Fluconazole has an accumulation effect. Instructions for use of fluconazole tablets - composition, indications, side effects, analogues and price. Side effects from the liver

The nature of side effects of fluconazole ranges from mild to severe. The most common side effects are mild, such as headache and abdominal pain. Serious side effects may include seizures, fever, and blistering of the skin. An allergic reaction is the most severe potential side effect of fluconazole and requires immediate medical attention.

Fluconazole- it's an antibiotic. It is prescribed for fungal infections and is used to treat infections throughout the body, including the mouth, lungs, bladder and blood. Fluconazole is sold under the trade name Diflucan ®.

The most common side effects of fluconazole are among the mildest. Such side effects include headache, abdominal pain, heartburn and diarrhea. Some patients experience an unpleasant taste in the mouth or experience different taste sensations when eating food. Other side effects include dizziness, itching and vomiting. These problems usually go away gradually, and if they persist or become more severe, you should report them to your doctor.

Some more severe side effects of fluconazole include flu-like symptoms, seizures, fever, and chills.

Patients may also experience loss of appetite, pain in the right upper abdomen, and nausea. Fluconazole may cause severe fatigue, weakness, or lack of energy in some people. This drug may also cause darkened urine or pale or brown stools.

Other serious side effects of fluconazole affect the skin. Side effects include blistering, peeling skin, rashes, and easy bruising or bleeding. Patients who experience any of these side effects of this drug should tell their doctor as soon as possible. Allergic reactions, which may include swelling above the neck, hives, or difficulty breathing, require immediate medical attention.

Fluconazole is taken either in liquid or tablet form, usually once a day, although the dose may depend on the type of infection requiring treatment.

You should not take the drug in doses exceeding those prescribed by your doctor. If an overdose occurs, the most common symptoms are an intense fear of being harmed by others and hallucinations, particularly auditory hallucinations and seeing objects that don't exist.

There are several medical conditions that should be reported to your doctor before starting treatment with fluconazole, as they may make taking this drug too risky. Such conditions include any heart rhythm disorder, liver or kidney disease, and a family or personal history of long QT syndrome, a rare inherited heart condition. It is also important to report alcohol abuse, acquired immunodeficiency syndrome (AIDS), and any type of cancer.

Fluconazole is a fairly serious antifungal drug that has a number of possible side effects, contraindications and drug interactions. Applies to prescription drugs, i.e. can only be prescribed by a doctor, taking into account the individual characteristics of the patient and the disease.

The severity of side effects does not depend on the route of administration of the drug, but on the dose per kg of body weight per day.

It is well absorbed from the intestine (bioavailability more than 90%), food intake does not affect absorption. The maximum concentration in the blood appears within an hour after administration. Penetrates into all tissues, including the brain. Excreted by the kidneys (mainly). Partially affects hormonal levels in men.

Studies on the effect of the drug on pregnant women

High doses of fluconazole negatively affect weight gain in rabbits and increase the frequency of miscarriages. This applies to dosages similar to 20 times the therapeutic dose for humans. With adequate amounts of fluconazole administered to the animal weight, no negative effects from the fetus or mother were identified. The existing negative effects when prescribing high doses are attributed to the moderate effect of the drug on hormonal levels.

For pregnant women, fluconazole is indicated only for severe infections that threaten the life of the mother and/or fetus. Only the attending physician can take responsibility, with a clear comparison of the risks and the expected effect. There are no direct studies of the use of fluconazole in pregnant and lactating women.

There is evidence of developmental abnormalities in children whose mothers were treated with fairly high doses of the drug (for severe fungal diseases), although a direct connection between these facts has not been proven. According to FDA standards, the risk to the fetus is assessed as C, i.e. speculative.

During the mother's therapy, breastfeeding should be stopped, because... fluconazole is contained in breast milk in the same concentrations as in the blood (as already mentioned, it penetrates well into all liquids).

Direct contraindications for use

Individual intolerance to the active substance or components of the dosage form; Simultaneous administration with terfenadine; Combination with quinidine, cisapride, astemizole.

Side effects of the drug

In the USA, a fairly serious study was conducted on 448 patients taking fluconazole in a standard therapeutic dosage, i.e. 150 mg once for the treatment of vaginal candidiasis (thrush). Every fourth person experienced the following side effects while taking the drug:

13% headache; 7% nausea; 6% abdominal pain; 3% diarrhea; 1% dyspepsia; 1% dizziness; 1% taste disturbance.

The rest felt some poorly differentiated negative sensations. In isolated cases, fluconazole causes a severe allergic reaction.

In a larger study (4048 patients), the incidence of complications was observed when fluconazole was combined with other drugs and diseases. The worst combination of fluconazole and cytostatics was in HIV patients. The main side effects were the same as in the first group of subjects.

Effect of fluconazole on the liver (hepatotoxicity)

Sometimes fluconazole causes serious liver complications, including death. When the drug is discontinued, the symptoms of liver damage subside. For this reason, during long courses of treatment with fluconazole, the doctor must periodically prescribe liver tests (AST, ALT, etc.).

In severe cases, the hepatotoxic effect manifests itself in the form of hepatitis, impaired bile outflow (cholestasis), and acute liver failure. All these sad outcomes were observed mainly in patients with HIV, malignant neoplasms, and severe forms of tuberculosis.

This may be due to the parallel use of heavy specific antibiotics: isoniazid, rifampicin, phenytoin, pyrazinamide.

Side effects sometimes observed while taking the drug

A side effect differs from a side effect in that the connection between the event and the use of a specific drug has not been proven. However, manufacturing companies are required to record everything that happens to the patient (control group) during treatment and include it in the instructions:

Convulsions; Skin rashes, Stevens-Johnson syndrome, toxic skin lesions (epidermal necrolysis); Exfoliative dermatitis in patients with AIDS and malignant tumors; Violation of the composition of cellular elements of the blood: leukopenia (decreased number of leukocytes), thrombocytopenia (decreased number of platelets);

Fat metabolism disorders: increased cholesterol levels (hypercholesterolemia), triglycerides;

Decreased potassium levels.

