Learn all about using fluconazole against candidiasis and other fungal infections

Fluconazole is a drug widely used to treat candidiasis, although this is not its only indication. It is an antifungal that fights infections caused by fungi.

The expected action of Fluconazole is that it prevents the growth of fungi, as it inhibits these microorganisms from synthesizing compounds (steroids) necessary for survival.

The drug is usually given orally and is well absorbed, reaching blood levels in half an hour to six hours. To give you an idea: normally, the average time for the onset of symptom relief after administration of the drug, in the case of the treatment of vaginal candidiasis, is one day.

Below you can better understand what Fluconazole is for, why it is a widely used drug, what are its trade names and its contraindications.

What is Fluconazole used for? The main indications

Most people, when hearing about Fluconazole, already associate the drug with the treatment of candidiasis. “It is widely used for candidiasis because it has a spectrum that includes killing Candida albicans”, comments Domingos Mantelli (CRM-SP: 107,997), gynecologist and obstetrician.

However, it is worth noting that Fluconazole also has action against other fungi: Cryptococcus neoformans, Microsporum spp., Blastomyces dermatitides and Histoplasma capsulatum, for example.

In this way, many fungal infections can be treated with Fluconazole, for example:

Vaginal candidiasis: infection caused by Candida and one of the most prevalent alterations among women. Symptoms are irritation of the vulva and vagina, usually accompanied by redness and intense itching, in addition to the presence of a whitish vaginal discharge.

Oral thrush: Also known as “thrush in the mouth”, it is more common in children (even babies). The symptoms, in general, are the appearance of whitish plaques in the mouth, tongue or throat; burning in the mouth; pain or difficulty swallowing.

Penile candidiasis: in men, the symptoms of candidiasis are usually itching and apparent “scaling” of the glans (end of the penis).

Pityriasis versicolor: A fungal infection in which the fungus interferes with the normal pigmentation of the skin, resulting in small patches spread over the body.

Tinea cruris: also known as ringworm in the groin, it is an infection that usually affects the groin, thighs and buttocks, causing reddened plaques and intense itching.

Onychomycosis: This is a nail infection caused by fungi.

Tinea pedis: popularly known as chilblains, it is a fungal infection that usually attacks the sole and spaces between the toes.

These are just examples of indications. Mantelli points out that the drug can be used for many types of fungal infections, as it has a broad spectrum for catching and treating fungal infections.

How should the drug be taken?

Mantelli highlights that the drug should be taken depending on each case, and always following the instructions of the doctor in charge. “But generally, for candidiasis, you need to take a single-dose tablet for a woman and a single-dose tablet for a man. It is the couple in a single dose. Depending on the degree of infection, sometimes this treatment can extend a little longer,” she says.

In the case of a fungal skin infection, the indication is usually one tablet per week, and the treatment can last from two to six weeks. But, it is worth stressing, each case is a case, so only the doctor can indicate the correct dosage and the particularities of each treatment.

Fluconazole contraindications

“Usually, the contraindications are: if the person has an allergy to some type of medication; or if the problem is an infection caused not by fungi, but by bacteria and viruses… Because then it won’t do any good to take Fluconazole”, comments Mantelli.

Pregnant women should not take Fluconazole (unless recommended by a doctor they trust), and use during breastfeeding is also not recommended.

Another special attention is that Fluconazole should not be used in parallel with terfenadine or cisapride, due to the high risk of cardiac arrhythmia.

Cautions and side effects

Below you can see some points that deserve attention in relation to the use of this medication:

• Especially people who have serious illnesses, such as heart problems, kidney and/or liver disorders, should inform their doctor before starting treatment with Fluconazole.
• A single dose of Fluconazole (150 mg) is not recommended for children under 18 years of age or the elderly, unless medically supervised.
• Pregnant and breastfeeding women should not use Fluconazole unless there is medical or dental advice.

Fluconazole is a generally well-tolerated drug, but some adverse reactions that have already been observed during clinical studies, according to the package insert itself, are:

• headache;
• Abdominal pain;
• Diarrhea;
• Nausea;
• Skin reactions can occur, but are more common in patients with HIV;
• liver toxicity;
• Excessive doses, far above those usually recommended, can cause psychiatric disorders (such as hallucinations and paranoia).

Drug interactions with Fluconazole

According to information in the package insert, care must be taken when associating Fluconazole with the following types of medicines:

• Anticoagulants;
• Benzodiazepines;
• cisapride;
• Cyclosporine;
• Hydrochlorothiazide;
• Phenytoin;
• Rifabutin;
• Rifampicin;
• Sulphonylureas;
• Tacrolimus;
• Terfenadine;
• Theophylline;
• Zidovudine.

“Drug interactions can happen in many cases, it depends a lot on what the patient is using, some antibiotics can interfere, contraceptives… Therefore, it is important to always be informed to the doctor what the patient is using”, comments Mantelli.

Fluconazole trade names

You can find Fluconazole for sale by different names, such as:

• Zelix;
• Zoltec;
• Zoltre;
• Candizol;
• Flucazol;
• Flucomed;
• Fluconal;
• Flucone;
• Flutec;
• Glyfucan;
• readus;
• Monipax;
• Pronazol;
• Riconazole;
• Triazole;
• Unizol.

It is also possible to purchase it in generic form. The price can vary a lot, but it is possible to find Fluconazole 150mg with 1 capsule (single dose) on sale on the internet for about R$18.

Other ways to treat candidiasis

Mantelli points out that other treatments for candidiasis include vaginal creams that contain some antifungals and other substances mixed in, depending on the type of discharge the patient has. “So we can use it only orally, orally and vaginally together, or sometimes only vaginally, depending on the type of discharge and indication for each patient”, she explains.

It is worth noting that, although Fluconazole is an easily available drug, it should not be used on its own, regardless of the case.

In the case of treatment with Fluconazole, it is also essential to follow the doctor’s instructions, always respecting the schedules, doses and duration of treatment. Also, do not interrupt the treatment without the doctor’s knowledge.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.