Diflucan (Fluconazole)

Drug Info

• Brand Name: Diflucan;
• Active Ingredient: Fluconazole;
• Manufacturer: Pfizer.

Active substance Fluconazole

Fluconazole is the main drug substance of Diflucan.

This active ingredient is effective in most fungal diseases that are caused by: Candida spp., Microsporum spp., Trychoptyton spp., Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis, Cryptococcus neoformans.

After oral intake, Fluconazole is very well absorbed in the gastrointestinal tract and penetrates into all body fluids. Its concentration in saliva, sputum, cerebrospinal fluid is almost the same as in blood plasma, due to which maximum efficiency is achieved in the treatment of fungal infections of any localization.

Fluconazole has a very simple action mechanism. When it gets into the body, a change occurs in the cytochrome P450 protein system. Most pathogenic microorganisms, including fungi, are directly dependent on the oxidative and reduction processes that are created by these proteins. By inhibiting this system of enzymes, Fluconazole inhibits the ability of pathogenic fungi to reproduce.

Unlike many other antifungal medicines, Diflucan does not inhibit cytochrome P450 enzymes throughout the body. It acts only in pathogenic cells, due to which the body does not suffer during the use of this drug.

Diflucan is considered one of the safest antifungal medications.

Indications for use

Diflucan has a wide range of use due to its activity against most known pathogens of fungal diseases, namely:

• All forms of candidiasis (genital, skin, candidiasis of the mucous membranes of the mouth cavity, etc.);
• Cryptococcal meningitis;
• Prevention of cryptococcosis in immunocompromised patients;
• Skin mycoses;
• Pityriasis versicolor;
• Mycosis of the skin of legs and nails.

This drug can be used for candidiasis against the background of immunodeficiency and immunosuppressive therapy.

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Treatment regimens and dosages

Diflucan is produced in a very wide range of dosages: 50 mg; 100 mg; 150 mg and 200 mg. In addition, Fluconazole tablets are available at a dosage of 400 mg for patients who have a reduced sensitivity to the drug, or need a loading dose to quickly stop fungal activity.

This range of dosages allows you to choose the most accurate treatment regimen, depending on the type of fungal infection, its localization and severity.

The dosage regimen is selected individually in each clinical case.

• Genital candidiasis is the easiest to treat. Most patients only need to take 1 tablet of Diflucan 150 mg to suppress the activity of pathogenic fungi. If necessary, the therapy is repeated after 2 weeks by taking one more tablet of Diflucan 150 mg;
• In the treatment of candidiasis of the mucous membranes of the mouth cavity, pharynx or esophagus, Diflucan dosage is 50 mg per day for 2–4 weeks;
• With pityriasis versicolor, Diflucan is taken 300 mg once a week for 2 weeks. The use of two tablets of Diflucan 150 mg at a time will not cause side effects if there is a long interval before the next dose;
• For onychomycosis, Diflucan 150 mg is taken once a week. Treatment continues until the infected nail is replaced. It takes 3–6 months and 6–12 months for the replacement of fingernails and toenails, respectively.

The peculiarity of the use of Diflucan for nail and skin fungus is that the dosage is small but the treatment is long. In extreme cases, a slight increase in the dose of Diflucan by up to 200 mg per week is allowed.

Recommendations for use

Fungi are very difficult to treat, and quite often they develop resistance to antifungal drugs. Interruption of treatment leads to relapse. So, the tablets should be used according to the instructions.

• Treatment should not be stopped until a complete cure, as pathogens can develop resistance to the action of Fluconazole, and subsequent therapy will be ineffective;
• Food does not affect the rate of absorption of active substances in the intestines and their bioavailability, so Diflucan tablets can be taken both on an empty stomach and after meals;
• Diflucan can be taken by children, but the treatment regimen in this population requires individual dose titration.

Missed Dose

As a rule, Diflucan tablets are taken only once a day. If you forget to take a dose during the day and your next dose is less than 12 hours away, wait until the next dose. Take only 1 tablet as directed. Don’t take a double or triple dose to make up for missed doses of Diflucan.

Precautions

• When taking Diflucan in HIV, the risk of skin allergic reactions increases;
• With long use of Diflucan, it is recommended to regularly monitor the functions of the liver and kidneys, since 80 % of the drug is excreted through the kidneys;
• The hepatotoxic effect of Fluconazole is usually reversible, the symptoms disappear after discontinuation of therapy, but a more comfortable therapy withdrawal requires the use of hepatoprotectors;
• In organic heart disease, Fluconazole is contraindicated.

For children under 3 years of age, patients with liver failure, patients with lactose intolerance, Diflucan is strictly contraindicated.

Diflucan during pregnancy

Diflucan use should be avoided during pregnancy unless the fungal infection threatens the life of a pregnant woman. The decision to prescribe the drug during pregnancy can only be made by a professional doctor with experience in using this medication in pregnant women.

Possible side effects

Usually, Diflucan does not cause severe side effects and is well tolerated. According to patient feedback on Diflucan, the most frequent symptoms are as follows:

• Dizziness;
• Muscle cramps;
• Abdominal pain;
• Skin rash/itching.

Also, during treatment, changes in blood counts, kidney or liver function are possible. With continued use of tablets (more than 2 weeks), it is recommended to check these functions and monitor the functioning of the body.

Diflucan: interaction with other drugs

Fluconazole has a fairly long list of interactions with other drugs. Specifically, it is contraindicated to use Fluconazole-based medications with a number of drug groups, namely:

• Anticoagulants;
• Benzodiazepines;
• Oral contraceptives;
• Sulfonylureas.

Also, special care should be taken when using Diflucan together with: Azithromycin, Cisapride, Cyclosporine, Rifampin, and Theophylline.

Storage

Store in a dark place, out of the reach of children, at a temperature not exceeding 30°C.

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