II. Indications
- Onychomycosis
- Yeast Vaginitis (Single dose)
III. Dosing
-
Tinea Capitis
- Daily: 6 mg/kg/day (up to 150 mg to 300 mg) daily for 3 to 6 weeks
- Weekly: 6 mg/kg/day (up to 150 mg to 300 mg) weekly for 8 to 12 weeks
-
Onychomycosis
- Adult: 150 to 300 mg (up to 450 mg) orally once per week
- Child: 3 to 6 mg/kg once weekly
- Course
- Fingernail: 3-6 months
- Toenail: 6-12 months
- Yeast Vaginitis
- Adult dose: 150 mg PO for 1 dose
IV. Monitoring
-
Onychomycosis or Yeast Vaginitis
- No routine lab tests recommended
- Some guidelines have recommended baseline labs
- Complete Blood Count (CBC)
- Liver transaminases (AST, ALT)
- Serum Creatinine
V. Adverse effects (5% of patients)
- Nausea
- Headache
- Pruritus
- Liver Function Test abnormalities
VI. Drug Interactions
- Absorption not affected by gastric pH
- Significant sedation with Benzodiazepines
- Cimetidine decreases Fluconazole levels
- Hydrochlorothiazide increases Fluconazole levels
- Rifampin decreases Fluconazole levels
-
Oral Hypoglycemics (e.g. Sulfonylureas)
- Risk of Hypoglycemia
- Fluconazole increases Theophylline levels
- Increased bleeding risk with Warfarin
VII. Precautions
- As of 2016, evidence of Miscarriage risk, with even 1-2 doses
- Previously thought safe in pregnancy if limited to occassional single dose
- Mølgaard-Nielsen (2016) JAMA 315(1):58-67 +PMID:26746458 [PubMed]
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Related Studies (from Trip Database) Open in New Window
| Fluconazole (on 6/18/2017 at Walmart.com) | ||
| Fluconazole 150mg | #1 tablet for $4.00 | $4.00 each |
| Fluconazole 150mg | #3 tablets for $10.00 | $3.33 each |
| fluconazole (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| FLUCONAZOLE 10 MG/ML SUSP | Generic | $0.31 per ml |
| FLUCONAZOLE 100 MG TABLET | Generic | $1.06 each |
| FLUCONAZOLE 150 MG TABLET | Generic | $1.67 each |
| FLUCONAZOLE 200 MG TABLET | Generic | $1.47 each |
| FLUCONAZOLE 40 MG/ML SUSP | Generic | $0.79 per ml |
| FLUCONAZOLE 50 MG TABLET | Generic | $1.05 each |
| diflucan (on 6/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| DIFLUCAN 150 MG TABLET | Generic | $1.67 each |
Ontology: Fluconazole (C0016277)
| Definition (CHV) | a kind of antifungal drug |
| Definition (NCI_NCI-GLOSS) | A drug that treats infections caused by fungi. |
| Definition (NCI) | A synthetic triazole with antifungal activity. Fluconazole preferentially inhibits fungal cytochrome P-450 sterol C-14 alpha-demethylation, resulting in the accumulation of fungal 14 alpha-methyl sterols, the loss of normal fungal sterols, and fungistatic activity. Mammalian cell demethylation is much less sensitive to fluconazole inhibition. |
| Definition (MSH) | Triazole antifungal agent that is used to treat oropharyngeal CANDIDIASIS and cryptococcal MENINGITIS in AIDS. |
| Definition (CSP) | alpha-(2,4-difluorophenyl)-alpha- (1,2,4-triazol-1-ylmethyl)-1,2, 4- triazole-1-ethanol; an antifungal with potential efficacy for patients unable to take amphotericin B or who are immunologically compromised, as in AIDS. |
| Definition (PDQ) | A synthetic triazole with antifungal activity. Fluconazole preferentially inhibits fungal cytochrome P-450 sterol C-14 alpha-demethylation, resulting in the accumulation of fungal 14 alpha-methyl sterols, the loss of normal fungal sterols, and fungistatic activity. Mammalian cell demethylation is much less sensitive to fluconazole inhibition. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40842&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40842&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C500" NCI Thesaurus) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D015725 |
| SnomedCT | 31865003, 387174006 |
| LNC | LP14993-7, MTHU002296 |
| English | 1H-1,2,4-Triazole-1-ethanol, alpha-(2,4-difluorophenyl)-alpha-(1H-1,2,4-triazol-1-ylmethyl)-, alpha-(2,4-difluorophenyl)-alpha- (1,2,4-triazol-1-ylmethyl)-1,2, 4- triazole-1-ethanol, fluconazole, FLUCONAZOLE, Fluconazole, fluconazole (medication), Fluconazole [Chemical/Ingredient], Fluconazole product, Fluconazole (product), Fluconazole (substance), FCZ |
| Swedish | Flukonazol |
| Czech | flukonazol |
| Finnish | Flukonatsoli |
| Russian | FLUKONAZOL, ФЛУКОНАЗОЛ |
| Japanese | フルコナゾール |
| Polish | Flukonazol |
| Spanish | fluconazol (producto), fluconazol (sustancia), fluconazol, Fluconazol |
| French | Fluconazole |
| German | Fluconazol |
| Italian | Fluconazolo |
| Portuguese | Fluconazol |
Ontology: Diflucan (C0699601)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D015725 |
| English | diflucan, Diflucan, Pfizer Brand of Fluconazole, Triflucan |