Side effects from taking fluconazole in children

The studies were conducted in the USA and Europe and included 577 children from one day old to 17 years old inclusive. The dosage for all was 15 mg/kg body weight/day for a long period. In total, side effects were identified in 13% of cases:

5.4% vomiting; 2.8% abdominal pain; 2.3% nausea; 2.1% diarrhea.

In 2.3%, treatment was discontinued due to severe side effects.

Interaction with other drugs

Increases the half-life of sugar-lowering tablets (sulfonylureas), which can lead to hypoglycemia. Those. in the case of diabetes insipidus in the elderly, hypoglycemic drugs have a much stronger effect; Slows down the excretion of theophylline and zidovudine, saquinavir, increases the concentration of sirolimus, which may require an additional dose titer of these substances; Increases the concentration of cytostatics, which is important for patients with transplanted internal organs; In combination with anticoagulants (Clexane, rivaroxaban, warfarin), it can provoke different types of bleeding. If a sign of any bleeding is detected while taking fluconazole, the drug is immediately discontinued; When combined with hydrochlorothiazide, which is part of many blood pressure medications (Enap-N, etc.), the concentration of fluconazole increases sharply (one and a half times), which must be taken into account, since the risks of side effects also increase, incl. renal failure; Increases the toxicity of drugs from the NSAID group - diclofenac, meloxicam, naproxen, etc. Given that all of these drugs are routine (and many are over-the-counter), the patient should exercise increased caution when using NSAIDs during treatment with fluconazole; May cause cardiac arrhythmias when combined with quinidine, cisapride, astemizole and other antifungal agents; When taken together with tacrolimus, it can cause renal failure; When combined with midazolam, it can cause mental disorders; Enhances the effect of amitriptyline.

This medicine may cause harm in the following conditions:

Overdose and first aid

Main symptoms: diarrhea, nausea up to vomiting, there may be convulsions.

Skin rashes

Treatment: gastric lavage with parallel administration of diuretics. Hospitalization is required. The admitted patient is sent for three-hour hemodialysis (allowing the concentration of the drug to be reduced by almost 50%), otherwise doctors act according to the circumstances, depending on the type of interaction. As a rule, a similar situation occurs in elderly patients with a large number of concomitant prescriptions.

There is information about one patient who, with an overdose of fluconazole, experienced symptoms of paranoid delusions and hallucinations. Considering that this was a 42-year-old HIV patient (drug addict), such side effects may not be considered typical for an overdose.

If you or your loved ones have been prescribed fluconazole for a long course, try to eliminate the risk of drug interactions, carefully listen to the recommendations of your doctor, and do not drink alcohol during this period. Particular attention should be paid to elderly relatives who are taking many different medications at the same time, since this significantly increases the risk of side effects while taking fluconazole.

Video about the consequences of six months of fluconazole therapy

General practitioner at a city clinic. Eight years ago I graduated from Tver State Medical University with honors.

In recent decades, there has been a pronounced tendency towards an increase in the incidence of opportunistic infections - diseases that do not cause pathological effects in a healthy person, but manifest themselves fully when resistance decreases. Among such infections are vulvovaginal candidiasis, an infectious disease of the external genitalia initiated by fungi of the genus Candida. Fungi are opportunistic flora in a woman’s body, which means the manifestation of a pathogenic effect only under certain conditions - when the activity of the immune system decreases.

A special problem in gynecology is chronic recurrent vulvovaginal candidiasis, the treatment of which is a problem for women and specialists. The modern pharmaceutical industry and the time of antibiotics make it possible to select a treatment for chronic thrush and treat it effectively. One of the most popular and effective antifungal drugs is fluconazole.

Different fluconazole regimens are used to treat different types of thrush, and its effect will depend on the dosage. The following forms of thrush in women are distinguished:

acute thrush;
chronic form;
persistent (constant);
carrier status

In addition, fluconazole is used for prophylactic purposes during antibiotic treatment, before surgical interventions and menstruation.

The cause of the formation of a chronic form of candidiasis is diabetes mellitus, thyroid disease, hormone therapy, including oral contraceptives, and concomitant infectious diseases. The process often becomes chronic during therapy with immunosuppressants, with uncontrolled treatment with antibiotics, the action of which leads to the death of beneficial flora and the proliferation of fungi. It is advisable to use fluconazole while taking antibacterial agents for the purpose of preventive action in the aspect of thrush.

The resistance of yeast-like fungi is another problem in the treatment of the disease. When fighting the symptoms of vulvovaginitis, drug regimens that are inferior in effect are often used, which leads to the gradual formation of resistance. In addition, there is a diversity of candida species that cause a chronic process. In the recurrent form, it is often not Candida albicans that is detected, but other types of fungi; the effect of one or another antifungal agent is not always able to suppress the growth of such fungi.

Features of the use of fluconazole

Depending on the form of the disease and the purpose of use, the age of the patient, fluconazole is used in different regimens and doses.

Treatment of acute thrush and its prevention

When using antibiotics, it is advisable to take 150 mg fluconazole tablets once for prophylactic purposes, and with long-term antibacterial therapy, repeat the same dosage every other week to enhance the antifungal effect.

The prophylactic effect of fluconazole is also used in the following situations:

before gynecological operations;
on the eve of the installation of an intrauterine device;
before diagnostic studies (hysteroscopy);
if necessary, cauterization of the cervix and other interventions associated with diseases of the cervical spine.

For primary acute thrush, a single use of the drug is used in conjunction with local treatment with suppositories. To provide an antifungal effect, a dose of 150 mg is used. If it is necessary to treat a child, the dosage is calculated based on 3-12 mg/kg of weight.

