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Fluconazole Dosage: Uses, Side Effects, and Interactions Explained
Fluconazole: Key Points and Overview
Fluconazole is an antifungal medication commonly used to treat a variety of fungal infections, such as yeast infections, oral thrush, and cryptococcal meningitis. It works by inhibiting the growth of fungi. Fluconazole is available in different forms and strengths, depending on the specific condition being treated. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are also available to assist with any questions or concerns you may have.
Fluconazole: Brand and Generic Names
Brand Name: Diflucan (Fluconazole)
The generic name, Fluconazole, refers to the active ingredient, while Diflucan is the brand name given by the manufacturer. In this case, Fluconazole is the generic name, listed in parentheses.
Pharmacologic Category of Fluconazole
Category: Antifungal Agent, Azole Derivative
Fluconazole Dosage and Treatment Guidelines
Fluconazole is prescribed for a range of fungal infections. The dosage and duration of treatment depend on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.
Fluconazole Dosage for Candidiasis (Systemic)
Initial dose: 400 mg on the first day
Maintenance dose: 200-400 mg once daily
Duration: 2-4 weeks, depending on the severity of the infection
Fluconazole Dosage for Cryptococcal Meningitis
Initial dose: 400 mg on the first day
Maintenance dose: 200-400 mg once daily
Duration: 10-12 weeks after a negative cerebrospinal fluid culture
Fluconazole for Vaginal Yeast Infection
Single dose: 150 mg taken by mouth once
Fluconazole Dosage for Oral Thrush (Oropharyngeal Candidiasis)
Initial dose: 200 mg on the first day
Maintenance dose: 100 mg once daily
Duration: At least 2 weeks
Fluconazole Dosage for Esophageal Candidiasis
Initial dose: 200-400 mg on the first day
Maintenance dose: 100-400 mg once daily
Duration: At least 3 weeks and for 2 weeks after symptoms resolve
Fluconazole for Other Serious Fungal Infections
Initial dose: 400 mg on the first day
Maintenance dose: 200-400 mg once daily
Duration: Varies based on the type and severity of the infection
Fluconazole Dosage for Tinea (Ringworm)
Typical dose: 150 mg once weekly
Duration: 2-6 weeks, depending on the location and severity of the infection
Fluconazole Dosage for Histoplasmosis
Initial dose: 200-400 mg once daily
Duration: Varies based on the severity of the infection
Fluconazole Dosage for Coccidioidomycosis
Initial dose: 200-400 mg once daily
Duration: Varies based on the severity of the infection
Fluconazole Dosage for Blastomycosis
Initial dose: 200-400 mg once daily
Duration: Varies based on the severity of the infection
Fluconazole Dosage Forms and Strengths
Available Forms:
- Tablets: 50 mg, 100 mg, 150 mg, 200 mg
- Oral Suspension: 10 mg/mL, 40 mg/mL
- Intravenous (IV) Solution: 2 mg/mL
Fluconazole Administration Instructions
Fluconazole can be taken with or without food. If you are using the oral suspension, make sure to shake the bottle well before each dose. For the IV form, it will be administered by a healthcare professional. It is important to complete the full course of the medication, even if your symptoms improve before finishing treatment. If you miss a dose, take it as soon as you remember, but do not take two doses at once to make up for the missed dose.
Fluconazole Contraindications
A contraindication is a specific condition where a medication should not be used because it could be harmful. If you have any of the following conditions, Fluconazole may not be safe for you. Always discuss your medical history with your healthcare provider before starting any new medication.
Allergy to Fluconazole: If you have had an allergic reaction to Fluconazole or any of its components, you should not take this medication. Allergic reactions can range from mild rashes to severe, life-threatening reactions like anaphylaxis.
Heart rhythm problems (QT prolongation): Fluconazole can affect the heart’s electrical activity, leading to QT prolongation, which can cause dangerous heart rhythms, especially in those with a history of heart issues.
Liver disease: Fluconazole is processed by the liver, and in individuals with liver disease, it can cause further damage. If you have a history of liver problems, your doctor may recommend an alternative treatment.
Kidney disease: Since Fluconazole is eliminated through the kidneys, individuals with kidney disease may not clear the drug effectively, increasing the risk of side effects.
Pregnancy (high doses): High doses of Fluconazole (400-800 mg/day) during pregnancy have been linked to birth defects. It is contraindicated in pregnant women unless the benefits outweigh the risks.
Fluconazole Drug Interactions
Fluconazole can interact with other medications, increasing the risk of side effects or reducing the effectiveness of one or both drugs. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Common medications that interact with Fluconazole include:
Warfarin (Coumadin): Fluconazole can increase the effects of warfarin, raising the risk of bleeding.
