Fungal infections are very common in people all over the world. According to the WHO statistical data one in four suffers from the fungal infection of different etiology. The risk of contamination is everywhere: in city transport, on the sand beach, during the contact with the already contaminated person and so on. Moreover, stresses, therapy with some medications and suffered diseases are also among the factors that may cause the fungal infection to grow on the human body. Even hot weather, tight underwear and footwear may trigger the infection.
Fungal infections are not so harmless as they may seem. They cause serious changes in the body that may lead to the serious health disorders and even death. The history knows the facts when whole villages and ancient towns died from fungal infections. That is why the appearance of antifungal agents has turned to be a real saver for people and opened a new era in medical science. This article is dedicated to one of the most popular antifungal drugs that is Diflucan or Fluconazole.
General Information about Diflucan
Diflucan refers to the group of antifungal agents. It is produced in the form of solid jelly capsules with white or light yellow powder inside. Fluconazole is an active ingredient of Diflucan. Each capsule contains 50 mg or 150 mg of Fluconazole. Auxiliary substances include Lactose, Amylum maidis, Colloidal silicon dioxide, Magnesium stearate, Sodium layril sulfate.
Diflucan is also available in the form of power for oral suspension (Fluconazole content is 10 mg) and solution for intravenous use (Fluconazole content is 2 mg).
Diflucan is a prescribed medication when it refers to Diflucan 50 mg and Diflucan powder and solution. Diflucan 150 mg is available as Diflucan over-the-counter (or Diflucan OTC) for the treatment of yeast infection.
How Diflucan works
Fluconazole is a powerful selective inhibitor of sterole synthesis in the fungal cell. Diflucan is very effective regarding the various types of yeast fungus and other fungus types.
Fluconazole is absorbed well in the human body both when taken orally and in case of intravenous use. Simulateous food ingestion does not influence the effectiveness of Diflucan. The substance penetrates in all body liquids.
Fluconazole is removed from the human body via kidneys; 80% of Fluconazole remain intact in urina.
Therapeutic indication of Diflucan
Diflucan is a very effective medication that shows strong performance while treating fungal infection of different etiology.
Diclucan is prescribed for the treatment of the following fungal infections:
Cryptococcosis including cryptococcal meningitis and infections of other localization (e.g. lungs and skin);
Generalized candidosis including candidemia, disseminated candidiasis and other forms of invasive candidal infection such as abdominal membrane infections, respiratory and urinary tract infections as well as eye infections;
Candidiasis of mucous membrane including oral and esophageal mucosa, non-invasive bronchopulmonary infections, candiduria, mucocutaneous and chronic atrophic oral candidiasis;
Genital moniliasis, yeast infection and its prophylaxis, Balanitis Candida;
Prophylaxis of fungal infections in patients with malignant tumors;
Different types of dermatomycosis;
Deep endemic mycoses including coccidioidomycosis, sporotrichosis, histoplasmosis
Diflucan dosage and rules of intake
DiflucanDiflucan dose differs depending upon the etiology and strength of the fungal infection. Yeast infection is effectively treated with single dose administration. In this case Diflucan 150 mg is taken. To prevent the returns of the yeast infection Diflucan 150 mg should be taken once a month within the period of 4 – 12 months.
In case of infections requiring the reingestion of the antifungal drug Diflucan therapy should be apllied until all the clinical and laboratory symptoms of the fungal infection disappear.
As a rule, adults are prescribed to take large single dose as a therapy start. The consequtive dosages are usually less and taken regularly. The starting dosage of Diflucan may reach 400 mg of Fluconazole (depending upon the diagnosis), regular dosages of Fluconazole very from 50 mg of Fluconazole per day (e.g. oropharingeal candidosis or fungal infection prophylaxis) to 200-400 mg of Fluconazole (e.g. cryptococcal meningitis, candidemia etc.). The proper dose of Diflucan should be defined only by the doctor after the results of medical tests are ready. The therapy duration also depends upon the diagnosis, patient’s health state and disease severity.
