From the Guidelines
Diflucan (fluconazole) is an antifungal medication used to treat various fungal infections, and for vaginal yeast infections, a single 150 mg oral dose is typically effective, as recommended by the Infectious Diseases Society of America 1.
Uses of Diflucan
- Vaginal yeast infections: a single 150 mg oral dose is typically effective
- Oral thrush: 200 mg on the first day followed by 100 mg daily for 1-2 weeks is commonly prescribed
- Esophageal candidiasis
- Cryptococcal meningitis
- Certain systemic fungal infections ### Mechanism of Action Diflucan works by inhibiting the fungal enzyme lanosterol 14α-demethylase, which disrupts fungal cell membrane formation.
Important Considerations
- Common side effects include headache, nausea, abdominal pain, and diarrhea
- Patients should be aware that Diflucan can interact with several medications including warfarin, oral hypoglycemics, and certain statins, potentially causing serious adverse effects
- Liver function should be monitored during extended treatment courses
- Diflucan should be taken as directed, and the full course should be completed even if symptoms improve before the medication is finished ### Dosage and Administration
- For patients with invasive candidiasis, fluconazole should be administered with a loading dose of 800 mg (12 mg/kg), followed by a daily dose of 400 mg (6 mg/kg) 2
- A lower dosage is required in patients with creatinine clearance <50 mL/min ### Alternative Treatments
- Itraconazole and voriconazole are alternative treatments for certain fungal infections, but their use is generally reserved for patients who have experienced treatment failure with fluconazole or have specific types of infections 3, 2
From the FDA Drug Label
Fluconazole tablets are indicated for the treatment of: Vaginal candidiasis (vaginal yeast infections due to Candida). Oropharyngeal and esophageal candidiasis In open noncomparative studies of relatively small numbers of patients, fluconazole tablets were also effective for the treatment of Candida urinary tract infections, peritonitis, and systemic Candida infections including candidemia, disseminated candidiasis, and pneumonia. Cryptococcal meningitis Fluconazole tablets are also indicated to decrease the incidence of candidiasis in patients undergoing bone marrow transplantation who receive cytotoxic chemotherapy and/or radiation therapy.
The use of Diflucan (Fluconazole) is for the treatment of various fungal infections, including:
- Vaginal candidiasis
- Oropharyngeal and esophageal candidiasis
- Candida urinary tract infections
- Peritonitis
- Systemic Candida infections
- Cryptococcal meningitis It is also used for prophylaxis to decrease the incidence of candidiasis in patients undergoing bone marrow transplantation 4.
From the Research
Uses of Diflucan (Fluconazole)
- Diflucan (Fluconazole) is used to treat various fungal infections, including: + Candidiasis (oropharyngeal, esophageal, and disseminated forms) 5, 6, 7 + Cryptococcal meningitis 5, 6 + Coccidioidal meningitis 5, 6 + Vaginal candidiasis 8, 9
- It is also used as prophylaxis to prevent fungal infections in immunocompromised patients, such as those with cancer or AIDS 5, 6, 7
- Fluconazole has been shown to be effective in treating infections caused by various fungal species, including Candida spp., Cryptococcus neoformans, Blastomyces dermatitidis, Coccidioides immitis, and Histoplasma capsulatum 5
Administration and Pharmacokinetics
- Fluconazole can be administered orally or intravenously 5
- It is rapidly absorbed after oral dosing and penetrates well into body fluids and tissues, including cerebrospinal fluid 5
- Fluconazole is excreted largely unchanged in urine and has an elimination half-life of approximately 30 hours, allowing for once-daily dosing 5
Efficacy and Tolerability
- Fluconazole has been shown to be effective in treating various fungal infections, with response rates ranging from 50-90% 6
- It is generally well tolerated, with infrequent serious adverse effects or laboratory test abnormalities 5, 6
- However, hepatotoxicity and exfoliative skin reactions have been reported, and wider clinical experience is needed to fully assess the risk of these adverse effects 6