Fluconazole
Brand names
- Apo-Fluconazole
- Diflucan
- Nu-Flucon
Usage
To treat
fungal infections of
the mouth and throat, such
as candidiasis (thrush), of
the vagina (yeast infection),
or throughout the body, as
well as meningitis (inflammation of the protective
membranes surrounding
the brain). Often used to
treat AIDS-related fungal
infections. May also be
used to prevent recurring
fungal infections in susceptible patients weakened by
AIDS or by chemotherapy
or radiation treatment.
How it works
Fluconazole prevents fungal
organisms from manufacturing vital substances required
for their growth and function.
This medicament is effective only for
infections caused by fungal
organisms. It will not work for
bacterial or viral infections.
Side effects
- Serious
- Skin rash or
itching,
fever or chills. Seek medical help
right away.
- Common
- No common side effects have been reported with the use
of fluconazole.
- Less common
- Diarrhea,
nausea, vomiting,
constipation,
dizziness,
headache, redness or flushing of skin.
Possible interactions
- Other medicaments:
Fluconazole may increase the effects of:
- benzodiazepines.
- celecoxib (Celebrex).
- dofetilide (Tikosyn).
- felodipine (Plendil).
- oral antidiabetic medicaments (chlorpropamide, glipizide, glyburide,
tolbutamide,
others) and cause hypoglycemia; check
sugar levels carefully.
- phenytoin (Dilantin, etc.) or fosphenytoin (Cerebyx) and cause phenytoin or
fosphenytoin toxicity; monitor
blood levels.
- serolimus (Rapamune), and tacrolimus (Prograf). Serolimus and tacrolimus
levels should be used to guide dosing.
- triazolam (Halcion), leading to toxicity.
- tricyclic antidepressants.
- trimetrexate (Neutrexin).
- warfarin (Coumadin) and cause unwanted bleeding. Dosing changes and
more frequent INRs are prudent.
- zidovudine (AZT) and result in toxicity. The zidovudine dose may need to be
decreased if this combination is to be continued.
The following medicaments may decrease the effects of fluconazole:
- cimetidine (Tagamet).
- rifampin (Rifadin, Rimactane, etc.).
Fluconazole taken concurrently with:
- amphotericin B (Amphotec, others) may decrease amphotericin benefits.
- astemizole (Hismanal) may result in fatal toxicity to the heart.
- atorvastatin (Lipitor), and other HMG-CoA inhibitors, may increase risk of
muscle toxicity.
- cisapride (Propulsid) may lead to adverse effects on the heart.
- hydrochlorothiazide (Esidrix, others) may increase potassium loss.
- loratadine (Claritin) may result in increased blood levels of loratadine, but
to date, toxicity to the heart has not been reported. Since blood levels may
be increased if combined use is undertaken, it is prudent to decrease the
dose of loratadine.
- losartan (Cozaar) may blunt blood pressure control.
- oral contraceptives (birth control pills) may blunt contraception and result
in pregnancy.
- quetiapine (Seroquel) may lead to quetiapine toxicity.
- ritonavir (Norvir) may increase ritonavir blood levels.
- terfenadine (Seldane) may result in toxicity to the heart.
- Foods:
- Caution is advised regarding grapefruit or grapefruit juice. Avoid eating
grapefruit for an hour after taking this medicine.
- Herbal medicines or minerals:
- Echinacea: some patients use Echinacea to
attempt to boost their immune systems. Unfortunately, use of
Echinacea is not
recommended in people with damaged immune systems. This herb may
also actually weaken any immune system if it is used too often or for too
long a time.
- Beverages:
- Grapefruit juice should be avoided.
- Discontinuation:
- Take all of the medicine. Ongoing therapy for months may be
needed. Ask your doctor when it is okay to stop this medicine.
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