Fluconazole is an antifungal drug that belongs to the class of drugs known as triazole antifungals. It is commonly used to treat fungal infections caused by various types of yeast and fungi. Fluconazole tablet uses works by inhibiting the growth and spread of the fungi, helping to clear up the infection.
This medicine is available in different forms, including oral tablets, oral suspension, and intravenous (IV) injections. It can be used to treat a wide range of fungal infections, including vaginal yeast infections, oral thrush, esophageal candidiasis (infection of the throat), cryptococcal meningitis (a type of fungal infection that affects the brain and spinal cord), and certain systemic fungal infections.
Due to its broad spectrum of activity and generally good tolerability, fluconazole is often considered a first-line treatment for many fungal infections. However, it is important to note that fluconazole may interact with other medicines, so it is important to tell your doctor about any other medications you are taking.
As with all medicines, fluconazole may cause side effects, although these are usually mild. Common fluconazole tablet side effects may include nausea, headache, stomach pain, diarrhea, and skin rash. Serious side effects are rare but can occur and it is important to seek medical attention if you experience any severe or persistent side effects while taking fluconazole. To effectively eradicate the fungal infection, it is also essential to take the prescribed dose and complete the full course of treatment.
How does Fluconazole work?
Fluconazole works by inhibiting the synthesis of ergosterol, a vital component of the fungal cell membrane. Ergosterol is necessary for the integrity and function of the fungal cell membrane and its inhibition disrupts the structure and permeability of the membrane.
When fluconazole is administered, it is absorbed into the bloodstream and distributed throughout the body. It then enters the cells of the fungus and targets an enzyme called cytochrome P450 14 alpha demethylase (also known as CYP51). This enzyme is involved in the conversion of lanosterol to ergosterol, a crucial step in fungal cell membrane synthesis.
By inhibiting the activity of CYP51, fluconazole prevents the formation of ergosterol and leads to the accumulation of abnormal sterols in the fungal cell membrane. This disruption weakens the membrane, alters its permeability, and affects the essential functions of the fungal cell. As a result, the growth and reproduction of the fungus is inhibited, eventually leading to its death or elimination by the immune system.
It’s important to note that fluconazole specifically targets fungal cells and has minimal effect on human cells. This is because the mechanism of ergosterol synthesis is different in fungi and humans. This selectivity makes fluconazole an effective antifungal with a relatively low risk of adverse effects on human cells.
Fluconazole Tablet Uses
Fluconazole has several uses in the treatment of fungal infections. Some common indications for the use of fluconazole include
- Vaginal yeast infections: Fluconazole is often prescribed as a single oral dose to treat vaginal yeast infections (vulvovaginal candidiasis). It helps to relieve symptoms such as itching, burning, and abnormal discharge.
- Oral thrush: Fluconazole tablet uses to treat oral thrush (oral candidiasis), a fungal infection of the mouth and throat. It is usually given as a liquid suspension or oral tablet.
- Oesophageal candidiasis: Fluconazole is an effective treatment option in cases where the fungal infection has spread to the esophagus, causing oesophageal candidiasis. It is usually taken orally for a specific length of time as prescribed by a healthcare professional.
- Cryptococcal meningitis: Fluconazole is used to treat cryptococcal meningitis, a serious fungal infection that affects the membranes surrounding the brain and spinal cord. In this case, fluconazole is often given intravenously (IV) in high doses over a long period of time, sometimes in combination with other antifungal medicines.
- Systemic fungal infections: Fluconazole tablet uses for the treatment of certain systemic fungal infections, including candidemia (fungal infection of the bloodstream) and disseminated candidiasis (an infection that has spread throughout the body). The dose and duration of treatment may vary depending on the severity and type of infection.
Fluconazole Tablet Side effects
Fluconazole is generally well tolerated, but like all medicines, it can cause side effects in some people. Common side effects of fluconazole may include
- Nausea and vomiting
- Headache
- Stomach pain or discomfort
- Diarrhea
- Skin rash or itching
- Dizziness or drowsiness
- Changes in taste
- Increased liver enzymes (seen in blood tests)
These fluconazole tablet side effects are usually mild and may go away on their own without the need for medical attention. However, if any of these side effects persist or worsen, it is advisable to consult a doctor.
In rare cases, fluconazole may cause more severe fluconazole tablet side effects that require immediate medical attention. These may include
- Severe allergic reactions (e.g. rash, itching, swelling, severe dizziness, difficulty breathing)
- Liver dysfunction or hepatitis (symptoms may include yellowing of the skin or eyes, dark urine, persistent nausea or vomiting, and abdominal pain)
- Severe skin reactions (such as blistering, peeling skin, or severe skin rash)
- Irregular heartbeat or palpitations
- Unusual bleeding or bruising
- Signs of a serious skin condition called Stevens-Johnson syndrome (such as rash, fever, and blistering)
It is important to seek immediate medical attention if you experience severe or persistent fluconazole tablet side effects while taking fluconazole.
How to dispose of Fluconazole?
Proper disposal of medicines, including fluconazole, is important to ensure the safety of the environment and to prevent accidental ingestion or misuse. Here are some guidelines for the disposal of fluconazole:
- Follow specific instructions: Check the packaging of the medicine or the patient information leaflet that comes with the medicine. It may contain specific instructions on how to dispose of the medicine. If so, follow these instructions.
