Fluconazole (intravenous)

Overview

Fluconazole belongs to a class of medicines known as aziole antifungal agents. These medicines treat serious infections caused by fungi and yeast, primarily by killing them, and stopping their growth and spread. These infections can happen in various parts of the body. A common infection is candidiasis, which can occur in the mouth, throat, vagina, stomach and the urinary tract. Patients who are receiving cancer or radiation therapy, or who have recently had bone marrow transplants are at higher risk of candidiasis infections, and thus are often prescribed fluconazole to help prevent these infections.

While an effective treatment for fungal and yeast infections, fluconazole can interact with certain medical conditions, which necessitates care during prescription. These conditions include liver disease, kidney problems, electrolyte imbalances as well as heart problems, particularly problems with heart rhythm, such as QT prolongation. Patients whose medical history includes these conditions should discuss them with their doctor prior to starting treatment with fluconazole.

Fluconazole can also affect unborn babies, especially during the first trimester. Pregnant patients, or patients who think they may have become pregnant while being treated with this medicine should consult their doctors as quickly as possible.

The intravenous route of fluconazole is usually prescribed only for the first few doses. Patients should receive these doses at a hospital or clinic, and the medicine should be injected by a doctor or a nurse. After a while, patients are usually switched to the oral form of the medication. Although some patients may feel better after a short while of treatment, they are required to finish the entire course of fluconazole that has been prescribed. Otherwise there is a chance of recurring infection which may then be difficult to treat. However, some patients may require months of treatment before they see any improvement with their infection.

Used correctly, fluconazole is an effective antifungal agent which can help patients with fungal and yeast infections.

Conditions Treated

  • Fungal and yeast infections

Type Of Medicine

  • Antifungal agent

Side Effects

While using fluconazole, patients may encounter some side effects as a result of taking the medicine. These effects range from mild to serious. Not all patients on this medicine will encounter side effects. However, if they do notice any of these effects, they should let their doctor know as soon as possible. The following lists of side effects are not complete, and patients should still keep an eye out for unusual signs and symptoms and seek further medical advice if they develop them.

Some side effects may develop that do not require immediate attention of the doctor, unless they persist or become worse over time. These symptoms should go away by themselves after a short period of time. If the patient has any questions about these side effects, they should talk to their doctor. They include:

  • Heartburn

Other side effects can be more serious. If patients notice any of the following, they should inform their doctor right away:

  • Difficulty with swallowing

Some serious side effects will require medical help right away, such as:

  • Severe dizziness

It is extremely rare, but treatment with fluconazole may lead to an elevated risk of serious, and possibly fatal liver disease. Patients should look out for the following, and seek immediate medical help:

  • Severe pain in the stomach or abdominal area

An allergic reaction to this drug is rare. Patients should however monitor themselves in case they encounter the following signs of a serious allergic reaction:

  • Rashes

Dosage

Fluconazole via an intravenous route should only be given by a trained medical professional such as a doctor or nurse, usually in the setting of a hospital or clinic. It is usually given intravenously, or injected into a vein, for only a few doses, before the patient is switched to an oral form of this medicine.

Dosage is based on the condition and requirements of the individual patient and may vary. The doctor will determine the dosage schedule and strength of the dose depending on these factors. For children, their weight will also affect the strength of the dose.

In the event that the doctor decides that the patient should take the medication at home, the patient or their caregiver should be familiar with the procedure of injecting fluconazole. They should always check the product visually for any contamination prior to using fluconazole, and know of the proper channels of disposal after using the medicine. If they have any questions or doubts at all, they should clarify them with the doctor before beginning treatment.

Fluconazole works optimally when there is a constant amount of it in the body. Therefore, patients should stick to the dosing schedule that has been prescribed by their doctor. They should also continue the full course of medicine, even if they start to feel well before they have finished. This is to prevent the return of any infections.

