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Fluconazole
⚠️ In patients with recurrent fungal infections, always consider testing for HIV if risk factors are present.
📖 About
Always check the BNF link here.
- 💊 Triazole antifungal compound.
- 🧪 Inhibits fungal growth by disrupting sterol synthesis.
⚙️ Action
- 🔬 Inhibits fungal cytochrome P450 enzymes.
- 🧱 Reduces ergosterol synthesis, weakening fungal cell membranes.
🧪 Properties
- 📈 Good oral absorption and distribution, including CSF penetration.
- ⏱️ Long half-life (~30 hours).
- 💧 Primarily eliminated renally.
💉 Indications / Dose
- 👄 Oral candidiasis: 50–100 mg PO OD for 2 weeks.
- 🫁 Oesophageal candidiasis: 50–100 mg PO OD for 3 weeks.
- 👩 Vaginal candidiasis: 150 mg PO single dose.
- 🦶 Tinea pedis and related dermatophyte infections: 50 mg PO OD for 2–4 weeks.
- 🧠 Invasive candidiasis / cryptococcal meningitis (specialist input): 200–400 mg PO/IV daily for ~12 weeks.
🔄 Interactions
- ⚠️ Potent CYP450 enzyme inhibitor → ↑ toxicity of theophylline, ciclosporin, phenytoin, tacrolimus.
- ⬇️ Reduces clopidogrel efficacy (↓ conversion to active metabolite).
⚠️ Cautions
- 🧪 Stop immediately if signs of hepatotoxicity develop.
- 💓 May prolong QTc interval → caution in cardiac disease.
- 💧 Dose adjustment required in renal impairment.
⛔ Contraindications
- 📌 See BNF for complete list.
💥 Side Effects
- 🤢 GI: nausea, vomiting.
- 🌡️ Hypersensitivity reactions: rash, Stevens–Johnson syndrome, TEN, anaphylaxis.
- 🧪 Hepatic: hepatotoxicity.
- 🧠 Neurological: headache, seizures.
- 🩸 Electrolyte: hypokalaemia.
- 💇 Alopecia (rare with prolonged use).
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