Treatment of the recurrent form

Treatment for exacerbations involves taking fluconazole three times, 150 mg every 72 hours. Gynecologists note that after the main course of treatment with fluconazole, the duration of action of the drug must be extended by repeated dosing of 150 mg once a week for six months. This time of use of fluconazole provides the necessary duration of action for chronic candidiasis. The relapse rate is reduced by 90%. According to ongoing studies, it has been established that such a long period of taking fluconazole does not lead to the development of candida resistance. In addition, there is no significant incidence of side effects from the drug.

For example, the CDC recommends a different treatment regimen for recurrent thrush. The recommended dosage time is two days, 150 mg daily. To prolong the action, a regimen is used for 6 months with a weekly dose of 150 mg of fluconazole.

In addition to these regimens, in case of a chronic process, women are recommended to take fluconazole tablets during the first day of menstruation for 6 months to enhance the antifungal effect of the drug and prolong the effect.

The issue of the effectiveness of the original fluconazole (Diflucan) compared to generics is still being discussed by experts. But the vast majority of studies confirm the same effectiveness when using cheaper generics and original tablets.

Before starting treatment for thrush in all its varieties, time is devoted to a thorough diagnosis:

A bacterioscopy of a vaginal smear is performed to assess the degree of leukocyte infiltration, the nature of the vaginal epithelium (superficial, intermediate and parabasal);
sowing the genital tract secretions for flora and sensitivity to antibiotics, antifungal agents; during the study, the total microbial contamination, the degree of growth of bacteria and candida (weak, moderate, strong growth), the composition of the isolated microflora, the quantitative ratio of species are determined;
cytology smear from the cervical canal to exclude dysplasia and carcinoma;
PCR for viral and bacterial infections.

The discovery during the study of single round yeast cells, the absence of pronounced leukocytosis and superficial squamous epithelium, indicates carriage and this condition does not require therapeutic action. The presence of mycelium, an increase in the number of leukocytes, and the detection of intermediate and parabasal epithelium in large quantities indicate a relapse of chronic thrush and require therapeutic action according to a scheme lasting 6 months. Leukocytosis and yeast in smears, the presence of a clinical appearance in the form of cheesy discharge, itching, hyperemia and burning indicate acute candidiasis. In this case, fluconazole is taken once. Its duration of action is long - several days, so the combination of this regimen with local treatment in the form of suppositories gets rid of the infection quickly.

The fight against persistent or recurrent infection involves monitoring the effect of drugs during therapy. The effect of fluconazole is assessed based on the suppression of disease symptoms, as well as during laboratory diagnostics.

During treatment with fluconazole, laboratory diagnostics are not performed to avoid distortion of the result. To assess the effect of the drug, smears are performed 2 weeks after taking the last tablet. Further, diagnostics are carried out 1 month, 4, 9 and 12 months after therapy.

Effect of fluconazole

The effect of fluconazole does not depend on food intake, so the tablets can be taken before, during and after meals. The drug is well absorbed in the stomach. After an hour and a half, the maximum concentration of the drug is recorded in the blood, which means that the initial relief of itching and burning begins 2-4 hours after taking the tablet. the maximum concentration in the blood is observed on days 4-5, and when using a double dose - on the second day.

Thus, in the treatment of chronic thrush, which involves taking the drug for six months, after stopping the use, fluconazole acts for several more months. This property allows you to use the medication once a day, and when treating acute uncomplicated candidiasis, use it once. In addition, the drug has water-soluble properties, which explains its accumulation in all tissues of the body.

If you have kidney disease, you should be careful during therapy; due to its long action and half-life, fluconazole can damage kidney tissue.

If the remedy is ineffective and symptoms recur, it is necessary to undergo a detailed diagnosis. As a rule, genital tract secretions are inoculated on nutrient media to determine the type of candida and sensitivity to antibiotics. Vaginal microbiocenosis and detection of sexually transmitted infections (chlamydia, urea and mycoplasmosis, genital herpes, HPV) are also examined. Therapy of the sexual partner is mandatory. An important factor in the effectiveness of the fight against thrush is the complete restoration of the lactic acid flora with the help of suppositories (Acilact, Vaginorm, Laktonorm, Ecofemin). During the treatment of candidiasis, the intestinal flora is also normalized with the help of probiotics (Biogaia, Enterozermina, Linex). With intestinal dysbiosis, the chances of chronic infection increase. In addition, wearing synthetic underwear, using tampons, and self-medication in the form of douching are excluded.

Side effects and contraindications

The medication may exhibit side effects during therapy if taken for a long time. As a rule, treatment of acute thrush is not accompanied by adverse events.

Common side effects include:

headache;
dizziness;
perversion of taste;
epigastric pain;
nausea and diarrhea;
allergic rash;
decreased leukocyte levels;
lipid metabolism disorders;

In some cases, hepatitis and jaundice may occur.

Contraindications include:

pregnancy;
breast-feeding;
age up to one year;
individual intolerance.

For kidney diseases, the drug is prescribed in a lower dosage.

Release form

Fluconazole is produced in the form of capsules, tablets for oral administration, and also as a solution for injection. As a rule, capsule or tablet forms of release are used. for severe fungal infections, intravenous injections are used: in HIV-infected people, for generalized lesions of internal organs, skin and mucous membranes.

The dosage of capsules and tablets is 50, 100, 150 mg, and the number of pieces in the package is different, allowing the product to be used both once and for a long time.

The cost of the product depends on the manufacturer and country. Generics, for example, Diflazon, Medoflucon, Mikomax, Mikoflucan, will cost much less than Diflucan. Fluconazole is produced in many countries.

Since the antifungal drug is active against not only candida, but also suppresses the growth of microsporium, cryptococci, trichophyton, it is used for fungal meningitis, pneumonia, skin fungus: lesions of the feet, groin area, nails, and pityriasis versicolor. During the treatment of malignant tumors, the drug is used for the treatment and prevention of fungal infections of the mucous membranes.

