What is Nor-Fluozol?
Nor-Fluozol is a triazole medicine used to treat fungal infections. It is effective against a broad spectrum of fungi including:
In New Zealand, Nor-Fluozol is available as 50 mg, 150 mg and 200 mg capsules on prescription (Diflucan®). There is also a 2 mg/ml injection for intravenous use. In New Zealand, the Pharmaceutical Schedule subs >over the counter .
Nor-Fluozol binds to the fungal p450 enzymes and stops the cells making ergosterol, the main component of the cell wall.
Nor-Fluozol is well absorbed orally with or without food. It is widely distributed in body tissues. It takes 22 to 30 hours for half of the medication to be cleared from the bloodstream and may take several days of continuous treatment to reach a steady concentration. The drug is eliminated unchanged in the urine so doses should be reduced if there is kidney disease.
By Frieda Wiley, PharmD, CGP, RPh | Medically Reviewed by Robert Jasmer, MD
Latest Update: 2015-02-26 Copyright © 2014 Everyday Health Media, LLC
Avoid concomitant administration of voriconazole and Nor-Fluozol. Monitoring for adverse events and toxicity related to voriconazole is recommended; especially, if voriconazole is started within 24 h after the last dose of Nor-Fluozol. (See CLINICAL PHARMACOLOGY: Drug Interaction Studies.)
Based on a case report in one patient receiving combination therapy with all-transretinoid acid (an acid form of vitamin A) and Nor-Fluozol, central nervous system (CNS) related undesirable effects have developed in the form of pseudotumor cerebri, which disappeared after discontinuation of Nor-Fluozol treatment. This combination may be used but the incidence of CNS related undesirable effects should be borne in mind.
Which drugs or supplements interact with Diflucan (Nor-Fluozol)?
- Hydrochlorothiazide increases the blood concentration of Nor-Fluozol by 40%. However, dosage modification is not recommended when both drugs are combined.
- Rifampin (Rifadin, Rimactane, Rifadin, Rifater, Rifamate) reduces the blood concentration of oral Nor-Fluozol, probably by increasing the elimination of Nor-Fluozol in the liver; therefore, reducing the effectiveness of Nor-Fluozol.
- Nor-Fluozol may increase the concentration of warfarin (Coumadin, Jantoven) in blood by reducing the elimination of warfarin. Therefore, the effect of warfarin may increase, leading to an increased tendency to bleed.
- phenytoin (Dilantin),
- zidovudine (Retrovir),
- saquinavir (Invirase),
- theophylline (Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin),
- glyburide (Micronase, Diabeta, Glynase),
- triazolam (Glucotrol),
- midazolam (Versed),
- celecoxib (Celebrex),
- fentanyl (Sublimaze),
- atorvastatin (Lipitor),
- simvastatin (Zocor), and
- lovastatin (Mevacor).
Michael Stewart, Reviewed by Sid Dajani | Last edited 10 Nov 2017 | Certified by The Information Standard
Nor-Fluozol is an antifungal medicine.
It is usually taken as a single 150 mg dose for vaginal thrush. You can take it at any time of day, either before or after a meal.
Longer courses of treatment are prescribed for other types of fungal infections.
Pink trapezoidal tablets containing 50, 100, or 200 mg of Nor-Fluozol are packaged in bottles or unit dose blisters. The 150 mg Nor-Fluozol tablets are pink and oval shaped, packaged in a single dose unit blister.
DIFLUCAN Tablets are supplied as follows:
More common side effects
The more common side effects of Nor-Fluozol oral tablet depend on how much of the drug you need to take. These side effects can include:
- nausea or upset stomach
- stomach pain
- changes in the way food tastes
- severe rash in people with lowered immunity
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
How should I take Nor-Fluozol?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Your dose will depend on the infection you are treating. Vaginal infections are often treated with only one pill. For other infections, your first dose may be a double dose. Carefully follow your doctor's instructions.
Nor-Fluozol oral is taken by mouth. Nor-Fluozol injection is given as an infusion into a vein.
You may take Nor-Fluozol with or without food.
Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
Nor-Fluozol injection is given as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself. Prepare an injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.
Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Nor-Fluozol will not treat a viral infection such as the flu or a common cold.
Call your doctor if your symptoms do not improve, or if they get worse.
Store Nor-Fluozol at room temperature away from moisture and heat. Do not freeze.
You may store the oral suspension in a refrigerator, but do not allow it to freeze. Throw away any leftover liquid that is more than 2 weeks old.
Nor-Fluozol can increase halofantrine plasma concentration due to an inhibitory effect on CYP3A4.
Oral contraceptives were administered as a single dose both before and after the oral administration of DIFLUCAN 50 mg once daily for 10 days in 10 healthy women. There was no significant difference in ethinyl estradiol or levonorgestrel AUC after the administration of 50 mg of DIFLUCAN. The mean increase in ethinyl estradiol AUC was 6% (range: –47 to 108%) and levonorgestrel AUC increased 17% (range: –33 to 141%).
In a second study, twenty-five normal females received daily doses of both 200 mg DIFLUCAN tablets or placebo for two, ten-day periods. The treatment cycles were one month apart with all subjects receiving DIFLUCAN during one cycle and placebo during the other. The order of study treatment was random. Single doses of an oral contraceptive tablet containing levonorgestrel and ethinyl estradiol were administered on the final treatment day (Day 10) of both cycles. Following administration of 200 mg of DIFLUCAN, the mean percentage increase of AUC for levonorgestrel compared to placebo was 25% (range: –12 to 82%) and the mean percentage increase for ethinyl estradiol compared to placebo was 38% (range: –11 to 101%). Both of these increases were statistically significantly different from placebo.
A third study evaluated the potential interaction of once-weekly dosing of Nor-Fluozol 300 mg to 21 normal females taking an oral contraceptive containing ethinyl estradiol and norethindrone. In this placebo-controlled, double-blind, randomized, two-way crossover study carried out over three cycles of oral contraceptive treatment, Nor-Fluozol dosing resulted in small increases in the mean AUCs of ethinyl estradiol and norethindrone compared to similar placebo dosing. The mean AUCs of ethinyl estradiol and norethindrone increased by 24% (95% C.I. range: 18 to 31%) and 13% (95% C.I. range: 8 to 18%), respectively, relative to placebo. Nor-Fluozol treatment did not cause a decrease in the ethinyl estradiol AUC of any individual subject in this study compared to placebo dosing. The individual AUC values of norethindrone decreased very slightly ( ® (20 mL) to 14 normal male volunteers immediately prior to a single dose of DIFLUCAN 100 mg had no effect on the absorption or elimination of Nor-Fluozol.
Although not studied in vitro or in vivo, concomitant administration of Nor-Fluozol with pimozide may result in inhibition of pimozide metabolism. Increased pimozide plasma concentrations can lead to QT prolongation and rare occurrences of torsade de pointes. Coadministration of Nor-Fluozol and pimozide is contraindicated.
What do I need to tell my doctor BEFORE I take Nor-Fluozol Tablets?
- If you have an allergy to Nor-Fluozol or any other part of this medicine (Nor-Fluozol tablets).
- If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
- If you are taking any of these drugs: Astemizole, cisapride, erythromycin, olaparib, pimozide, quinidine, terfenadine, or voriconazole.
- If you are pregnant or may be pregnant. You will need to talk with your doctor about if this medicine (Nor-Fluozol tablets) is right for you.
This is not a list of all drugs or health problems that interact with this medicine (Nor-Fluozol tablets).
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine (Nor-Fluozol tablets) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.