: 100–200 mg, once daily, or 200 mg, 3 times weekly

Purpose: Treating esophageal candidiasis

  • Adult: Initially 200–400 mg on day 1, followed by 100–200 mg once daily for 14–30 days.
  • Children 0–14 days: Initially 6 mg/kg, followed by 3 mg/kg, every 72 hours. Maximum dose of 12 mg/kg every 72 hours.
  • Children 15–27 days old: Initially 6 mg/kg, followed by 3 mg/kg every 48 hours. Maximum dose of 12 mg/kg every 48 hours.
  • Children aged 28 days–11 years : Initially 6 mg/kg, followed by 3 mg/kg, once daily.

Objective: To prevent recurrence of esophageal candidiasis in HIV patients

  • Adult: 100–200 mg, once daily, or 200 mg, 3 times weekly.

Purpose: Treating invasive candidiasis

  • Adult: Initially 800 mg on day 1, followed by 400 mg once daily for 2 weeks.
  • Children ≥4 weeks to 11 years: 6–12 mg/kg, once daily.

Purpose: Treat cryptococcal meningitis

  • Adult: Initially 400 mg on day 1, followed by 200–400 mg once daily for 6–8 wk. Followed by 200 mg once daily for up to 1 year after starting treatment for those at risk of relapse.
  • Children ≥4 weeks to 11 years: 6–12 mg/kg, once daily. Maintenance dose 6 mg/kg, once a day.

Purpose: Chronic candidiasis of dentures

  • Adult: 50 mg once daily for 14 days.

Purpose: Treat candiduria (candida found in urine)

  • Adult: 200–400 mg, once daily, for 7–21 days.

Purpose: Treat chronic skin candidiasis

  • Adult: 50–100 mg once daily for 28 days.

Purpose: Preventing fungal infections in patients with compromised immune systems

  • Adult: 200–400 mg, once daily.
  • Children aged ≥4 weeks–11 years: 3–12 mg/kg, once daily.

Purpose: Tinea pedis , tinea corporis, tinea cruris

  • Adult: 150 mg, once a week, or 50 mg, once a day.

Purpose: Treat phlegm ( tinea versicolor )

  • Adult: 300–400 mg, once per week, for 1–3 weeks, or 50 mg, once daily, for 2–4 weeks.

Purpose: Treat fungal nail infection ( tinea unguium )

  • Adult: 150 mg, once a week.

The duration of treatment with fluconazole may vary for each patient, depending on the patient's immune condition. If the patient's immune condition is weak, administration of fluconazole will take longer.

How to Use Fluconazole Properly

Fluconazole for injection or infusion will be given through a vein (intravenously/IV). Giving fluconazole can only be done by a doctor or medical officer under the supervision of a doctor.

If you are prescribed oral fluconazole, follow your doctor's advice and read the information on the drug packaging before starting to take it. Do not stop medication without consulting your doctor, even if your symptoms of infection have improved. This is done to prevent the fungus from growing back.

Fluconazole in tablet or capsule form can be taken before or after meals. Swallow tablets or capsules with plain water.

Take fluconazole at the same time every day to maximize the effect of the drug. If you forget to take fluconazole, consume it immediately if it is not yet close to the schedule for taking the next drug. If it is close, ignore the missed dose and do not double the dose at the time of taking the next drug.

Generally, patients will feel better after a few days after starting treatment with fluconazole. Call your doctor immediately if your symptoms don't improve or if they get worse.

Store fluconazole tablets or capsules in a closed container, in a cool place away from sunlight. Keep medicine out of reach of children.

Interactions of Fluconazole with Other Drugs

The following are some of the interactions that can occur when using fluconazole together with other drugs:

  • Increased risk of arrhythmias when used with astemizole , cisapride, terfenadine , quinidine, pimozide , or erythromycin
  • Increased risk of developing severe respiratory distress when used with fentanyl
  • Increased risk of developing hypoglycemia when used with glipizide or glimepiride
  • Increased risk of bleeding when used with anticoagulant drugs , such as warfarin
  • Increased risk of side effects from ciclosporin , midazolam , nevirapine , amitriptyline , theophylline , or parecoxib when used together
  • Increased risk of myopathy and rhabdomyolysis when used with simvastatin or atorvastatin
  • Decreased fluconazole levels when used with rifampicin

Fluconazole Side Effects and Dangers

Some of the side effects that can occur after using fluconazole are:

  • Headache or dizziness
  • Stomach ache
  • Nauseous
  • Vomit
  • Hair loss
  • Disorders of the sense of taste
  • Diarrhea

Consult your doctor if the side effects above do not subside immediately or get worse. You need to see a doctor immediately if you experience an allergic drug reaction or more serious side effects, such as:

  • skin rash
  • Liver disorders characterized by right-sided abdominal pain, loss of appetite, dark urine, pale stools, or jaundice
  • Heart beat
  • The body feels very tired
  • Easy bruising or bleeding
  • Severe dizziness as if you were about to faint
  • Seizure
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