Use of fluconazole

Antifungal drug. Effectively suppresses the vital activity of many types of fungi, including malignant neoplasms. Dispensed according to prescription.

Diseases for which fluconazole is used

Generalized candidiasis.
Cryptococcosis. Including as part of maintenance therapy in the treatment of AIDS.
Candidiasis of the mucous membranes.
Prevention of fungal infections in malignant neoplasms.
Genital candidiasis. Treatment and prevention to reduce the risk of relapse.
Deep endemic mycosis, paracoccidioidomycosis, coccidioidomycosis, histoplasmosis, sporotrichosis.
Skin fungal infections.

Types of fluconazole

Capsules:

50 mg AB (active substance).
100 mg AB.
150 mg AB.
200 mg AB.

Suspension:

Infusion solution:

Side effects of fluconazole

Nervous system. Cramps, dizziness, headache.
Digestive system. Nausea, vomiting, stomach pain, dyspepsia, flatulence, diarrhea, digestive disorders.
Skin. Hyperemia, rash, toxic epidermal necrolysis, alopecia, Stevens-Johnson syndrome.
The cardiovascular system. Paroxysmal ventricular tachycardia, prolongation of the QT interval.
Hematopoietic system. Granulocytosis, neutropenia, leukopenia, thrombocytopenia.
Liver and gall bladder. Liver failure, toxic liver damage, hepatocellular necrosis, hepatitis, jaundice, increased levels of aspartate aminotransferase, alkaline phosphatase, alanine aminotransferase, bilirubin.
Other. Hypertriglyceridemia, hypercholesterolemia, deterioration of taste, hypokalemia.

Contraindications for fluconazole

Age up to 5 years (for injections - up to 16 years).
Increased sensitivity.
Pregnancy, lactation.
Simultaneous use of terfenadine (with a fluconazole dosage of more than 400 mg/day) and cisapride.

Use with extreme caution:

Impaired absorption of lactose.
Simultaneous use of terfenadine (at a fluconazole dosage of more than 400 mg/day, combination with terfenadine is contraindicated).
Elevated levels of liver enzymes.
Kidney failure.

Fluconazole during pregnancy

During pregnancy, taking the drug is permissible only if the benefit from it outweighs the potential harm to the fetus. Fluconazole passes into breast milk. If treatment is necessary during lactation, it is recommended to stop breastfeeding.

In contact with

Content

Fluconazole has found its application as part of the treatment of all forms of candidiasis and its prevention. The effect of fluconazole is fungicidal, and the time of influence on fungi is long, which allows it to be used as a single application or once a week.

Different fluconazole regimens are used to treat different types of thrush, and its effect will depend on the dosage. The following forms of thrush in women are distinguished:

acute thrush;
chronic form;
persistent (constant);
carrier status

In addition, fluconazole is used for prophylactic purposes during antibiotic treatment, before surgical interventions and menstruation.

Features of the use of fluconazole

Depending on the form of the disease and the purpose of use, the age of the patient, fluconazole is used in different regimens and doses.

Treatment of acute thrush and its prevention

The prophylactic effect of fluconazole is also used in the following situations:

before gynecological operations;
on the eve of the installation of an intrauterine device;
before diagnostic studies (hysteroscopy);
if necessary, cauterization of the cervix and other interventions associated with diseases of the cervical spine.

During diagnostic or gynecological surgical interventions conditions are created for disruption of the composition of the vaginal microflora, and the antifungal effect of fluconazole prevents this.

Treatment of the recurrent form

Before starting treatment for thrush in all its varieties, time is devoted to a thorough diagnosis:

A bacterioscopy of a vaginal smear is performed to assess the degree of leukocyte infiltration, the nature of the vaginal epithelium (superficial, intermediate and parabasal);
sowing the genital tract secretions for flora and sensitivity to antibiotics, antifungal agents; during the study, the total microbial contamination, the degree of growth of bacteria and candida (weak, moderate, strong growth), the composition of the isolated microflora, the quantitative ratio of species are determined;
cytology smear from the cervical canal to exclude dysplasia and carcinoma;
PCR for viral and bacterial infections.

The effect of fluconazole is considered positive when the leukocyte reaction in smears decreases and there is no yeast mycelium, and relapses cease for 12 months.

Effect of fluconazole

Duration of action of fluconazole quite long-term, the drug tends to accumulate in tissues and continue to have an antifungal effect after discontinuation of the drug.

Thus, in the treatment of chronic thrush, which involves taking the drug for six months, after stopping the use, fluconazole acts for several more months. This property allows you to use the medication once a day, and when treating acute uncomplicated candidiasis - use it once. In addition, the drug has water-soluble properties, which explains its accumulation in all tissues of the body.

If you have kidney disease, you should be careful during therapy; due to its long action and half-life, fluconazole can damage kidney tissue.

Side effects and contraindications

The medication may exhibit side effects during therapy if taken for a long time. As a rule, treatment of acute thrush is not accompanied by adverse events.

Common side effects include:

headache;
dizziness;
perversion of taste;
epigastric pain;
nausea and diarrhea;
allergic rash;
decreased leukocyte levels;
lipid metabolism disorders;

In some cases, hepatitis and jaundice may occur.

Contraindications include:

pregnancy;
breast-feeding;
age up to one year;
individual intolerance.

For kidney diseases, the drug is prescribed in a lower dosage.

Release form

The dosage of capsules and tablets is 50, 100, 150 mg, and the number of pieces in the package is different, allowing the product to be used both once and for a long time.

Part drug in capsule form active ingredient included fluconazole . The capsules also contain additional components: low molecular weight potato starch, calcium stearate or magnesium stearate.

Fluconazole tablets contains a similar active ingredient, as well as sodium lauryl sulfate as an additional component.

