Fluconazole

The US label lists vaginal candidiasis (yeast infection), and candidiasis of the mouth, throat and oesophagus.

It was also effective in small studies of Candida infections of the urine, abdomen and blood.

It is used for cryptococcal meningitis, and to reduce candidiasis in bone marrow transplant patients receiving chemotherapy or radiation.

The label asks for fungal cultures before treatment where possible.

• Vaginal candidiasis
• Mouth, throat and oesophagus candidiasis
• Other Candida infections
• Cryptococcal meningitis
• Preventing candidiasis during bone marrow transplant treatment

The label says fluconazole blocks a fungal enzyme, lanosterol 14-alpha-demethylase, that makes ergosterol.

Without normal sterols the fungus cannot grow. The effect is described as fungistatic.

Human cells are much less sensitive to this enzyme block.

For vaginal candidiasis, the US label gives a single 150 mg oral dose.

For mouth and throat candidiasis, it describes 200 mg on the first day, then 100 mg once daily.

For other infections the daily dose depends on the organism and your response. A loading dose of twice the daily dose is generally used on day one.

The oral and intravenous daily dose are the same. The label notes that too short a course may allow the infection to come back.

Indian pack labels may differ from the US label, and your prescriber's instruction always comes first.

Use with caution in liver disease. The label reports rare serious hepatic toxicity, including deaths, mostly in people with serious underlying illness.

It can prolong the QT interval. Caution is advised in low potassium, advanced heart failure and with other QT-prolonging medicines.

Pregnancy: the label says avoid it except in severe or life-threatening infection. Birth defects were described after high-dose use in the first trimester.

Breastfeeding: low levels pass into breast milk after a single 150 mg dose.

Children: it has been studied in children aged 6 months to 13 years for mouth and throat candidiasis.

Older adults: the label notes more reports of anaemia and acute kidney failure in people aged 65 and older.

Allergy: the label advises caution if you are allergic to other azole antifungals.

• Contraindicated: erythromycin, pimozide, quinidine
• Medicines cleared by CYP2C9, CYP2C19 and CYP3A4 need checking
• Effect persists 4 to 5 days after stopping
• Fluconazole is a moderate inhibitor of CYP2C9 and CYP3A4 and a strong inhibitor of CYP2C19.
• It can raise levels of other medicines cleared by these enzymes.
• The label says erythromycin, pimozide and quinidine are contraindicated with it, because of QT prolongation risk.
• The enzyme-blocking effect lasts 4 to 5 days after the last dose.
• The label gives a long list of interacting medicines, so share your complete medicine list with your doctor and pharmacist.

No match in this label text. Ask your pharmacist about any medicine you take.

The label reports hallucination and paranoid behaviour after overdose.

Treatment is supportive. A 3-hour dialysis session lowers blood levels by about half.

Seek medical help at once.

The label says to store tablets at 20 to 25 degrees C. Keep out of children's reach.

We did not find Fluconazole in the Schedule H, H1, X or G lists we checked. Follow your doctor's prescription and the pharmacist's guidance for the pack you have.

Fluconazole is on the National List of Essential Medicines 2022 in these forms: Tablet 400 mg (page 74); Oral liquid 50 mg/ 5 mL (p) (page 74).

NPPA ceiling prices exist for scheduled formulations of fluconazole. They are in the table below.

The Jan Aushadhi (PMBJP) list we checked has 6 product rows for fluconazole.

Fluconazole appears in 3 entries of the banned fixed-dose combination list we checked. Use the banned medicine checker to test a specific combination.

The NPPA ceiling is the highest price per unit for a scheduled formulation, in the list dated 30.09.2020.

The prices below are per unit. Check the pack and seller, because prices can be revised after that date.

Jan Aushadhi lists the fluconazole products below. We did not capture a price for them, so check the store or the official list.

• Capsule 100 mg, per 1 capsule: ceiling INR 25.19
• Capsule 150 mg, per 1 capsule: ceiling INR 18.49
• Capsule 200 mg, per 1 capsule: ceiling INR 36.40
• Oral Liquid 50mg/5ml, per 1 ml: ceiling INR 2.61
• Tablet 100 mg, per 1 tablet: ceiling INR 7.96
• Tablet 150 mg, per 1 tablet: ceiling INR 11.81
• Tablet 200 mg, per 1 tablet: ceiling INR 18.73
• Tablet 400 mg, per 1 tablet: ceiling INR 31.15
• Injection 200 mg/100 ml, per each pack: ceiling INR 106.11
• Jan Aushadhi: Fluconazole Tablets IP 150 mg, pack 1's (row p33:sno742)
• Jan Aushadhi: Fluconazole Dusting Powder 2% w/w, pack 30g (row p81:sno1769)
• Jan Aushadhi: Fluconazole Tablets IP 50 mg, pack 4's (row p91:sno1982)
• Jan Aushadhi: Fluconazole Tablets IP 200 mg, pack 4's (row p91:sno1983)
• Jan Aushadhi: Fluconazole Tablets IP 400 mg, pack 1's (row p91:sno1984)
• Jan Aushadhi: Fluconazole Injection 2mg per ml, pack 100ml Bottle (row p91:sno1985)