Fluconazole

Fluconazole is a antifungal (triazole) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Vaginal candidiasis (vaginal thrush)
• Oral and oesophageal candidiasis
• Fungal skin infections (tinea/ringworm, pityriasis versicolor)
• Fungal nail infections (onychomycosis)
• Cryptococcal meningitis and other systemic fungal infections
• Prevention of fungal infections in immunocompromised patients

The dose of Fluconazole depends entirely on the type of infection. For vaginal thrush, a single 150 mg dose is often sufficient. Skin infections may need 150 mg once weekly for 2–4 weeks, while nail or systemic infections need higher doses for weeks to months. Only your doctor can decide whether you need a single dose or a longer course — do not guess by yourself. Fluconazole can be taken with or without food. Children's doses are based on body weight and must be set by a doctor.

This is an antifungal — if a course is prescribed, complete it fully even when symptoms improve, and do not use it without a prescription.

Fluconazole is generally well tolerated. Common side effects include nausea, abdominal discomfort, diarrhoea, headache, and skin rash. Less commonly it may alter taste or cause dizziness. Rare but serious effects include liver problems (yellowing of eyes or skin, dark urine, persistent vomiting), severe skin reactions with blistering or peeling, and heart rhythm changes at high doses. Stop the medicine and see a doctor immediately if any of these serious signs appear.

Use fluconazole with caution if you have liver disease, kidney disease, or heart rhythm problems (long QT). Your doctor may adjust the dose in kidney impairment for multi-dose courses. If a rash develops during treatment, report it promptly; stop the drug if the rash spreads or blisters. People with recurrent thrush (four or more episodes a year) should see a doctor to look for underlying causes such as diabetes rather than repeatedly self-treating.

Fluconazole inhibits liver enzymes and raises the levels of many drugs, including warfarin (bleeding risk), phenytoin, sulfonylurea diabetes medicines like glibenclamide and glimepiride (risk of low blood sugar), statins (muscle damage risk), and tacrolimus or ciclosporin. It must not be combined with cisapride, terfenadine, or erythromycin in high doses due to dangerous heart rhythm effects. Rifampicin lowers fluconazole levels. Tell your doctor and pharmacist about every medicine you take.

Fluconazole is contraindicated in people with known allergy to fluconazole or other azole antifungals. It must not be taken with cisapride or terfenadine. Repeated or high-dose use is contraindicated in pregnancy unless a specialist decides otherwise. Significant caution or avoidance applies in severe liver disease and in patients with congenital long QT syndrome.

Pregnancy: Avoid fluconazole in pregnancy, especially repeated or high doses in the first trimester, which have been linked to birth defects and miscarriage risk. For vaginal thrush in pregnancy, doctors usually prefer topical treatments. Lactation: A single 150 mg dose is generally considered compatible with breastfeeding, but longer courses should only be used on a doctor's advice. Always inform your doctor if pregnant or breastfeeding.

Store below 30°C in a dry place away from direct sunlight and moisture. Keep capsules in the original blister pack until use and keep all medicines out of the reach of children. Reconstituted suspensions should be used within the period stated on the label. Do not use after the expiry date.