Release form

This medicine is available in Fluconazole capsules 150 mg, 50 mg, 100 mg. These are blue capsules containing white or yellowish granular powder. Contained in blister packs, which are placed in cardboard boxes. Fluconazole tablets, syrup, gel, suppositories, and solution for intravenous administration of Fluconazole are also produced.

pharmachologic effect

The abstract contains information that the drug acts as an antifungal agent, inhibiting specifically the synthesis fungal sterols . Belongs to class triazole compounds .

There is a specific effect on fungal enzymes, which depend on cytochrome P450 . The active substance demonstrates activity against a variety of strains Candida spp.(including effective against visceral candidiasis), Cryptococcus neoformans(including effective against intracranial infections), Trichophytum spp., Microsporum spp.. The drug is also active against microorganisms that are causative agents of endemic mycoses: Coccidioides immitis, Hystoplasma capsulatum, Blastomyces dermatitidis.

The remedy stops the transformation into ergosterol lanosterol fungal cells. Under its influence, the permeability of the cell membrane increases, the process of its growth and replication is inhibited. It is highly selective for cytochrome P450 of fungi, but in the human body it almost does not inhibit these enzymes. Does not demonstrate antiandrogenic activity.

Pharmacokinetics and pharmacodynamics

Wikipedia shows that after oral administration, the drug is actively absorbed into the human gastrointestinal tract. In plasma, the concentration of the active substance is more than 90% of the level that is observed if intravenous administration is practiced. The absorption of the substance is not affected by food intake, so it does not matter how you take it, before or after meals. After taking the medicine orally, the highest concentration in the blood occurs after 0.5–1.5 hours. The half-life from the blood is 30 hours. That is, you can take the product once a day. At vaginal candidiasis A single dose of the drug is sufficient, for which one tablet or another form of the drug is used.

11–12% of the active substance binds to blood plasma proteins. When the drug begins to work depends on the treatment regimen. If you take the medicine once daily, then a stable concentration of the active component in the human blood is observed on the fourth or fifth day (in 90% of people). If on the first day of treatment the patient is given a double daily dose, then this effect is observed already on the second day of treatment.

Penetrates into all fluids in the body. It is excreted from the body through the kidneys, approximately 80% is excreted unchanged.

Indications for use

The following indications for use of the drug are determined:

infectious diseases caused by candida (disseminated candidiasis, generalized candidiasis, other forms of invasive candidiasis;
mucous membranes (including pharynx, oral cavity, esophagus);
candiduria ;
chronic atrophic and mucocutaneous candidiasis of the oral cavity (develops in people with dentures);
non-invasive bronchopulmonary infections ;
genital candidiasis (vaginal candidiasis in acute form and with relapses);
prevention of recurrent manifestations of vaginal candidiasis (if the disease develops three times a year), candidal balanitis ;
cryptococcal infection, cryptococcal meningitis ;
ringworm (including mycoses of the body, feet, groin area);
endemic mycoses deep ;
development prevention fungal infections in people who have undergone cytostatic or radiation therapy.

Contraindications

There are the following contraindications for the use of this medicine:

manifestation of high sensitivity to fluconazole or to azole compounds, which are similar in chemical structure to fluconazole;
parallel use if the patient receives a dose of Fluconazole 400 mg per day or more;
parallel reception astemizole any other medications that increase the QT interval;
age up to 4 years.

Caution should be taken in case of liver failure, also renal failure, when a rash appears in people suffering from a superficial fungal infection, in potentially pro-arrhythmogenic conditions in people with risk factors (organic heart disease, taking medications that provoke the development of , electrolyte imbalance). How to take Fluconazole in this case, you should definitely ask a specialist.

Side effects

When treated with the drug, the patient may develop the following side effects:

abdominal pain, diarrhea ;
headache;
nausea , ;
skin rash;
hepatotoxic effects;
anaphylactic reactions.

How to take the medicine when such effects occur, and whether it is worth continuing treatment, should be individually consulted with a doctor.

Instructions for use of Fluconazole (Method and dosage)

The drug is prescribed for oral administration (capsules Fluconazole Stada, Fluconazole Teva, tablets) or for use by intravenous administration. There are also other forms of medication, the active ingredient of which is fluconazole - suppositories, ointment.

The solution is infused at a rate not exceeding 10 ml per minute.

Fluconazole tablets, instructions for use

The dosage of the drug depends on the disease and its severity.

Patients with disseminated candidiasis, candidemia on the first day, 400 mg is prescribed, then the dose should be reduced to 200 mg. Children for treatment purposes generalized candidiasis A dose of 6–12 mg per 1 kg of weight per day is indicated.

Patients with oropharyngeal candidiasis 50 mg to 100 mg of Fluconazole is indicated once a day, the treatment period is 1-2 weeks.

To people suffering atrophic candidiasis of the oral mucosa , indicated at 50 mg once a day. Treatment is combined with the use of local products for the treatment of prostheses. When treating other candidiasis infections of the mucous membranes, 50–100 mg per day is prescribed, the period of therapy is from 14 to 30 days.

In order to prevent the development of relapses oropharyngeal candidiasis in people with 150 mg once a week is indicated. If mucosal candidiasis develops in children, the dose should be taken at the rate of 3 mg of drugs per 1 kg of weight per day. On the first day, you can give your child a double dose.

Patients with cryptococcal infections and cryptococcal meningitis , as a rule, 200–400 mg of drugs are prescribed once a day. On the first day, 400 mg of the drug is indicated. The duration of treatment can be from 6 to 8 weeks. Children are prescribed a dose of 6–12 mg per 1 kg of weight per day.

To people suffering infectious skin diseases , it is recommended to prescribe 150 mg once a week or drink 50 mg of the drug once a day. Treatment should be continued for 2-4 weeks. For men and women, sick mycosis of the feet , sometimes longer therapy is required - up to 6 weeks.

