Fluconazole (Diflucan)

• Type of Drug: Antifungal.
• Prescribed for: Infections of the blood, mouth, throat, vagina, or central nervous system due to Candida, Aspergillus, or Cryptococcus.

Fluconazole (Diflucan) General Information

Fluconazole is an antifungal agent that is effective against a variety of fungal organisms, including Aspergillus, Cryptococcus, arid Candida. It works by inhibiting important enzyme systems in the organisms it attacks. Fluconazole’s effectiveness against Candida and Cryptococcus has made this drug an important contributor in the fight against the opportunistic fungal infections that afflict many people with AIDS.

Fluconazole (Diflucan) Cautions and Warnings

Do not take Fluconazole if you are allergic to it. People who are allergic to similar antifungals (Ketoconazole, Miconazole, and Itraconazole) may also be allergic to Fluconazole, but cross-reactions are not common and serious allergic reaction is rare.

Rarely, Fluconazole causes liver damage. The drug should be used with caution in people with pre-existing liver disease. In studies with laboratory animals, Fluconazole caused an increase in liver tumors.

Skin rash may be an important sign of drug toxicity, especially in people with AIDS or others with compromised immune function. Report any skin rashes, especially ones that don’t heal readily, to your doctor.

Fluconazole (Diflucan) Possible Side Effects

Side effects are, generally, more common among AIDS patients, but they follow the same pattern for all people taking this drug.

• Most common: nausea, headache, skin rash, vomiting, abdominal pain, and diarrhea.
• Less common: Fluconazole may cause some liver toxicity, as measured by increases in specific lab tests. These changes in lab values are more common in people with AIDS or cancer, who are more likely to be taking several drugs, some of which may also be toxic to the liver; these include Rifampin, Phenytoin, Isoniazid, Valproic Acid, and oral antidiabetes agents. People with AIDS or cancer who take Fluconazole for fungal infections rarely develop severe liver or skin problems.

Fluconazole (Diflucan) Drug Interactions

• Cimetidine and Rifampin may reduce blood levels of Fluconazole, but the importance of these interactions is not known.
• Fluconazole may increase the amount of the oral antidiabetes drugs Tolbutamide, Glyburide, and Glipizide in the blood, causing low blood sugar. Cyclosporine, Phenytoin, Theophylline, Warfarin, and Zidovudine are similarly affected. Dosage adjustments of these drugs may be required to offset the effect of Fluconazole.
• Fluconazole may interfere with the effectiveness of oral contraceptive drugs.
• Hydrochlorothiazide may increase blood levels of Fluconazole up to 40 percent.

Food Interactions

Fluconazole may be taken without regard to food or meals.

Usual Dose

Adult and Adolescent (age 14 and older): 100 to 400 mg, once a day.
Child (age 3 to 13): 1.3 to 2.6 mg per pound of body weight once a day.
Child (under age 3): not recommended.

Fluconazole (Diflucan) Overdosage

Symptoms of a very large Fluconazole overdose may include breathing difficulty, lethargy, excess tearing, droopy eyelids, excess salivation, loss of bladder control, convulsions, and blue discoloration of the skin under the nails. Overdose victims should be taken to a hospital emergency room for treatment. ALWAYS bring the medicine bottle.

Special Information

Regular visits to your doctor are necessary to monitor your liver function and general progress.

Call your doctor if you develop reddening, loosening, blistering or peeling of the skin, darkening of the urine, yellowing of the skin or eyes, loss of appetite, or abdominal pain (especially on the right side). Other symptoms need be reported only if they are bothersome or persistent.

If you forget to take a dose of Fluconazole, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.

Fluconazole (Diflucan) Special Populations

Pregnancy/Breast-feeding
Animal studies with Fluconazole show very specific effects on the developing fetus that have not been seen in humans. Nevertheless, pregnant women should not use Fluconazole unless the possible benefits clearly outweigh the risks.
Fluconazole passes into breast milk. Nursing mothers who must take this drug should bottle-feed their babies.

Seniors
Because seniors are more likely to have lost some kidney function, they may require a reduced dosage.