Fluconazole: Price, Dosage & Where to Buy

Fluconazole is an antifungal medicine in the azole group, used to treat infections caused by Candida and other fungi. It is most commonly prescribed for vaginal candidiasis, also called a vaginal yeast infection. Fluconazole is available as a generic medicine and requires a prescription in the United Kingdom.

Fluconazole is an azole antifungal medicine. It interferes with an enzyme that fungi need to make ergosterol, a substance that helps maintain the fungal cell membrane. Lower ergosterol production weakens the membrane and limits the fungus's ability to grow and survive.

Human cells do not make ergosterol in the same way, which allows the medicine to act selectively on fungal organisms. Fluconazole has activity against Candida and Cryptococcus species described in its indications.

Its oral absorption is rapid and almost complete, and the label states that the daily dose is the same for oral and intravenous administration. The medicine is largely excreted in urine, so treatment selection and monitoring may require clinical judgement, particularly for people with serious underlying illness or other medicines.

Fluconazole is used for vaginal candidiasis, commonly called a vaginal yeast infection. It is also indicated for candidiasis affecting the mouth and throat, known as oropharyngeal candidiasis, and the oesophagus, known as oesophageal candidiasis. Label information also describes use for Candida urinary tract infections, peritonitis and systemic Candida infections, including candidemia, disseminated candidiasis and pneumonia.

It is used to treat cryptococcal meningitis and to reduce the incidence of candidiasis in patients undergoing bone marrow transplantation who receive cytotoxic chemotherapy and/or radiation therapy. Treatment may be adjusted when fungal culture and other laboratory results identify the causative organism.

The label lists tablets containing 50 mg, 100 mg, 150 mg, and 200 mg, oral suspension concentrations of 10 mg/mL and 40 mg/mL, and intravenous injection strengths of 2 mg/mL, 200 mg/100 mL, and 400 mg/200 mL. The usual starting dose is 150 mg as a single oral dose for vaginal candidiasis. The label lists 200 mg on the first day followed by 100 mg once daily for oropharyngeal and oesophageal candidiasis.

The label lists doses up to 400 mg/day for oesophageal candidiasis based on medical judgement. The usual starting dose is 400 mg on the first day followed by 200 mg once daily for acute cryptococcal meningitis. The label lists 400 mg once daily for prophylaxis during bone marrow transplantation.

Paediatric regimens are weight-based and vary by age, infection and clinical circumstances. The label lists treatment duration according to the infection and response, including at least 2 weeks for oropharyngeal candidiasis and a minimum of three weeks for oesophageal candidiasis.

Store the tablets at 20°C to 25°C, with excursions permitted to 15°C to 30°C, at controlled room temperature. Keep the medicine in its packaging, protected from excess moisture and out of reach of children, as directed on the label.

A missed dose can reduce the amount of antifungal medicine available to control the infection. General pharmacy practice is to follow the prescribed schedule when the omission is noticed, unless the next scheduled dose is close, and not to double doses.

The correct action depends on the infection, formulation and treatment plan. A pharmacist or doctor can advise if a dose is missed, particularly when treating a serious or systemic fungal infection.

Use in pregnancy should be avoided except in severe or potentially life-threatening fungal infections where the anticipated benefit outweighs the possible risk to the fetus. Case reports describe congenital anomalies after high-dose maternal fluconazole of 400 mg/day to 800 mg/day during most or all of the first trimester.

Epidemiological studies suggest potential risks of spontaneous abortion and congenital abnormalities after 150 mg as a single or repeated dose in the first trimester, although these studies have limitations and the findings have not been confirmed in controlled clinical trials. Discuss pregnancy or possible pregnancy with a doctor or pharmacist.