Patients with pityriasis versicolor It is recommended to take 300 mg once a week, the treatment period is 2 weeks. Depending on the intensity of your symptoms, your doctor may prescribe another dose of Fluconazole in the third week. It is possible to use another treatment regimen - 50 mg 1 time per day, the treatment period is two to four weeks.

Sick onychomycosis Prescribe 150 mg once a week. Therapy should continue until a healthy nail grows in place of the diseased nail.

People suffering deep endemic mycosis , sometimes undergo a long course of treatment with the drug, which can last up to two years. The dose per day is 200–400 mg.

The instructions for the use of fluconazole provide that for vaginal candidiasis, a single dose of the drug is taken, its dose is 150 mg.

As a rule, Fluconazole for thrush is effective after a single dose. But your doctor will tell you more about how to take Fluconazole for thrush after an individual consultation. Before determining how to take any medicine for thrush if you have thrush, the specialist takes into account the causes of the disease and the individual characteristics of its course. For chronic thrush, Fluconazole Teva or other types of the drug are prescribed to prevent relapses at a dose of 150 mg once a month. The product should be used for 4-12 months. For the purpose of prevention, capsules are prescribed in a dose of 50–400 mg once a day, depending on how high the risk of the disease is. For children with thrush, Fluconazole tablets are prescribed at a dose of 3–12 mg of medication per 1 kg of weight per day. How much to drink depends on the severity of the infection.

If Fluconazole and Zidovudine , the patient should be monitored by a doctor, as the side effects of Zidovudine may increase.

If treatment is prescribed at the same time Astemizole , Cisapride , Tacrolimus , or any other drug that is metabolized by the cytochrome P450 system, an increase in the concentration of these drugs in the blood is possible.

The absorption of Fluconazole is not affected by simultaneous administration or antacids.

Terms of sale

They are sold in pharmacies by prescription; a specialist gives the prescription in Latin.

Storage conditions

Fluconazole suppositories, Fluconazole ointment, cream, tablets and capsules should be stored in a dark place, drugs should be protected from direct sunlight.

Best before date

special instructions

If liver dysfunction is observed during treatment, constant monitoring by a physician is important. If signs of liver damage are observed, the medication should be discontinued.

When using the medicine topically for men and women, it should be taken into account that people with AIDS are more likely to develop a variety of skin reactions.

It is necessary to take into account not only how long it takes for Fluconazole to act, but also the fact that if treatment is stopped prematurely, relapses may develop. Therefore, it is important to completely complete the prescribed treatment regimen. It is important to take this into account when using Fluconazole for nail fungus, since reviews for nail fungus indicate that if treatment is stopped prematurely, a relapse of the disease may occur.

Many patients have a question about whether Fluconazole is an antibiotic or not? Please note that this is an antifungal agent, not an antibiotic.

Whether men can take this drug depends on the diagnosis. Fluconazole for men is prescribed for fungal infections; it must be taken exactly as prescribed.

Fluconazole analogs

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Fluconazole analogues are products with a similar active ingredient. The price of analogues depends on the manufacturer and the form of release of the drug. There are a number of analogues of this drug: Diflucan , Vero-Fluconazole , Flucostat , Fluconazole Teva ,Fluconazole Stada and etc.

Which is better: Fluconazole or Diflucan?

Often patients compare two drugs with antifungal action - Fluconazole and . What is the difference between these medicines? Both drugs are based on the active substance fluconazole. Diflucan is available in tablets of 50 mg, 100 mg, 150 mg, and other forms. But the price of Diflucan is much higher.

Flucostat or Fluconazole - which is better?

Talking about what's different Flucostat from Fluconazole, it should be noted that both drugs contain the same active substance. Flucostat is a more expensive medicine. What is the difference between these medications, and which one is best prescribed in a particular case, is determined by a specialist. As a rule, Fluconazole is more often prescribed when prophylaxis is necessary for cancer patients after radiation and chemotherapy.

Fluconazole or Nystatin - which is better?

– is an antifungal drug, antibiotic, active against bacteria candid . Under the influence of Nystatin, the permeability of the membrane of fungal cells is disrupted, which contributes to disruption of their growth and reproduction. Which drug is preferred in a particular case depends on the diagnosis and the doctor’s prescription.

For children

The instructions indicate that the drug is prescribed to children after they reach 5 years of age. Dosage for children is determined depending on the disease. As a rule, it is determined at the rate of 6-12 mg per 1 kg of child weight. For children under 5 years of age, the medicine is prescribed strictly according to indications and under the supervision of a specialist.

Fluconazole and alcohol

When discussing Fluconazole's compatibility with alcohol, doctors do not recommend drinking alcohol during treatment. This combination is very dangerous for the liver. In addition, alcohol during treatment can provoke the development of unpleasant side effects from the gastrointestinal tract, blood vessels, and heart.

Fluconazole during pregnancy and lactation

Fluconazole is rarely prescribed during pregnancy, especially in the 1st trimester and 2nd trimester. The only exceptions are when a woman is diagnosed with a severe fungal infection. During lactation, the drug is not prescribed, as the substance passes into breast milk.

Reviews about Fluconazole

Due to the high fungicidal activity of this drug, patient reviews and doctors' reviews of Fluconazole are mostly positive. Patients leaving reviews about Fluconazole Teva, as well as reviews about Fluconazole Stada on the forums, they write that the drug helps to quickly and effectively eliminate the symptoms of fungal diseases. Users mention that the tablets are relatively inexpensive, but at the same time they allow you to completely get rid of nail fungus and other unpleasant diseases. In some cases, it is enough to take Fluconazole 150 mg once to completely overcome the symptoms of the disease.

Very often, women write positive reviews about Fluconazole when thrush . It is noted that the medicine not only relieves thrush, but also helps prevent relapses of the disease.