- Do not flush down the toilet: Do not flush fluconazole down the toilet or pour it down the drain unless directed to do so by specific disposal instructions. Flushing medicines can contribute to water pollution and harm aquatic life.
- Take-back programs: Check to see if there are local take-back programs or medication disposal sites in your area. These programs allow you to safely dispose of unused or expired medicines, including fluconazole, for proper disposal. Contact your local pharmacy, hospital, or law enforcement agency to inquire about such programs.
- Household waste: If there are no special instructions or take-back programs, you can dispose of fluconazole in your household trash. Here’s how:
- Remove the medication from its original container and combine it with a waste product like dirt, kitten litter, or coffee grinds. If individuals discover the medication in the trash, this will deter them from taking it.
- To avoid leaks, put the mixture in a bag or container that is tightly closed.
- Dispose of the sealed bag or container in your normal household waste.
- Protect your privacy: Before disposing of any medication packaging, be sure to remove or scratch off any personal information to protect your privacy.
Alternatives For Fluconazole Tablet
If you are looking for alternatives to fluconazole for treating fungal infections, there are several other antifungal medicines available. The specific alternative will depend on the type of infection being treated and individual factors. Here are some examples of alternative antifungal medications:
- Itraconazole: Itraconazole is an antifungal drug in the same class as fluconazole (triazole antifungals). Fluconazole tablet uses to treat various fungal infections, including vaginal yeast infections, oral thrush, and systemic fungal infections. It is available as an oral capsule or solution.
- Voriconazole: Voriconazole is another antifungal drug that is effective against a wide range of fungal infections. It is often used to treat invasive aspergillosis, candidemia, and certain other serious fungal infections.
- Amphotericin B: Amphotericin B is a broad-spectrum antifungal drug that is particularly useful in treating severe systemic fungal infections. It is administered intravenously and is often reserved for serious or life-threatening infections due to its potential side effects. Liposomal amphotericin B is a formulation that has a reduced risk of certain side effects.
- Caspofungin: Caspofungin is an antifungal drug in a class known as echinocandins. It is used to treat invasive candidiasis and certain types of fungal infections caused by Aspergillus. Caspofungin is given intravenously.
How is Fluconazole taken?
Fluconazole can be taken in different forms depending on the specific formulation prescribed by a healthcare professional. Common forms of fluconazole include
- Oral tablets: Fluconazole is available as oral tablets. The tablets have to be consumed whole along with some water.The dosage and frequency of administration will be determined by the healthcare provider based on the type and severity of the fungal infection.
- Oral suspension: Fluconazole is also available as an oral suspension (liquid). Before each usage, the suspension should be thoroughly shaken.The suspension should be shaken well before each use and a measuring device or oral syringe should be used for accurate dosing. The suspension may be taken directly by mouth or mixed with a small amount of liquid or soft food (e.g. applesauce) for easier administration. Follow the instructions given by your doctor or on the medicine packaging.
- Intravenous (IV) injection: In certain cases, fluconazole may be given intravenously, usually in a hospital setting. The IV formulation is usually used for severe or systemic fungal infections. The dosage and administration schedule will be determined by the healthcare provider based on the specific condition being treated.
It is important that you follow the prescribed dosage and administration instructions given to you by your healthcare provider. The duration of treatment may vary depending on the type and severity of the fungal infection. It is generally recommended that you complete the full course of treatment as prescribed, even if your symptoms improve before you have finished.
What are the interactions of Fluconazole with other drugs?
Fluconazole may interact with other medicines, potentially reducing their effectiveness or increasing the risk of side effects. It is important to tell your doctor about all medicines you take, including prescription and over-the-counter medicines and herbal supplements. This list may not describe all possible interactions between fluconazole and other medications:
1. Medicines that may increase the risk of side effects Fluconazole may increase the concentration and duration of certain drugs in your body, which may increase the risk of fluconazole tablet side effects. Some examples include
- Warfarin and other blood thinners: Fluconazole may increase the effects of blood thinners, increasing the risk of bleeding. Close monitoring of blood coagulation parameters is necessary.
- Phenytoin, carbamazepine, and other anticonvulsants: Fluconazole may increase the blood levels of these drugs.
- Rifampin: Rifampin may decrease the concentration of fluconazole in the body, which may decrease its effectiveness.
2. Medications that may decrease the effectiveness of fluconazole Certain medications may decrease the level of fluconazole in your body, making it less effective in treating fungal infections. Some examples include
- Rifampin and rifabutin: These antibiotics can lower the levels of fluconazole in your body, reducing its antifungal activity.
- Certain antacids and medicines that reduce stomach acid: Taking fluconazole with antacids containing aluminum or magnesium, or with proton pump inhibitors (such as omeprazole) may reduce the absorption of fluconazole.
3. What may interact with fluconazole? Fluconazole may affect the levels and effects of certain medications. Some examples are
- Tacrolimus and cyclosporine: Fluconazole may increase the blood levels of these immunosuppressants, requiring careful monitoring and dose adjustment.
- Certain statins (cholesterol-lowering medicines): Fluconazole may increase the risk of muscle fluconazole tablet side effects when used with certain statins such as atorvastatin and simvastatin.
*Disclaimer: Please note that the information provided in this article is for educational purposes only and should not replace professional medical advice. Consult a healthcare professional for personalized guidance and recommendations regarding the Fluconazole tablet uses and fluconazole tablet side effects.
Author Contribution: Reviewed by Dr Ram Reddy, MD – General Physician, and Rajeshwar Rao, Pharm D.