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BASICS MEDICAMENTS GLOSSARY

Fluconazole

Brand names

  • Apo-Fluconazole
  • Diflucan
  • Nu-Flucon

Usage

To treat fungal infections of the mouth and throat, such as candidiasis (thrush), of the vagina (yeast infection), or throughout the body, as well as meningitis (inflammation of the protective membranes surrounding the brain). Often used to treat AIDS-related fungal infections. May also be used to prevent recurring fungal infections in susceptible patients weakened by AIDS or by chemotherapy or radiation treatment.

How it works

Fluconazole prevents fungal organisms from manufacturing vital substances required for their growth and function. This medicament is effective only for infections caused by fungal organisms. It will not work for bacterial or viral infections.

Side effects

Serious
Skin rash or itching, fever or chills. Seek medical help right away.
Common
No common side effects have been reported with the use of fluconazole.
Less common
Diarrhea, nausea, vomiting, constipation, dizziness, headache, redness or flushing of skin.

Possible interactions

Other medicaments:

    Fluconazole may increase the effects of:

  • benzodiazepines.
  • celecoxib (Celebrex).
  • dofetilide (Tikosyn).
  • felodipine (Plendil).
  • oral antidiabetic medicaments (chlorpropamide, glipizide, glyburide, tolbutamide, others) and cause hypoglycemia; check sugar levels carefully.
  • phenytoin (Dilantin, etc.) or fosphenytoin (Cerebyx) and cause phenytoin or fosphenytoin toxicity; monitor blood levels.
  • serolimus (Rapamune), and tacrolimus (Prograf). Serolimus and tacrolimus levels should be used to guide dosing.
  • triazolam (Halcion), leading to toxicity.
  • tricyclic antidepressants.
  • trimetrexate (Neutrexin).
  • warfarin (Coumadin) and cause unwanted bleeding. Dosing changes and more frequent INRs are prudent.
  • zidovudine (AZT) and result in toxicity. The zidovudine dose may need to be decreased if this combination is to be continued.
  • The following medicaments may decrease the effects of fluconazole:

  • cimetidine (Tagamet).
  • rifampin (Rifadin, Rimactane, etc.).
  • Fluconazole taken concurrently with:

  • amphotericin B (Amphotec, others) may decrease amphotericin benefits.
  • astemizole (Hismanal) may result in fatal toxicity to the heart.
  • atorvastatin (Lipitor), and other HMG-CoA inhibitors, may increase risk of muscle toxicity.
  • cisapride (Propulsid) may lead to adverse effects on the heart.
  • hydrochlorothiazide (Esidrix, others) may increase potassium loss.
  • loratadine (Claritin) may result in increased blood levels of loratadine, but to date, toxicity to the heart has not been reported. Since blood levels may be increased if combined use is undertaken, it is prudent to decrease the dose of loratadine.
  • losartan (Cozaar) may blunt blood pressure control.
  • oral contraceptives (birth control pills) may blunt contraception and result in pregnancy.
  • quetiapine (Seroquel) may lead to quetiapine toxicity.
  • ritonavir (Norvir) may increase ritonavir blood levels.
  • terfenadine (Seldane) may result in toxicity to the heart.
Foods:
Caution is advised regarding grapefruit or grapefruit juice. Avoid eating grapefruit for an hour after taking this medicine.
Herbal medicines or minerals:
Echinacea: some patients use Echinacea to attempt to boost their immune systems. Unfortunately, use of Echinacea is not recommended in people with damaged immune systems. This herb may also actually weaken any immune system if it is used too often or for too long a time.
Beverages:
Grapefruit juice should be avoided.
Discontinuation:
Take all of the medicine. Ongoing therapy for months may be needed. Ask your doctor when it is okay to stop this medicine.

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