Indications
Fluconazole, a member of the triazole class of antifungal agents, inhibits fungal enzymes essential for ergosterol synthesis. It is indicated for:
- Vaginal candidiasis: Acute or recurrent. Consider treatment for partners with symptomatic genital candidiasis.
- Mucosal candidiasis: Including oropharyngeal, esophageal, bronchopulmonary, candiduria, mucocutaneous, and chronic oral atrophic candidiasis.
- Dermal Infections: Including tinea pedis, cruris, versicolor, and nail fungal infections.
- Systemic Candidiasis: Including candidemia, disseminated candidiasis, and invasive infections in various organs.
- Cryptococcosis: Including cryptococcal meningitis and infections in immunocompromised patients.
- Prevention: For fungal infections in immunocompromised patients at risk, such as those undergoing chemotherapy or bone marrow transplant.
Additional Uses:
- Fungal urinary tract infections
- Disseminated candidiasis
- Prophylaxis for fungal infections in neutropenic cancer patients
- Acute treatment of systemic fungal infections like coccidioidomycosis and histoplasmosis.
Pharmacology
Fluconazole inhibits fungal cytochrome P-450 enzymes, crucial for ergosterol synthesis in cell membranes.
Dosage & Administration
- Adults: Dosage varies based on infection type and severity.
- Children: Dosage adjusted by weight and age, with special considerations for neonates and those with renal impairment.
Interaction
Fluconazole may interact with drugs like warfarin, sulfonylureas, hydrochlorothiazide, phenytoin, rifampicin, and contraceptives, affecting their plasma levels or efficacy.
Contraindications
Avoid fluconazole in patients with known hypersensitivity to the drug or related compounds.
Side Effects
Common side effects include gastrointestinal symptoms, while severe reactions like anaphylaxis are rare.
Pregnancy & Lactation
Due to potential fetal effects, avoid fluconazole during pregnancy or lactation unless absolutely necessary.
Precautions & Warnings
Monitor patients with serious underlying diseases for hepatic, renal, and hematological abnormalities. Discontinue treatment if severe cutaneous reactions occur.
Use in Special Populations
Dosage adjustments are necessary for the elderly and those with renal impairment or undergoing hemodialysis.
Overdose Effects
Supportive measures may suffice in case of overdose, with hemodialysis decreasing plasma levels significantly.
Therapeutic Class
Fluconazole belongs to the class of drugs used for subcutaneous and mycoses.
Storage Conditions
Store fluconazole in a dry place, away from light and heat, and out of reach of children.
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