As this medication is given by a medical professional, overdose is highly unlikely. However, patients may want to look out for the symptoms of overdose:

  • Changes in mental state, such as becoming fearful or suspicious

Interactions

Drugs may interact with one another, with various supplements or herbal products. These interactions may create unwanted side effects or even decrease the effectiveness of the medication. However, the patient may sometimes be prescribed medicines that interact with fluconazole if the doctor feels that it is necessary or if the medicines may interact for beneficial effects. In these cases, the patient should talk to their doctor about any doubts or questions they have, and if they should do anything to manage or decrease the likeliness of unwanted side effects.

It is advised that the patient keep a list of any medicines, supplements or herbal products that they are consuming, or have recently consumed, to share with their doctor. This will help to prevent any unwanted interactions.

The following are some more common medications and supplements that may interact with fluconazole. This is not a complete list; patients can ask their doctor for further information:

  • Alprazolam

Patients should refrain from certain foods and consumables during treatment with fluconazole, and especially from alcohol and tobacco as they have higher chances of interacting with medicines. The patient should consult further with their doctor about products to avoid.

There are certain medical conditions that may make fluconazole unsuitable for the patient. Patients should share their medical history with their doctor, especially if they have, or have had:

  • Imbalances of minerals in the body (electrolyte problems).

Warnings

Prior to starting treatment with fluconazole, patients should talk to their doctors if they have any questions about the medicine or treatment. If symptoms of the patient's condition do not improve or even worsen, they (or the parent, if the patient is a child) should check with the doctor. Treatment with fluconazole may be required to continue for several months before the infection gets better.

During treatment with this medication, it is important that the doctor checks the progress of the patient at regularly scheduled intervals, to ensure that the medicine is working as intended. If the doctor suspects signs of unwanted effects, the patient may be required to take blood tests.

Medicines such as Hismanal®, Propulsid®, Ery-Tab®, Orap®, Cardioquin® and Seldane® should be not taken while being treated with fluconazole due to the increased risk of unwanted effects.

While rare, fluconazole may lead to a higher chance of serious liver problems, which can be fatal. If patients notice more than one of the following symptoms, they should call their doctor right away:

  • Abdominal or stomach pain or tenderness

Another unlikely but serious reaction that fluconazole can induce is anaphylaxis, a severe allergic reaction, which can even be fatal. Patients who encounter the following signs after receiving treatment with this medication should seek emergency medical treatment:

  • Rashes

A serious skin reaction to fluconazole may also involve rashes and itching. If the patient notices any changes to their skin such as redness or irritation during treatment, they should contact their doctor.

As fluconazole interacts with certain heart conditions, patients should be alert for changes to their heart rhythm. In these cases, their heartbeat may become faster, or slower, or irregular, or they may experience dizziness or fainting. These symptoms will require medical attention. Patients should let their doctors know if they or their family has a medical history of heart problems, such as QT prolongation.

This medication may cause dizziness, drowsiness or patients to be less alert than usual. While on this medicine, patients should take care to refrain from activities that require mental alertness, such as driving or operating machinery, until they are familiar with their reaction to fluconazole and how to manage it.

For pregnant patients, it is not advised to take fluconazole for an extended period of time, particularly during the first trimester, as it may harm the fetus. If the patient thinks they have become pregnant during the course of treatment, or intends to become pregnant, they should inform their doctor and decide whether to stop this medication. Patients are advised to use effective forms of birth control while using fluconazole.

While there is little evidence that fluconazole will affect breast milk and young babies, breastfeeding patients may wish to consult with their doctor on whether to use fluconazole.

Young children may receive this medication if required, and dosage should be carefully monitored by their doctor. However, fluconazole should not be used with children under six months of age, as there is insufficient information on whether it is safe and efficient with children of this age.

Fluconazole is not expected to work differently with elderly patients than younger adults. However, elderly patients may be at elevated risk of age-related kidney problems. In such cases, they may wish to consult their doctor about decreasing the dosage or adjusting their dosage schedule.

Patients should not consume other medicines, supplements or herbal products without first discussing it with their doctor. These include both prescription and non-prescription products. They should also not start, stop, or adjust the consumption of any drug, supplement or herbal product without the knowledge of their doctor.

