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fluconazole - Diflucan

General
Information
Fluconazole (Diflucan) is an antibiotic that is used to treat fungal infections, or another way of saying the same thing is that fluconazole is an antifungal medication.
Specifics Fluconazole is a well-respected and very effective antifungal medication, and it has a long track record of effectiveness and safety.

Fluconazole works by inhibiting the production of fungus cell wall.  Fluconazole is used for a variety of purposes including but not limited to the following:

1.  Treat yeast infections in the mouth, throat, esophagus, vagina, blood, and many other locations in the body.
2.  Treat a serious infection called cryptococcosis (caused by a fungus called "Cryptococcus neoformans") which is found in the lungs, blood, brain, spinal fluid, and/or other organs.
3.  Treat many minor fungal conditions such as "ring worm", toenail fungus, etc.
4.  Prevent serious fungal infections in persons with very low immune systems

Fluconazole is such an excellent and safe drug there may be tendency for it to be overused.  If it is overused in individuals or overall in the community, yeast infections may become resistant to its effects.  Therefore, it is important to take this drug only when advised by someone that knows what they are doing.  Do not take this medication except on the advice of a healthcare provider.

Dosing Fluconazole may be given intravenously or by pill or liquid at a variety of doses to treat infections: the usual range is 100 - 200 mg once a day depending on the type of infection, your weight, and your kidney function.  Much higher doses may be given safely if necessary.
Adherence
This refers to your willingness, ability, and actual performance in taking your medications.

For further information and tips on adherence, go to the Adherence section of this site.

It is very important to take every dose that is prescribed unless instructed by your healthcare provider.

Do not adjust the dose or frequency of fluconazole without speaking to your healthcare provider first.

If you miss doses, the infection that is being treated may not get better or sometimes the infection can even get much worse by the germ developing resistance to fluconazole. 

It is strongly recommended that you consider using weekly pill boxes and arrange all of your doses a week in advance.  Buy a small pill box so that you can carry a dose or two of your medicines with you in case you are away from home.

Possible Side Effects
The package insert for most drugs including fluconazole is often overwhelming and scary with perhaps an overemphasis on side effects.  We have summarized the important and more common problems here.

Most people take fluconazole without any or very many side effects. 

Many side effects get better with time.

Possible side effects include bad taste in mouth, stomach upset, nausea, liver problems, fever, or allergic rashes.  Fluconazole tablets have a tendency to dissolve in the mouth, and the medication has a very bad taste.

Allergic rashes can be very minor to very serious (rarely,) but all rashes should be reported.  If you have rash that steadily gets worse or you have a rash and fever, you need to inform your healthcare provider immediately.

Interactions
This refers to the way that fluconazole affects other medications and how other medications might affect fluconazole
There are several drugs that should not be used with fluconazole:  terfenidine, astemizole, cisapride, rifampin

There are many, many other drugs which should be used with the knowledge of their possible interactions with fluconazole:

sedatives such as alprazolam (Xanax), midazolam (Versed)
migraine headache medicines
barbiturates
protease inhibitors (e.g., nelfinavir, indinavir, fosamprenavir, amprenavir, etc.)
immunosuppressants for bone marrow and organ transplants (e.g., cyclosporin)
estrogens
pain medications including methadone and fentanyl (Duragesic)
oral diabetic medications
seizure medications like phenytoin (Dilantin)
drugs to treat rhythm problems with the heart
drugs for erectile dysfunction (e.g., Viagra, Cialis, and Levitra)
...and many others.

Make sure that your healthcare provider is aware of all the medications you are taking so that important and possibly dangerous interactions are not overlooked.

Report to you healthcare provider or go to an Emergency Room if you have severe side effects, increasing side effects, shortness of breath, fever, jaundice (eyes and skin turn yellow,) nausea and vomiting (so that you cannot hold down your food and liquids) or rash.
You can download this handout in PDF format by clicking HERE.

6.30.2005