Fluconazole
Indications for use
- Treatment of vaginal candidiasis (thrush)
- Treatment of candidal balanitis in sexual partners
Age
- 16–60 years
- Refer patients under 16 or over 60 to their GP
Dose/Directions
- One 150 mg capsule as a single oral dose, swallowed whole with water
Duration
- Single dose treatment
- Symptoms should start to improve within 7 days; if not, refer to GP
Contra-indications/referral criteria
- Hypersensitivity to fluconazole, related azole substances or any of the excipients
- Pregnancy or breastfeeding
- Recurrent thrush (more than two episodes in the last six months) – refer to GP
- Abnormal or irregular vaginal bleeding, blood-stained vaginal discharge, vulval or vaginal ulcers or sores
- Foul-smelling vaginal discharge (may suggest a different infection)
- Associated lower abdominal pain or dysuria
- Adverse side effects following previous use of azole antifungals
Examples of drug interactions
- Warfarin and other coumarin anticoagulants: enhanced anticoagulant effect; monitor INR
- Medicines known to prolong the QT interval and metabolised via CYP3A4 (e.g. cisapride, astemizole, pimozide, quinidine, erythromycin): co-administration is contra-indicated
- Tacrolimus, sirolimus, ciclosporin: fluconazole may increase plasma levels; dose adjustment may be needed
- Sulphonylureas (e.g. glipizide, tolbutamide): increased risk of hypoglycaemia
- Phenytoin: increased plasma levels of phenytoin
- Statins metabolised by CYP3A4 (e.g. atorvastatin, simvastatin): increased risk of myopathy and rhabdomyolysis
Side-effects
- Among the most common: headache, nausea, abdominal pain, diarrhoea, flatulence, rash
Other pertinent information
- Available as Canesten Thrush Oral Capsule, Diflucan One, and generic fluconazole 150 mg capsules
- Patient should be advised that this product treats thrush; if they have not been previously diagnosed with vaginal thrush by a doctor, they should see their GP first to confirm the diagnosis
- May be combined with topical antifungal cream (e.g. clotrimazole) for external symptom relief
- Reclassified POM→P: 1995