Summary

Fluconazole is a form of azole antifungal, and is used to treat serious infections caused by fungi or yeast. These infections can include candidiasis, which can occur in the mouth, throat, esophagus, vagina, or in various other parts of the body, or fungal meningitis. Fluconazole works by preventing the growth of the fungus or yeast, and also by killing them.

In its intravenous route, fluconazole is available as a solution or injectable, and is often only injected by a trained medical professional such as a doctor or nurse. After the initial few doses, patients are switched to the medicine's oral route, which usually comes in the form of tablets. Both adults and children may receive this medicine. Patients should be careful to finish the entire course of medication to prevent recurring infection, even if they are feeling well after just a few doses. In some cases, patients may be required to take fluconazole for several months before the infection gets better.

This medication may cause interactions with certain medical problems such as liver disease, kidney disease and heart problems. Patients with this medical history should take care to inform their doctor prior to starting medication so that any unwanted interactions or effects can be better managed during treatment.

Pregnant patients should take special care to consult with their doctor on the use of fluconazole, as prolonged use of this medicine may cause harm to their unborn baby, especially during the first trimester. Breastfeeding patients may also consult with their doctor, but there is little evidence that fluconazole will hurt breastfeeding infants.

 

Fluconazole is often used to treat candidiasis in various parts of the body, and especially to prevent such infections with patients who are receiving radiation and cancer treatment, or who have had recent bone marrow transplants.

  • Indigestion
  • Burping
  • Nausea
  • Vomiting
  • Acid or sour stomach
  • Stomach upsets or discomforts
  • Experience of change in taste or unpleasant aftertaste
  • Thinning or loss of hair
  • Headaches
  • Dry mouth
  • Clay-colored stools
  • Black, tarry stools
  • Decreased urination
  • Loss of control over bladder
  • Painful or difficult urination
  • Diarrhea
  • Chills
  • Coughing
  • Vomiting blood
  • Tightness or discomfort in chest
  • Fever
  • Changes in mental state or mood
  • Pain in the muscles or joints
  • Pain in sides or back
  • Muscle spasms or jerking
  • Numbness of tingling in the lips or extremities (hands and feet)
  • Loss of appetite
  • Itching, hives or rashes
  • Blisters, peeling or loosening skin
  • Red lesions on skin that might have a purple center
  • Breath odor
  • Sore throat
  • Sores, ulcers or white spots in the mouth or on lips
  • Convulsions
  • Unusual bleeding or bruising
  • Pale skin
  • Irritation in eyes
  • Fainting
  • Seizures or convulsions
  • Quickened, slowing, or irregular heartbeat
  • Persistent nausea or vomiting
  • Yellowing of the eyes or skin
  • Dark urine
  • Unusual fatigue
  • Itching and swelling (especially in the face, tongue or throat)
  • Severe dizziness
  • Trouble with breathing
  • Hallucinations, such as as feeling, seeing or hearing things that are not there
  • Astemizole
  • Cetirizine
  • Cholecalciferol (vitamin D3)
  • Cisapride
  • Diphenhydramine
  • Doxycycline
  • Duloxetine
  • Esomeprazole
  • Erythromycin
  • Fluticasone (nasal)
  • Gabapentin
  • Ibuprofen
  • Levothyroxine
  • Lisinopril
  • Lorazepam
  • Metformin
  • Montelukast
  • Nystatin
  • Ondansetron
  • Omeprazole
  • Pimozide
  • Prednisone
  • Quinidine
  • Terfenadine
  • Tramadol
  • Liver disease. Fluconazole may worsen liver problems. Use with caution.
  • Kidney disease. As the removal of the medicine from the body may be slowed down or otherwise affected, use of fluconazole should be used carefully.
  • Heart disease. Fluconazole may increase chances of problems with the heart, especially with heart rhythm problems.
  • Problems with heart rhythm (such as QT prolongation)
  • Dark urine
  • Decreased appetite
  • Clay colored stools
  • Fevers
  • Headaches
  • Itching or skin rashes
  • Nausea or vomiting
  • Swelling in the feet or lower legs
  • Feeling unusually tired or weak
  • Yellowing eyes or skin
  • Itching
  • Swelling of the face, tongue and throat
  • Trouble with breathing
  • Pain in the chest