Fluconazole price, where to buy

The price of Fluconazole tablets depends on the packaging and manufacturer. You can buy Fluconazole in Moscow at prices ranging from 10 to 290 rubles. Capsules 150 mg (1 piece in a package) can be bought for 10-200 rubles. Capsules 50 mg can be purchased at a price of 25 rubles (7 pcs in a package). The cost of Fluconazole Teva 150 mg is 190-220 rubles per pack. (1 PC.).

The price of Fluconazole in Ukraine (Odessa, Kyiv, etc.) is 17-20 hryvnia (50 mg capsules, 7 pcs.). Price Fluconazole 150 mg in Kharkov, Zaporozhye, Dnepropetrovsk, etc. - on average 30 hryvnia (2 pcs per package). 150 mg tablets can be bought in Ukraine for an average of 20 hryvnia.

How much tablets for thrush cost in Kazakhstan and Belarus depends on the packaging and manufacturer. In Minsk, you can buy 150 mg capsules for 10,000 – 103,000 rubles, depending on the number of tablets in the package and the manufacturer.

How much other forms of release of the drug with fluconazole (suppositories, ointment, cream) cost also depends on the manufacturer.

Online pharmacies in Russia Russia
Online pharmacies in Ukraine Ukraine
Online pharmacies in Kazakhstan Kazakhstan

ZdravCity

Fluconazole caps. 150mg №4 Vertex JSC

Fluconazole capsules 150 mg No. 1 CanonpharmaCJSC Canonpharma Production

Fluconazole capsules 150 mg No. 1 Medicine productionMedicine production LLC

Fluconazole capsules 50 mg No. 7 Vertex Vertex JSC

Fluconazole-obl caps. 150mg №2JSC Obolenskoe farm. company

Alcohol and fluconazole are two substances that have a toxic effect on the liver. Yes, other systems and organs may suffer from this combination. Or, in extreme cases, treatment of the fungus with fluconazole will not have results if alcohol is consumed during this period. So, you shouldn’t experiment with your own health. To prove this, read this article.

The effect of fluconazole on the liver The effect of fluconazole and alcohol on brain cells The role of alcohol in the treatment of fungus

Fluconazole is an effective medical antifungal drug that has a wide spectrum of action. The work of the product is directly related to the destruction of biologically active substances necessary for the construction of membranes in fungal cells. Consequently, if there are not enough of these substances, then the vital activity of fungi is disrupted and their cells die.
Fluconazole, like other active medications, can cause many side effects. Central to this list is the detrimental effect on liver cells (hepatotoxicity).

It is noteworthy that the liver suffers from the toxic effect to the greatest extent when there is some kind of disturbance in the functioning of this organ. A healthy liver experiences virtually no negative effects.

Unfortunately, few patients are aware of the presence of this or that liver disease. The reason for this is the absence of symptoms, which are noticeable only in advanced cases. When prescribing an antifungal agent, a doctor must force the patient to check the functioning of the liver. In reality, such a procedure is not performed often, so the hepatotoxic effect of fluconazole cannot be excluded.
Impaired liver function when treated with this drug manifests itself in the following form:

Changes in laboratory data (increase in bilirubin in the blood, excessive activity of liver enzymes). The skin and sclera acquire a yellowish tint. Hepatitis. Necrosis of liver cells. All side effects can last either for a short time or have serious consequences, causing irreversible changes in the organ.

The prescription for the drug states that while taking fluconazole, it is prohibited to use other medications or hepatotoxic substances. Of course, alcohol is no exception, since it directly has a toxic effect on liver cells (hepatocytes), destroying and replacing them with fat cells or connective tissue cells. For minor liver ailments, the medicine may not have any effect, but combining it with alcohol will cause irreparable harm to the organ.

The effect of fluconazole and alcohol on brain cells

Fluconazole can also negatively affect neurons (brain cells). This side effect is rare and manifests itself as:

seizures; loss of performance; fatigue; dizziness; headache.

In case of overdose, hallucinations and delusions occur.
Alcohol affects brain cells in the same way as it affects hepatocytes. And the combination of alcohol intake with fluconazole treatment will increase the neurotoxic effect several times. Moreover, the induced condition is difficult to predict.

The antifungal drug also affects the circulatory system. All this is reflected in the activity of the heart, even causing ventricular flutter and atrial fibrillation.

Alcoholic drinks, especially strong ones, first simply dilate blood vessels, and then sharply narrow them.

It’s no wonder that chronic alcoholics experience increased blood pressure. All this puts a lot of stress on the heart and leads to various disorders of its functions. The combination of alcohol and fluconazole can cause a severe attack of arrhythmia.

Ethyl alcohol or alcohol when taken orally is characterized by rapid absorption into the blood and a significant effect on cellular metabolism. This disrupts the functioning of all active substances important in metabolic processes. And this, in turn, leads to leveling the effect of fluconazole and reducing its effect. Fluconazole is an effective drug in the fight against fungal infections. But at the same time, it has a number of side effects, including a detrimental effect on brain and liver cells. To avoid irreversible consequences, alcohol consumption is prohibited during treatment with fluconazole. This is indicated in the instructions for use of the drug and you should not skip these lines, arguing that fluconazole is not a “strong” medicine!

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The severity of side effects does not depend on the route of administration of the drug, but on the dose per kg of body weight per day.

Pregnancy

Side effects of the drug

13% headache; 7% nausea; 6% abdominal pain; 3% diarrhea; 1% dyspepsia; 1% dizziness; 1% taste disturbance.

The rest felt some poorly differentiated negative sensations. In isolated cases, fluconazole causes a severe allergic reaction.

This may be due to the parallel use of heavy specific antibiotics: isoniazid, rifampicin, phenytoin, pyrazinamide.

Increased cholesterol

Fat metabolism disorders: increased cholesterol levels (hypercholesterolemia), triglycerides;

Decreased potassium levels.

5.4% vomiting; 2.8% abdominal pain; 2.3% nausea; 2.1% diarrhea.

In 2.3%, treatment was discontinued due to severe side effects.

