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Antifungal Agent Fluconazole 150 mg: Generic Diflucan

FLUCONAZOLE, also known as Diflucan, belongs to the class of medicines called antifungals. Antifungals kill fungi or stop fungi from multiplying or spreading. When fungal infections occur in individuals with weakened immune systems, including people with HIV, they tend to be more serious and are called opportunistic infections.

Both oral and intravenous formulations of fluconazole are available. It is principally active against Candida spp. and Cryptococcus spp. However, Candida krusei is intrinsically resistant to fluconazole. Also, isolates of Candida glabrata often generate considerably high fluconazole MICs.

Usual Doses

Fluconazole comes in tablet and oral suspension forms taken by mouth and in liquid form that is generally given by intravenous infusion into a vein. The intravenous infusion form is usually reserved for more severe fungal infections. For oropharyngeal candidiasis, and other forms of mucocutaneous candidiasis, fluconazole is typically dosed at 50-150 mg/day. For invasive candidiasis, the commonly applied dose is ~6 mg/kg/day, or 400 mg in the typical 70 kg adult.

Doses of ~12 mg/kg are not FDA-approved, but are used with increasing frequency due to the desire to achieve higher blood levels and thus extend the range of use of the drug. Fluconazole is excreted by the kidneys, and the dose should be reduced in proportion to any reduction of kidney function.

Possible Side Effects

Along with its desired effects, fluconazole may cause some unwanted effects. Such adverse effects include fever and chills; skin rash or itching; sore throat; reddening, blistering, peeling, or loosening of skin and mucous membranes; dark or amber urine; loss of appetite; pale stools; stomach pain; unusual tiredness or weakness; yellow eyes or skin; and unusual bleeding or bruising. Individuals should tell a doctor if they have any of these side effects.

Typical report: "I have been experiencing stomach ache, headache, low back ache, palpitations, taste, nausea. Are these normal side effects? and if not, should I stop taking them. Of course, you can't reach a doctor over the weekend. I have taken 9 doses in 10 days. I forgot to take my normal dose on Friday night and felt great the next day but took one last night when I realized that I had missed a dose, and woke up in the middle of the night feeling sick again. This has been going going on for the last 3 or 4 doses. The reaction usually occurs 4-6 hours after taking the pill."

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Strong allergic reactions to Diflucan, although rare, have been reported. Diflucan passes into breast milk and may be harmful to a nursing baby.

Studies comparing Diflucan to amphotericin B in non-HIV infected patients have not been conducted. Drug interaction: Do not take Diflucan if you are taking cisapride (Propulsid).

Current Status

Fluconazole is a very widely used antifungal agent. It is one of the first-line drugs, particularly in treatment of infections due to Candida spp. other than Candida krusei and some Candida glabrata isolates. Fluconazole is commonly used also for prophylaxis in transplant patients. A doctor should be notified of any other medications being taken, including prescription, nonprescription (over-the-counter), or herbal medications.