Fluconazole

Fluconazole is a triazole antifungal medication widely used to treat fungal infections caused by Candida and Cryptococcus species. It is most commonly prescribed for vaginal thrush (vulvovaginal candidiasis), oral thrush (oropharyngeal candidiasis), and fungal skin infections. For uncomplicated vaginal thrush, a single oral dose is usually all that is needed.

Fluconazole works by inhibiting an enzyme called lanosterol 14-alpha-demethylase, which is essential for the production of ergosterol, a key component of the fungal cell membrane. Without ergosterol, the membrane becomes unstable and the fungal cell dies. This targeted mechanism means fluconazole is effective against fungi while having relatively little impact on human cells.

How to Take Fluconazole

For vaginal thrush, the standard treatment is a single 150 mg capsule taken by mouth. Swallow it whole with water at any time of day, with or without food. Symptoms usually begin to improve within 24 hours, with full resolution expected within a few days.

For oral thrush or other fungal infections, dosing schedules vary. Your prescriber will advise on the correct dose and duration based on the type and location of the infection. For recurrent vaginal thrush, a maintenance regimen of one 150 mg capsule weekly for up to six months may be recommended.

The dose of fluconazole depends on the condition being treated. A single 150 mg dose is standard for uncomplicated vaginal thrush. Oral thrush typically requires 50 to 100 mg daily for 7 to 14 days. More serious systemic fungal infections may require higher doses and longer treatment courses under specialist supervision. Dose adjustments are necessary for patients with impaired kidney function.

Common Side Effects

Fluconazole is generally well tolerated, especially at the single-dose level used for vaginal thrush. Possible side effects include:

• Nausea
• Abdominal pain
• Diarrhoea
• Headache
• Skin rash

Serious Side Effects

Rarely, fluconazole can cause liver toxicity, particularly with prolonged use or at higher doses. Contact your prescriber if you develop jaundice (yellowing of the skin or eyes), dark urine, or unexplained fatigue. Severe allergic reactions are rare but require immediate medical attention.

Fluconazole interacts with a number of other medications. It can increase the blood levels and effects of warfarin, certain statins (particularly simvastatin), ciclosporin, and some benzodiazepines. Always inform your prescriber of all medications you are currently taking.

Fluconazole should be used with caution in patients with pre-existing liver disease or kidney impairment. It is not recommended during pregnancy, particularly in the first trimester, unless the infection is severe and the benefit clearly outweighs the risk.

Fluconazole is contraindicated in individuals with known hypersensitivity to fluconazole or other azole antifungal agents. Co-administration with certain drugs that prolong the QT interval (such as cisapride, terfenadine, or pimozide) is contraindicated due to the risk of serious cardiac arrhythmias.