This medicine may cause harm in the following conditions:

Overdose and first aid

Main symptoms: diarrhea, nausea up to vomiting, there may be convulsions.

Skin rashes

There is information about one patient who, with an overdose of fluconazole, experienced symptoms of paranoid delusions and hallucinations. Considering that this was a 42-year-old HIV patient (drug addict), such side effects may not be considered typical for an overdose.

General practitioner at a city clinic. Eight years ago I graduated from Tver State Medical University with honors.

More details

The antifungal agent Fluconazole is a synthetic antimycotic that belongs to the group of triazole derivatives. The action of the drug is based on the inhibition of fungal cytochrome P450 enzymes.

In the human body, Fluconazole inhibits the cytochrome P450 enzyme CYP2C9, which is involved in the metabolism of anticoagulants - drugs that reduce blood clotting and prevent the formation of blood clots.

Fluconazole does not inhibit the main group of cytochrome P450-dependent enzymes in humans, which makes it safer for the liver than other classes of antifungals.

The antimycotic Fluconazole is used in the treatment of a wide range of fungal diseases; it is used in the treatment of:

candidiasis - skin, genitals, mouth, lungs; microsporia; trichophytosis; blastomycosis.

An antifungal agent is prescribed during treatment with antibiotics, chemotherapy, and organ transplantation to prevent fungal diseases.

The drug is available in tablets, capsules, and powders for injection. When taking capsules, the maximum concentration in the blood is created after 1.5 hours. The time during which the concentration of Fluconazole in the blood plasma decreases by 2 times is 30 hours.

The antimycotic easily penetrates into all body fluids and is maintained in a therapeutic dose throughout the day. The medicine is found in saliva, breast milk, cerebrospinal fluid, sputum, vaginal secretions, sweat fluid.

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The drug is excreted from the body by the kidneys; the duration of the half-life depends on their functional state. In case of renal failure, the elimination of the drug slows down.

An absolute contraindication for the antimycotic is an allergy to the drug, breastfeeding, and age under 4 years. It is prescribed with caution to elderly people, persons suffering from renal failure, liver diseases, and during pregnancy.

A relative contraindication is the simultaneous use of drugs with hepatotoxic effects and alcohol. In this case, when prescribing a medicine, the possible benefits or harm that it may have on human health are assessed.

The most pronounced side effects are observed in the digestive tract. Taking an antimycotic causes:

pain in the stomach; nausea, vomiting; perversion of taste, lack of appetite; jaundice, hepatonecrosis.

Fluconazole causes dysfunction of the nervous system. Long-term treatment with this antifungal agent can cause dizziness, fatigue, convulsions, and in case of overdose, hallucinations and changes in behavior.

Dangerous changes occur when the body reacts adversely to Fluconazole from the heart. Changes in the cardiogram are noted (prolongation of the Q-T interval), atrial fibrillation. Less commonly, there is a decrease in potassium in the blood, damage to the hematopoietic system and kidneys.

In the video, information about the drug Fluconazole:

The danger of compatibility between Fluconazole and ethyl alcohol lies in their effect on the liver and heart. Simultaneous use of the drug and ethanol can cause severe allergic reactions - anaphylactic shock, angioedema.

In addition, if you take alcohol together with Fluconazole, dysfunction of the balance organs is possible with the development of true vertigo - a disease in which dizziness can last for several hours.

Alcohol, like antimycotics, negatively affects the electrocardiogram (ECG). These toxic compounds, when used together, make changes to the ECG that threaten sudden death.

One of the possible side effects of taking Fluconazole is prolongation of the Q-T interval on the ECG. Alcohol, especially with long-term abuse, causes a similar ECG change.

The cardiotoxic effect of Fluconazole and ethanol is manifested by dizziness and loss of consciousness. The asymptomatic course of this disorder is especially dangerous. With a hidden, asymptomatic form of long QT interval syndrome, the risk of sudden death increases.

Both alcohol and Fluconazole have a toxic effect on the liver and cause an increase in bilirubin in the blood, a breakdown product of red blood cells.

Liver dysfunction is accompanied by:

yellowing of the skin, whites of the eyes; darkening of urine and feces; irritability, weakness; drowsiness, fainting.

Like alcohol, Fluconazole can increase the level of the liver enzyme alkaline phosphatase, causing nausea, abdominal pain, and fever.

The use of antimycotics and alcohol affects the liver in a similar way:

activates the enzymes alanine aminotransferase, aspartate aminotransferase; increases the risk of liver failure.

The most likely consequence of the simultaneous interaction of Fluconazole and alcohol is hepatonecrosis of the liver. Moreover, the alcohol itself will change the effect of the drug on the body.

The most dangerous changes in cardiac activity are:

heart rhythm disturbance; cardiac ischemia; heart attack

The most dangerous consequences of taking the drug and large doses of alcohol are cirrhosis of the liver, sudden death due to cardiac arrest.

Doctors note that you should not drink even small doses of alcohol when taking antimycotics. The substances are not compatible with each other. But is it possible to drink alcohol 30 hours after Fluconazole, after the half-life of the drug has passed?

In this case, you need to remember that the half-life corresponds to a halving of the therapeutic concentration, and not to the complete elimination of the drug from the body.

In case of liver failure, in old age, this antimycotic remains in the body for a long time, which is taken into account when prescribing the dosage - in this case it is reduced by 2 times.

A certain amount of Fluconazole is present in the blood plasma even after 30 hours. And with concomitant kidney diseases, the half-life interval itself may increase.

So how long before you can drink alcohol? For the body to completely clear Fluconazole, 3 days or more must pass if the patient has kidney disease. Trace levels of this antimycotic can be detected within 5 days.

You can drink alcohol after Fluconazole no earlier than 3 days later. It is advisable to extend this period to 5 days to allow the liver and kidneys to completely rid the body of the presence of the antimycotic.

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