Can Diflucan (fluconazole) cause nausea?

Does Diflucan (Fluconazole) Cause Nausea?

Yes, fluconazole (Diflucan) does cause nausea, which is one of its most common side effects, occurring in approximately 3.7% of patients taking the medication for 7 or more days. 1

Frequency and Characteristics of Nausea

• Nausea is the most frequent gastrointestinal adverse effect of fluconazole, according to the Centers for Disease Control and Prevention, though it occurs in a minority of patients and is generally mild and transient 2

• In patients receiving multiple doses for various infections, nausea occurred in 3.7% of over 4,000 patients treated in clinical trials lasting 7 days or more 1

• For single-dose therapy (150 mg for vaginal candidiasis), 7% of patients experienced nausea, making it the second most common side effect after headache 1

Comparison to Other Antifungals

• Fluconazole causes gastrointestinal symptoms less frequently than ketoconazole, which affects 10-40% of patients with similar symptoms 2

• The overall tolerability profile of fluconazole is favorable compared to other azole antifungals, with gastrointestinal complaints being generally mild 3, 4

Other Common Gastrointestinal Effects

Beyond nausea, fluconazole can cause additional gastrointestinal symptoms:

• Vomiting (1.7%) 1
• Abdominal pain (1.7%) 1
• Diarrhea (1.5%) 1
• Dyspepsia (1%) 2, 1

Clinical Management Considerations

• Most gastrointestinal side effects are mild to moderate in severity and do not require discontinuation of therapy 1

• Only 1.5% of patients discontinued fluconazole due to adverse clinical events in trials, indicating that nausea and other side effects are generally tolerable 1

• Taking fluconazole with food may help reduce gastrointestinal symptoms, though the medication can be taken with or without food 1

Special Population Considerations

• HIV-infected patients report adverse events more frequently (21%) compared to non-HIV infected patients (13%), though the pattern of side effects remains similar between groups 1

• The incidence of nausea and other adverse effects appears somewhat higher in patients with AIDS compared to HIV-negative cohorts, but the qualitative pattern is consistent 3