Phenytoin (Dilantin): Fluconazole can increase phenytoin levels in the blood, potentially leading to toxicity.
Rifampin (Rifadin): Rifampin can reduce Fluconazole’s effectiveness by speeding up its breakdown in the liver.
Oral hypoglycemics (Glyburide, Glipizide): Fluconazole can enhance the effects of these medications, causing low blood sugar (hypoglycemia).
Cisapride (Propulsid): Taking Fluconazole with cisapride can lead to serious heart rhythm problems (QT prolongation).
Statins (Atorvastatin, Simvastatin): Fluconazole can increase statin levels in the blood, raising the risk of muscle damage (myopathy).
Fluconazole in Pregnancy
Is it safe to take Fluconazole when pregnant?
Fluconazole is generally not recommended during pregnancy, especially in higher doses. Doses ranging from 400 to 800 mg per day have been associated with birth defects when taken during the first trimester. However, a single low dose (150 mg) used to treat vaginal yeast infections is considered relatively safe. If you are pregnant or planning to become pregnant, it’s important to discuss the potential risks and benefits of Fluconazole with your healthcare provider. They may recommend safer alternatives during pregnancy.
Fluconazole While Breastfeeding
Is it safe to take Fluconazole while breastfeeding?
Fluconazole does pass into breast milk, but the levels are typically low and unlikely to cause harm to a breastfeeding infant. However, it’s always best to consult your healthcare provider before taking Fluconazole while breastfeeding. They will help weigh the benefits and any potential risks for both you and your baby.
Estimated Cost of Fluconazole
The cost of Fluconazole can vary depending on the dosage and the pharmacy. Without insurance, a single 150 mg tablet (commonly prescribed for yeast infections) typically costs between $5 and $15 when using a GoodRx coupon. Prices may differ, so it’s a good idea to check with your pharmacy or use a discount service like GoodRx for the most up-to-date pricing.
Possible Alternatives to Fluconazole
If Fluconazole isn’t the right option for you, there are alternative treatments available for various fungal infections. Always consult your healthcare provider before making any changes to your treatment plan. Below are some alternatives based on specific conditions:
- Candidiasis: Alternatives include topical antifungal creams like clotrimazole (Lotrimin) or oral medications such as nystatin. Maintaining good hygiene and keeping affected areas dry can help prevent recurrence.
- Cryptococcal meningitis: Amphotericin B and flucytosine are often used as alternatives. Treatment typically requires hospitalization and close monitoring.
- Vaginal yeast infection: Over-the-counter antifungal creams like miconazole (Monistat) or oral medications such as itraconazole (Sporanox) may be used. Wearing loose-fitting clothing and avoiding scented hygiene products can help prevent future infections.
- Oral thrush: Nystatin oral suspension or clotrimazole lozenges are common alternatives. Practicing good oral hygiene, such as brushing twice daily and using mouthwash, can help prevent thrush.
- Esophageal candidiasis: Itraconazole (Sporanox) or posaconazole (Noxafil) may be used as alternatives. Maintaining good oral hygiene and managing underlying conditions like diabetes can reduce the risk of infection.
- Fungal skin infections: Depending on the type, alternatives may include topical treatments like terbinafine (Lamisil) or oral medications such as ketoconazole.
- Tinea (ringworm): Topical antifungal creams like terbinafine (Lamisil) or oral medications such as griseofulvin may be used. Keeping the skin clean and dry can help prevent tinea infections.
- Histoplasmosis: Itraconazole (Sporanox) is often used as an alternative. Avoiding exposure to bird or bat droppings, which can carry the fungus, may help prevent infection.
- Coccidioidomycosis: Itraconazole (Sporanox) or ketoconazole may be used as alternatives. Avoiding dusty environments in areas where this fungus is common can reduce the risk of infection.
- Blastomycosis: Itraconazole (Sporanox) is commonly used as an alternative. Avoiding exposure to moist soil and decaying wood, where the fungus thrives, can help prevent infection.
Recent Updates on Fluconazole Research
Recent studies have focused on Fluconazole’s effectiveness in treating resistant fungal infections. Researchers are exploring its use in combination with other antifungal agents to improve outcomes in patients with severe or resistant infections. Additionally, studies are investigating the long-term safety of Fluconazole, particularly for patients who require extended treatment for chronic conditions like cryptococcal meningitis or recurrent candidiasis.
As new research continues to emerge, staying informed about the latest findings is essential. If you have any questions about your treatment or are interested in exploring other options, our telemedicine providers are available to help you make the best decision for your health.
