Fluconazole
Generic Name
fluconazole-50-mg-capsule
Manufacturer
Various manufacturers
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| fluconazole 50 mg capsule | ৳ 8.00 | N/A |
Description
Overview of the medicine
Fluconazole is an antifungal medication used to treat various fungal infections, including vaginal yeast infections, oral thrush, esophageal candidiasis, and cryptococcal meningitis. It works by stopping the growth of fungi.
Uses & Indications
Dosage
Adults
Dosage varies by indication. For vaginal candidiasis: 150 mg single oral dose. For oropharyngeal candidiasis: 50-100 mg once daily for 7-14 days. For esophageal candidiasis: 50-400 mg once daily for 14-30 days. For systemic candidiasis and cryptococcal meningitis: Loading dose of 400 mg on day 1, followed by 200-400 mg once daily.
Elderly
No dose adjustment is typically required in elderly patients with normal renal function. For patients with renal impairment, dose adjustment is necessary.
Renal_impairment
For creatinine clearance (CrCl) >50 mL/min, use usual dose. For CrCl 21-50 mL/min, administer 50% of the usual daily dose. For CrCl <20 mL/min, administer 25% of the usual daily dose. Hemodialysis patients should receive 100% of the recommended dose after each dialysis session.
How to Take
Take fluconazole capsules orally, with or without food. Swallow the capsule whole with a glass of water.
Mechanism of Action
Fluconazole works by inhibiting the fungal cytochrome P450 enzyme 14α-demethylase, which is responsible for the demethylation of lanosterol to ergosterol. Ergosterol is a vital component of the fungal cell membrane; its inhibition leads to increased membrane permeability, leakage of cellular contents, and inhibition of fungal growth.
Pharmacokinetics
Onset
Onset of action varies depending on the type and severity of infection, generally within hours to days.
Excretion
Primarily renal; about 80% of the administered dose is excreted unchanged in the urine, and about 11% is excreted as metabolites.
Half life
Approximately 30 hours, which allows for once-daily dosing.
Absorption
Well absorbed orally, with bioavailability of >90% compared to intravenous administration. Peak plasma concentrations are achieved within 1-2 hours.
Metabolism
Minimally metabolized; approximately 11% of the dose is metabolized. It is a potent inhibitor of CYP2C9 and a moderate inhibitor of CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Known hypersensitivity to fluconazole, other azole antifungals, or any component of the formulation.
- Co-administration with terfenadine, astemizole, cisapride, pimozide, or quinidine in patients receiving multiple doses of fluconazole.
Drug Interactions
Warfarin
Increased prothrombin time; monitor INR closely.
Phenytoin
Increased phenytoin levels; monitor levels and adjust dose.
Rifampicin
Decreased fluconazole levels; consider increasing fluconazole dose.
Hydrochlorothiazide
Increased plasma concentrations of fluconazole.
Oral Hypoglycemics (sulfonylureas)
Increased blood glucose lowering effect; monitor blood sugar.
Cyclosporine, Tacrolimus, Sirolimus
Increased levels of immunosuppressants; monitor levels.
Statins (e.g., Atorvastatin, Simvastatin)
Increased risk of myopathy/rhabdomyolysis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptoms may include hallucinations and paranoid behavior. Management should involve symptomatic and supportive measures. Gastric lavage may be appropriate if performed within a short time after ingestion. Hemodialysis significantly reduces plasma levels of fluconazole.
Pregnancy & Lactation
Pregnancy Category D (for chronic, high-dose use in 1st trimester, otherwise C). Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Fluconazole is secreted in breast milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Known hypersensitivity to fluconazole, other azole antifungals, or any component of the formulation.
- Co-administration with terfenadine, astemizole, cisapride, pimozide, or quinidine in patients receiving multiple doses of fluconazole.
Drug Interactions
Warfarin
Increased prothrombin time; monitor INR closely.
Phenytoin
Increased phenytoin levels; monitor levels and adjust dose.
Rifampicin
Decreased fluconazole levels; consider increasing fluconazole dose.
Hydrochlorothiazide
Increased plasma concentrations of fluconazole.
Oral Hypoglycemics (sulfonylureas)
Increased blood glucose lowering effect; monitor blood sugar.
Cyclosporine, Tacrolimus, Sirolimus
Increased levels of immunosuppressants; monitor levels.
Statins (e.g., Atorvastatin, Simvastatin)
Increased risk of myopathy/rhabdomyolysis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptoms may include hallucinations and paranoid behavior. Management should involve symptomatic and supportive measures. Gastric lavage may be appropriate if performed within a short time after ingestion. Hemodialysis significantly reduces plasma levels of fluconazole.
Pregnancy & Lactation
Pregnancy Category D (for chronic, high-dose use in 1st trimester, otherwise C). Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Fluconazole is secreted in breast milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date, check packaging for exact date.
Availability
Pharmacies, Hospitals
Approval Status
FDA Approved
Patent Status
Generic
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established fluconazole's efficacy and safety for various fungal infections, supporting its use in both immunocompetent and immunocompromised patients.
Lab Monitoring
- Liver function tests (ALT, AST, alkaline phosphatase, bilirubin) periodically, especially in patients with pre-existing liver disease or those on prolonged therapy.
- Renal function tests (creatinine, BUN) in patients with impaired renal function.
- Electrolyte levels, particularly potassium, in patients at risk for QT prolongation.
Doctor Notes
- Monitor liver function tests (LFTs) periodically, especially in patients with pre-existing liver conditions or on prolonged treatment.
- Be aware of significant drug interactions, particularly with warfarin, phenytoin, and certain statins.
- Counsel patients on the importance of completing the full course of treatment to prevent resistance and recurrence.
Patient Guidelines
- Complete the full course of medication as prescribed, even if symptoms improve.
- Do not share your medication with others.
- Report any severe side effects, especially signs of liver problems (e.g., unusual fatigue, yellowing skin/eyes, dark urine).
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Fluconazole may cause dizziness or seizures in some individuals. If you experience these effects, avoid driving or operating heavy machinery.
Lifestyle Advice
- Maintain good hygiene practices to prevent recurrent fungal infections.
- Avoid excessive alcohol consumption during treatment as it can increase the risk of liver side effects.
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International brand names for this medicine. Click a brand to search for detailed information.
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