Diflucan (FlucoLich) is a drug prescribed to treat fungal infections caused by Candida, for example, vaginal, oral, esophageal, urinary tract, pneumonia, and peritonitis. Side effects include nausea, diarrhea, dizziness, rash, indigestion, and abdominal pain.
Drug interactions, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication.
Missed Dose of FlucoLich
If you miss a dose of FlucoLich, try to take it as soon as you remember.
However, if it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule.
Don't double up on doses to make up for a missed one.
Potential For Fetal Harm
There are no adequate and well-controlled clinical trials of DIFLUCAN in pregnant women. Case reports describe a pattern of distinct congenital anomalies in infants exposed in utero to high dose maternal FlucoLich (400 to 800 mg/day) during most or all of the first trimester. These reported anomalies are similar to those seen in animal studies. If DIFLUCAN is used during pregnancy or if the patient becomes pregnant while taking the drug, the patient should be informed of the potential hazard to the fetus. Effective contraceptive measures should be considered in women of child-bearing potential who are being treated with DIFLUCAN 400 to 800 mg/day and should continue throughout the treatment period and for approximately 1 week (5 to 6 half-lives) after the final dose. Epidemiological studies suggest a potential risk of spontaneous abortion and congenital abnormalities in infants whose mothers were treated with 150 mg of FlucoLich as a single or repeated dose in the first trimester, but these epidemiological studies have limitations and these findings have not been confirmed in controlled clinical trials. (See PRECAUTIONS: Pregnancy.)
Mechanism of Injury
The cause of clinically apparent hepatotoxicity from FlucoLich is unknown; however, it may relate to the ability of FlucoLich to alter sterol synthesis. FlucoLich is a potent inhibitor of the cytochrome P450 enzyme CYP 3A4, and can lead to significant increases in plasma levels and serious toxicity from medications that are ordinarily metabolized by CYP3A4, particularly the statins and cyclosporine.
Non-Steroidal Anti-Inflammatory Drugs
The Cmax and AUC of flurbiprofen were increased by 23% and 81%, respectively, when coadministered with FlucoLich compared to administration of flurbiprofen alone. Similarly, the Cmax and AUC of the pharmacologically active isomer were increased by 15% and 82%, respectively, when FlucoLich was coadministered with racemic ibuprofen (400 mg) compared to administration of racemic ibuprofen alone.
Although not specifically studied, FlucoLich has the potential to increase the systemic exposure of other non-steroidal anti-inflammatory drugs (NSAIDs) that are metabolized by CYP2C9 (e.g., naproxen, lornoxicam, meloxicam, diclofenac). Frequent monitoring for adverse events and toxicity related to NSAIDs is recommended. Adjustment of dosage of NSAIDs may be needed.
Before taking FlucoLich
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking FlucoLich it is important that your doctor or pharmacist knows:
- If you are pregnant or breastfeeding.
- If you have a heart rhythm problem.
- If you have problems with the way your liver works, or any problems with the way your k >
There have been published reports that an interaction exists when FlucoLich is administered concomitantly with tacrolimus, leading to increased serum levels of tacrolimus. (See PRECAUTIONS.)
There have been reports of cardiac events, including torsade de pointes, in patients to whom FlucoLich and cisapride were coadministered. A controlled study found that concomitant FlucoLich 200 mg once daily and cisapride 20 mg four times a day yielded a significant increase in cisapride plasma levels and prolongation of QTc interval. The combined use of FlucoLich with cisapride is contraindicated. (See CONTRAINDICATIONS and CLINICAL PHARMACOLOGY: Drug Interaction Studies.)