Diflucan dose for children should not exceed the adult dosage and is often calculated with regard to the child’s weight. The lowest Diflucan dose is 3 mg of Fluconazole per 1 kg.
Rules of Intake
The form of Diflucan intake depends upon the clinical state of the patient. Diflucan capsules should be swallowed in one piece. To make the oral suspension one should add 24 ml of water and shake the mixture thoroughly.
Diflucan is known to have some limitations and contraindications which are quite rare. Nevertheless, patients are recommended to take into account the following recommendations while deciding to treat with Diflucan.
People suffering from the fructose intolerance and glucose-galactose malabsorbtion should not take Diflucan powder for oral suspension. Diflucan capsules should not be prescribed for those patients who have galactose intolerance and lactase deficiency. Diflucan capsules are not used in small children under 3 years either. Diflucan is not recommended for patients with excessive sensitivity towards Fluconazole and other components of Diflucan.
Diflucan (Fluconazole) is prescribed with care if the patient is suffering from the following conditions:
Liver and kidney disorders;
Drug eruption as a consequence of Diflucan intake;
Potential arrhythmia and corresponding conditions such as heart diseases, electrolyte disturbance.
Pregnant women should avoid taking Fluconazole as a lot of fetal development disorders are known. The exception is the cases of severe fungal infections when the expected benefits exceed the potential risks for the fetus. That is why women of reproductive age should apply reliable contraceptive methods. Fluconazole penetrates the breast milk so it is not recommended to take Diflucan during the lactation.
Co-administration of Diflucan and other drugs
Diflucan is not co-administered with certain medications. These medication are divided into two groups: drugs prohibited to be taken with Fluconazole and drugs recommended to be taken under the doctor’s control.
The first group of medications (the group pf high risk) includes:
Cisapride: it causes negative consequences for the heart;
Terfenadine: severe arrhythmia, high concentration of Terfenadine in the blood plazm;
Astemizole: high concentration of Astemizole in the blood plasm, high risk of arrhythmia;
Pimozide: deterioration of Pimozide metabolism, risk of heart arrhythmia;
Quinidine: deterioration of Quinidine metabolism, risk of ventricular tachycyctole arrhythmia
Erythromycin: very high risk of cardiac toxicity development and sudden cardiac death.
The medications referring to the second group can be co-administered with Diflucan however their co-administration should be thoroughly controlled by the doctor and the dosage should be corrected in case of necessity.
The group includes the following drugs:
Drugs that influence Fluconazole such as hydrochlorothiazide, rifampicin;
Drugs that are affected by Fluconazole such as alfentanil, nortriptyline, anticoagulants, azithromycin, benzodiazines, calcium channel blockers, fentanyl, cyclophosphamode, methadone, prendisone, oral contraceptives.
The complete list of drugs that should be co-administered with Diflucan carefully is quite large. Thus, it is necessary to inform the doctor about any drugs that are prescribed and taken regularly.
Side effects of Diflucan
Diflucan is characterized by high tolerability. However during the clinical and postmarketing research certain side effects were distinguished. The most frequent side effects are connected with various internal systems of the human body. The patient may feel dizzy or suffer from the headaches, arrhythmia, change of taste, insomnia, somnolence or tremor.
Gastrointestinal side effects involve stomach aches, diarrhea, nausea, constipation, vomiting, dry mouth, hepatotoxicity, liver disorder, hepatitis, hepatocellular necrosis, and cholestasis.
Skin and allergic reactions include eruption, alopecia, exfoliative dermatological conditions including Stevens-Johnson syndrome and toxic epidermal necrolysis, excessive sweating, drug dermatitis, itching and different anaphylactic reactions.
Diflucan may cause certain disorders of blood formation such as leikopenia, thrombocytopenia, and anemia.
Other side effects of Diflucan include myalgia, weakness, asthenia, fatigue, vertigo or fever.
Some patients (especially those who suffer from AIDS, malignant tumours) may experience changes of blood parameters, liver and kidney functions. However the connection between these states and Diflucan therapy is not proved yet.
Doctors recommend that patients apply for the medical assistance if any uncomfortable health conditions or unusual health states are experienced.