| name | Fluconazole |
| classification | Azole antifungal |
| pharmacokinetics | | absorption | Well absorbed orally; peak plasma concentrations within 0.5-4 hours after administration | | distribution | Widely distributed throughout tissues and fluids, including cerebrospinal fluid; high concentrations in the kidneys and lungs | | metabolism | Primary metabolism in the liver by CYP2C19 and other enzymes; hepatic clearance is significant | | excretion | Primarily excreted in urine as metabolites. Elimination half-life is approximately 30 hours |
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| suggested dosage | | adult male 25yrs 70kg | | typical dosage for most indications | 150-400mg/day (depending on infection type & severity). Dosage adjustments may be required in patients with renal impairment. | | dosage examples | | 1 | | infection | Oral candidiasis | | dosage | 150mg/day x 7-14 days |
| | 2 | | infection | Vulvovaginal candidiasis | | dosage | 150mg single dose or 150mg/day x 1-3 days |
| | 3 | | infection | Cryptococcal meningitis | | dosage | 400mg/day |
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| indications | | 1 | Oral candidiasis | | 2 | Vulvovaginal candidiasis | | 3 | Ornithosis | | 4 | Cryptococcal infections | | 5 | Systemic fungal infections (e.g., candidiasis, aspergillosis) | | 6 | Coccidioidomycosis | | 7 | Histoplasmosis | | 8 | Blastomycosis |
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| safety in pregnancy | | category c | Fluconazole is generally considered category C during pregnancy. Potential risks exist, but efficacy may be important for maternal health. Thorough discussion with the physician is crucial. | | precautions | Use is only recommended if potential benefit outweighs risk. Always follow clinical guidelines and consult with the prescribing physician |
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| safety in breastfeeding | | potential exposure | Fluconazole is excreted into breast milk. Potential risks to the infant must be weighed against maternal benefits. Consult a healthcare provider before using during breastfeeding. | | precautions | Monitor the infant for potential adverse effects. Use of the lowest effective dose for the shortest duration is recommended |
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| side effects | | 1 | Gastrointestinal upset (nausea, vomiting, diarrhea) | | 2 | Headache | | 3 | Rash | | 4 | Hypersensitivity reactions (e.g., skin rash, itching, swelling) | | 5 | Hepatic dysfunction | | 6 | Cardiac arrhythmias (rare) |
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| contraindications | | 1 | Hypersensitivity to fluconazole or other azole antifungals | | 2 | Severe hepatic impairment |
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| interactions | | 1 | CYP2C9 and 2C19 substrates may have altered clearance by fluconazole, potentially leading to drug-drug interactions. Common drugs that could interact are warfarin, oral contraceptives, and others. | | 2 | Potentially increased risk of cardiac events in combination with some medications |
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| warnings and precautions | | 1 | Monitor liver function tests, particularly with prolonged or higher doses | | 2 | Avoid alcohol while taking fluconazole | | 3 | Caution in patients with renal impairment or pre-existing liver conditions | | 4 | Consider the possibility of interactions with other medications |
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| additional information | | monitoring | Routine monitoring for side effects is important, especially liver function tests, particularly during long-term or high-dose therapy | | patient education | Advise patients to report any unusual symptoms immediately to their prescribing physician, including any skin rash or changes in liver function tests. Adhere to the prescribed regimen | | special considerations for 25 year old male | Generally, fluconazole is well tolerated in young adults but careful consideration of potential drug interactions, especially with concurrent use of other medications, is crucial. |
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