Infectious Disease Book

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FluconazoleAka: Diflucan

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  1. Indications
    1. Onychomycosis
    2. Yeast Vaginitis (Single dose)
  2. Dosing
    1. Onychomycosis
      1. Adult Dose: 450 mg PO once per week
      2. Course
        1. Fingernail: 3-6 months
        2. Toenail: 6-12 months
    2. Yeast Vaginitis
      1. Adult dose: 150 mg PO for 1 dose
  3. Monitoring: Onychomycosis or Yeast Vaginitis
    1. No routine lab tests recommended
  4. Adverse effects (5% of patients)
    1. Nausea
    2. Headache
    3. Pruritus
    4. Liver Function Test abnormalities
  5. Drug interactions
    1. Absorption not affected by gastric pH
    2. Significant Sedation with Benzodiazepines
    3. Cimetidine decreases fluconazole levels
    4. Hydrochlorothiazide increases fluconazole levels
    5. Rifampin decreases fluconazole levels
    6. Oral Hypoglycemics (e.g. Sulfonylureas)
      1. Risk of Hypoglycemia
    7. Fluconazole increases theophylline levels
    8. Increased bleeding risk with Warfarin
  6. References
    1. Desai (1996) Am Fam Physician 54(4):1337
    2. Gupta (1999) J Am Acad Dermatol 41:237
    3. Friedlander (1999) Pediatr Infect Dis J 18(2):205
    4. Wildfeuer (1997) Mycoses 40:259

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