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FluconazoleSystematic (IUPAC) name2-(2,4-difluorophenyl)-1,3-bis(1H-1,2,4-triazol-1-yl)propan-2-olIdentifiersCAS number86386-73-4ATC codeD01AC15 J02AC01PubChem3365DrugBankAPRD00327ChemSpider3248Chemical dataFormulaC13H12F2N6O Mol. mass306.271 g/molPharmacokinetic dataBioavailability>90%Protein binding11–12%MetabolismHepatic 11%Half life30 hours (range 20-50 hours)ExcretionRenal 61–88%Therapeutic considerationsPregnancy cat.D (Au), C (U.S.)Legal statusS3/S4 (Au), POM (UK), ℞-only (U.S.)RoutesOral, IV, topicalFluconazole (INN) (pronounced /fluːˈkɒnəzoʊl/) is a triazole antifungal drug used in the treatment and prevention of superficial and systemic fungal infections. In a bulk powder form, it appears as a white crystalline powder, and it is very slightly soluble in water and soluble in alcohol. It is commonly marketed under the trade name Diflucan or Trican (Pfizer). In Mexico it is sold over the counter as Alfumet.// Pharmacology Mode of actionLike other imidazole- and triazole-class antifungals, fluconazole inhibits the fungal cytochrome P450 enzyme 14α-demethylase. Mammalian demethylase activity is much less sensitive to fluconazole than fungal demethylase. This inhibition prevents the conversion of lanosterol to ergosterol, an essential component of the fungal cytoplasmic membrane, and subsequent accumulation of 14α-methyl sterols. Fluconazole is primarily fungistatic, however may be fungicidal against certain organisms in a dose-dependent manner. Interestingly, when fluconazole was in development at Pfizer it was decided early in the process to avoid producing any chiral centers in the drug so that subsequent synthesis and purification did not encounter difficulties with enantiomer separation and associated variations in biological effect. A number of related compounds were found to be extremely potent teratogens and subsequently discarded. MicrobiologyFluconazole is active against the following microorganisms:Blastomyces dermatitidisCandida spp. (except C. krusei and C. glabrata candida albicans)Coccidioides immitisCryptococcus neoformansEpidermophyton spp.Histoplasma capsulatumMicrosporum spp.Trichophyton spp. PharmacokineticsFollowing oral dosing, fluconazole is almost completely absorbed within two hours. Bioavailability is not significantly affected by the absence of stomach acid. Concentrations measured in the urine, tears and skin are approximately 10 times the plasma concentration, while saliva, sputum and vaginal fluid concentrations are approximately equal to the plasma concentration, following a standard dose range of between 100 mg and 400 mg per day. The elimination half-life of fluconazole follows zero order kinetics and only 10% of elimination is due to metabolism, the remainder is excreted in urine and sweat. Patients with impaired renal function will be at risk of overdose as well as patients taking drugs such as warfarin. Clinical use IndicationsFluconazole is indicated for the treatment and prophylaxis of fungal infections where other antifungals have failed or are not tolerated (e.g. due to adverse effects), including:Candidiasis caused by susceptible strains of CandidaTinea corporis, tinea cruris or tinea pedisOnychomycosisCryptococcal meningitisFluconazole can be used first-line for the following indications:CoccidioidomycosisCryptococcosisHistoplasmosisProphylaxis of candidiasis in immunocompromised people DosageDosage, varies with indication and between patient groups, ranging from: a two week course of 150 mg/day for vulvovaginal candidiasis, to 150–300 mg once weekly for resistant skin infections or some prophylactic indications. 500–600 mg/day may be used for systemic or severe infections, and in urgent infections such as meningitis caused by yeast 800 mg/day have been used. Pediatric doses are measured at 6-12 mg/kg/d . A loading dose will be indicated when entering a daily dosage schedule, for example a loading dose of 200 mg on the first day is commonly used with 150 mg/day following that. ContraindicationsFluconazole is contraindicated in patients with:Known hypersensitivity to fluconazole or other azole antifungalsConcomitant use of cisapride, due to risk of serious cardiac arrhythmias (relative contraindication). PrecautionsFluconazole therapy has been associated with QT interval prolongation, which may lead to serious cardiac arrhythmias. Thus it is used with caution in patients with risk factors for prolonged QT interval such as electrolyte imbalance or use of other drugs which may prolong the QT interval (particularly cisapride).Fluconazole has also rarely been associated with severe or lethal hepatotoxicity and liver function tests are usually performed regularly during prolonged fluconazole therapy. Additionally, it is used with caution in patients with pre-existing liver disease.High concentrations of fluconazole have been detected in human breast milk from patients receiving fluconazole therapy, thus its use is not recommended in breastfeeding mothers. Adverse effectsAdverse drug reactions associated with fluconazole therapy include:Common (≥1% of patients): rash, headache, dizziness, nausea, vomiting, abdominal pain, diarrhea, and/or elevated liver enzymesInfrequent (0.1–1% of patients): anorexia, fatigue, constipationRare (<0.1% of patients): oliguria, hypokalaemia, paraesthesia, seizures, alopecia, Stevens-Johnson syndrome, thrombocytopenia, other blood dyscrasias, serious hepatotoxicity including hepatic failure, anaphylactic/anaphylactoid reactionsVery rare: prolonged QT interval, torsades de pointes Drug interactionsFluconazole is an inhibitor of the human cytochrome P450 system, particularly the isozymes CYP2C9 and CYP3A4. In theory, therefore, fluconazole decreases the metabolism and increases the concentration of any drug metabolised by these enzymes. Additionally, its potential effect on QT interval increases the risk of cardiac arrhythmia if used concurrently with other drugs that prolong the QT interval.
The indications and use of Diflucan (fluconzole) is in vaginal candidiasis.Diflucan for oral thrush is use because this infection is cause by yeast or fungus pathogen in the area of the mouth and tongue.Diflucan or Fluconazole is the name for this medication used in the treatment and prevention of superficial or systemic fungal infections, is a broad-spectrum antifungal agent.Diflucan for candida infection treatment is antifungal agents, that can be use by several administration route. Is available in tablets, oral suspension, cream and intravenouns solution.What is Diflucan And How It Can Cure Yeast InfectionsHave a yeast infection? Information nursing mothers need to know about breastfeeding and Diflucan for thrush treatment. Diflucan This medicination is indicated and use by your doctor for the treatment of vaginal candidiases,oropharyngeal, esophageal candidiasis, Cryptococcal meningitis and ot. Many women consider taking diflucan for vaginal yeast infections. Say NO to prescription Yeast Infection Diflucan method. This article includes information on the Candida diet, Herxheimer reaction, and the use of natural antifungals such as caprylic acid and medications such as nystatin and diflucan. The most common pathogen cause this oral infection is Candida albicans who cause lesion in the mucous membranes of the mouth.The pharmaceutical firm Pfizer confirmed on Wednesday
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