Fluconazole
Generic Name
Fluconazole 50 mg tablet
Manufacturer
Various manufacturers (e.g., Square Pharmaceuticals, Beximco Pharmaceuticals)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| fluconazole 50 mg tablet | ৳ 6.00 | ৳ 60.00 |
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 systemic candidiasis.
Uses & Indications
Dosage
Adults
Dosage varies by indication. For vaginal candidiasis, a single 150 mg oral dose is common. For oropharyngeal candidiasis, 50-100 mg once daily for 7-14 days. For systemic infections, higher doses (up to 400 mg daily) may be used.
Elderly
No dosage adjustment is necessary for elderly patients with normal renal function. For those with renal impairment, adjust as per renal impairment guidelines.
Renal_impairment
Dose reduction or extended dosing intervals are recommended based on creatinine clearance (e.g., 50% of normal dose if CrCl < 50 mL/min).
How to Take
Fluconazole tablets can be taken with or without food. Swallow the tablet whole with a glass of water. For oral thrush, it may be advised to dissolve the tablet slowly in the mouth before swallowing.
Mechanism of Action
Fluconazole inhibits fungal cytochrome P450-dependent 14-alpha-demethylase, which is essential for ergosterol synthesis in the fungal cell membrane. This inhibition leads to the accumulation of 14-alpha-methyl sterols and a subsequent decrease in ergosterol, disrupting the fungal cell membrane and inhibiting fungal growth.
Pharmacokinetics
Onset
Within 1-2 hours (peak plasma concentration).
Excretion
Primarily excreted unchanged in urine (approximately 80% of the dose).
Half life
Approximately 30 hours.
Absorption
Well absorbed orally, bioavailability > 90%.
Metabolism
Minimally metabolized; primarily by CYP2C9, CYP2C19, and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to fluconazole or other azole antifungals
- Co-administration with terfenadine, astemizole, cisapride, pimozide, quinidine, or erythromycin due to risk of QT prolongation and torsades de pointes
Drug Interactions
Warfarin
Increased prothrombin time, risk of bleeding.
Phenytoin
Increased phenytoin levels, monitor for toxicity.
Rifampicin
Decreased fluconazole levels, consider increasing fluconazole dose.
Hydrochlorothiazide
Increased plasma fluconazole levels.
Oral Hypoglycemics (sulfonylureas)
Increased plasma concentration of sulfonylureas, risk of hypoglycemia.
Cyclosporine, Tacrolimus, Sirolimus
Increased plasma levels of these immunosuppressants, monitor levels and adjust dose.
Benzodiazepines (e.g., midazolam, triazolam)
Increased benzodiazepine levels due to inhibition of CYP3A4 metabolism.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include hallucinations and paranoid behavior. Management involves symptomatic treatment and supportive measures. Gastric lavage may be considered. Hemodialysis significantly reduces plasma levels of fluconazole.
Pregnancy & Lactation
Pregnancy Category D (single dose for vaginal candidiasis is C). Use in pregnancy only if the potential benefit outweighs the potential risk to the fetus. Fluconazole is excreted in breast milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to fluconazole or other azole antifungals
- Co-administration with terfenadine, astemizole, cisapride, pimozide, quinidine, or erythromycin due to risk of QT prolongation and torsades de pointes
Drug Interactions
Warfarin
Increased prothrombin time, risk of bleeding.
Phenytoin
Increased phenytoin levels, monitor for toxicity.
Rifampicin
Decreased fluconazole levels, consider increasing fluconazole dose.
Hydrochlorothiazide
Increased plasma fluconazole levels.
Oral Hypoglycemics (sulfonylureas)
Increased plasma concentration of sulfonylureas, risk of hypoglycemia.
Cyclosporine, Tacrolimus, Sirolimus
Increased plasma levels of these immunosuppressants, monitor levels and adjust dose.
Benzodiazepines (e.g., midazolam, triazolam)
Increased benzodiazepine levels due to inhibition of CYP3A4 metabolism.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include hallucinations and paranoid behavior. Management involves symptomatic treatment and supportive measures. Gastric lavage may be considered. Hemodialysis significantly reduces plasma levels of fluconazole.
Pregnancy & Lactation
Pregnancy Category D (single dose for vaginal candidiasis is C). Use in pregnancy only if the potential benefit outweighs the potential risk to the fetus. Fluconazole is excreted in breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by FDA and DGDA
Patent Status
Expired (generic available)
WHO Essential Medicine
YesClinical Trials
Fluconazole has undergone extensive clinical trials demonstrating its efficacy and safety in various fungal infections. Ongoing trials continue to explore its role in emerging fungal pathogens and resistance.
Lab Monitoring
- Liver function tests (ALT, AST, alkaline phosphatase, bilirubin)
- Renal function tests (creatinine, BUN)
- Electrolytes (especially potassium) in patients at risk for arrhythmias
- Complete blood count (CBC) during long-term therapy
Doctor Notes
- Monitor liver function tests periodically during long-term therapy.
- Caution in patients with pre-existing cardiac conditions due to potential for QT prolongation.
- Advise patients on potential drug interactions, especially with warfarin and sulfonylureas.
Patient Guidelines
- Take fluconazole exactly as prescribed by your doctor.
- Do not stop taking the medicine early, even if you feel better, as the infection may return.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Seek immediate medical attention if you experience severe allergic reactions, yellowing of skin/eyes, or severe skin rash.
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 take a double dose to make up for a missed one.
Driving Precautions
Fluconazole may cause dizziness or seizures in some individuals. If you experience these side effects, avoid driving or operating machinery.
Lifestyle Advice
- Maintain good personal hygiene to prevent recurrence of fungal infections.
- Wear breathable clothing, especially for skin and vaginal candidiasis.
- Avoid excessive moisture in affected areas.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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