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Diflucan is a common synthetic antifungal drug of the triazole group. It is prescribed for the treatment and prevention of candidiasis, meningitis and some other mycoses. This antibacterial agent should be taken as prescribed.Buy Now
Diflucan is an antifungal drug of the triazole series. It is a potent selective inhibitor of sterol synthesis in the fungal cell.
- Cryptococcosis, including cryptococcal meningitis and infections at other sites (eg, lungs, skin), incl. in patients with a normal immune response and in AIDS patients, organ transplant recipients and patients with other forms of immunodeficiency; maintenance therapy to prevent relapse of cryptococcosis in AIDS patients;
- Generalized candidiasis, including candidemia, disseminated candidiasis and other forms of invasive candidiasis, such as infections of the peritoneum, endocardium, eyes, respiratory and urinary tract, incl. in patients with malignant tumors in the ICU and receiving cytotoxic or immunosuppressive drugs, as well as in patients with other factors predisposing to the development of candidiasis;
- Candidiasis of the mucous membranes, including the mucous membranes of the oral cavity and pharynx, esophagus, non-invasive bronchopulmonary infections, candiduria, mucocutaneous and chronic atrophic oral candidiasis (associated with wearing dentures), incl. in patients with normal and suppressed immune function; prevention of recurrence of oropharyngeal candidiasis in AIDS patients;
- Genital candidiasis; acute or recurrent vaginal candidiasis; prevention in order to reduce the frequency of vaginal candidiasis relapses (3 or more episodes per year); candidal balanitis;
- Prevention of fungal infections in patients with malignant tumors predisposed to the development of such infections as a result of cytotoxic chemotherapy or radiation therapy;
- Mycoses of the skin, including mycoses of the feet, body, groin, pityriasis versicolor, onychomycosis, and skin candidal infections;
- Deep endemic mycoses in patients with normal immunity, coccidioidomycosis.
|Treatment for cryptococcal meningitis||400 mg on the first day, then 200-400 mg once a day for 6-8 weeks or more if necessary. Sometimes the drug dose is increased to 800 mg.|
|Preention of cryptococcal meningitis||200 mg once a day until your doctor stops taking the drug.|
|Treatment of coccidioidomycosis||200-400 mg once a day for 11-24 months or more as required. Sometimes the drug dose is increased to 800 mg.|
|Treating a fungal infection of the blood or internal organs caused by candida||800 mg on the first day, then 400 mg once a day until your doctor withdraws the drug intake.|
|Treatment of the mucous membranes of the oral cavity, pharynx infections, as well as the treatment of prosthetic stomatitis||200-400 mg on the first day, then 100-200 mg once a day until your doctor withdraws the drug intake.|
|Treatment of thrush of the mucous membranes – the drug dose depends on the infection location||50–400 mg once a day for 7–30 days until your doctor withdraws the drug intake.|
|Prevention of re-development of the mucous membranes of the oral cavity and pharynx infections||100-200 mg once a day or 200 mg 3 times a week, during the period when there is a risk of infection.|
|Treatment of genital candidosis||Single dose of 150 mg|
|Reducing the frequency of recurrent vaginal yeast infections||150 mg once every 3 days, for a total of 3 doses (on days 1, 4 and 7), then once a week for 6 months, during the period when there is a risk of infection.|
|Treatment of fungal infections of the skin and nails||Depending on the infection location: 50 mg once a day, 150 mg once a week, 300-400 mg once a week for 1-4 weeks (treatment of the athlete’s foot can be up to 6 weeks, treatment of a nail infection continues at the site of the infected nail).|
|Prevention of candida infection (if the immune system is weakened)||200-400 mg once a day, during the period when there is a risk of infection.|
The drug is usually very well tolerated.In clinical and post-marketing studies of Diflucan, the adverse reactions described below were noted.
- The nervous system: headache, dizziness, convulsions, taste change, paresthesia, insomnia, drowsiness, tremors.
- The digestive system: abdominal pain, diarrhea, flatulence, nausea, dyspepsia, vomiting, oral mucosa dryness, constipation.
- The hepatobiliary system: hepatotoxicity, in some cases with a fatal outcome, increased concentration of bilirubin, serum aminotransferase activity (ALT and AST), alkaline phosphatase, liver dysfunction, hepatitis, hepatocellular necrosis, jaundice, cholestasis, hepatocellular damage.
- The skin: rash, alopecia, exfoliative skin lesions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, acute generalized exanthematous pustulosis.
- The hematopoietic system: leukopenia, including neutropenia and agranulocytosis, thrombocytopenia, anemia.
- The immune system: anaphylaxis (including angioedema, facial edema, urticaria, itching).
- The cardiovascular system: an increase in the QT interval on the ECG, ventricular tachysystolic arrhythmia of the “pirouette” type.
- The side of metabolism: increased concentration of cholesterol and triglycerides in blood plasma, hypokalemia.
- The musculoskeletal system: myalgia.
- Others: weakness, asthenia, increased fatigue, fever, excessive sweating, vertigo.
- Simultaneous administration of terfenadine during repeated use of fluconazole at a dose of 400 mg/day or more;
- Simultaneous use with drugs that increase the QT interval and are metabolized by the CYP3A4 isoenzyme, such as cisapride, astemizole, erythromycin, pimozide and quinidine;
- Hypersensitivity to fluconazole, other components of the drug, or azole substances with a structure similar to fluconazole.
With care: impaired liver function indicators; impaired renal function; the appearance of a rash against the background of the use of fluconazole in patients with superficial fungal infection and invasive/systemic fungal infections; simultaneous use of terfenadine and fluconazole at a dose of less than 400 mg/day; potentially proarrhythmic conditions in patients with multiple risk factors (organic heart disease, electrolyte imbalance and concomitant therapy that promotes the development of such disorders).
Pregnancy and lactation
There have been no adequate and well-controlled studies of the drug safety in pregnant women. During pregnancy, the use of fluconazole should be avoided, except in cases of severe and potentially life-threatening fungal infections, when the expected benefit of treatment to the mother outweighs the possible risk to the fetus. It is necessary to consider effective methods of contraception in women of childbearing age during the entire period of treatment and for about a week (5-6 half-lives) after taking the last drug dose.
Fluconazole is found in breast milk in concentrations close to plasma levels, so its use in women during breastfeeding is not recommended.
In one case of an overdose of Diflucan, a 42-year-old patient infected with HIV developed hallucinations and paranoid behavior after taking 8200 mg of fluconazole. The patient was hospitalized, his condition returned to normal within 48 hours.
Treatment: in case of an overdose, symptomatic therapy (including supportive measures and gastric lavage) is performed. Diflucan (Fluconazole) is excreted mainly in the urine, so forced diuresis is likely to accelerate its excretion. A 3-hour hemodialysis session reduces plasma fluconazole levels by about 50%.