Fluconazole instructions for use and analogues of the drug, release forms and cost in pharmacies

Fluconazole is prescribed for the prevention and treatment of fungal infections. This is a synthetic drug that disrupts the life of pathogens. It is most often prescribed as part of drug therapy for candidiasis, but it can be used to treat other fungal diseases. Used in pediatric and therapeutic practice. Treatment is carried out under the supervision of a doctor.

Fluconazole was developed more than 20 years ago, but this drug is still included in the list of the safest and most effective medications according to the World Health Organization.

Features of application

Treatment must be continued until clinical and hematological remission occurs.
Premature cessation of treatment leads to relapses. Treatment can be started if culture or other laboratory test results are absent, but if they are available, appropriate adjustment of fungicidal therapy is recommended.

During treatment, it is necessary to monitor blood counts, kidney and liver function. If renal or liver dysfunction occurs, you should stop taking the drug.

In rare cases, the use of fluconazole was accompanied by toxic changes in the liver, incl. with a fatal outcome, mainly in patients with serious concomitant diseases. In the case of hepatotoxic effects associated with fluconazole, there was no obvious dependence on the total daily dose, duration of therapy, gender and age of the patient. The hepatotoxic effects of fluconazole were usually reversible; its signs disappeared after cessation of therapy. If clinical signs of liver damage that may be associated with fluconazole appear, the drug should be discontinued.

People with AIDS are more likely to develop severe skin reactions when taking many drugs. In cases where a rash develops in patients with a superficial fungal infection and is assessed as definitely related to fluconazole, the drug should be discontinued. If a rash appears in patients with invasive/systemic fungal infections, they should be carefully monitored and fluconazole should be discontinued if bullous changes or erythema multiforme occur.

Caution must be exercised when taking fluconazole simultaneously with cisapride, rifabutin or other drugs metabolized by the cytochrome P 450 system. Effect on the ability to drive vehicles and machines

Influence on the ability to drive vehicles and machinery.

Fluconazole does not affect the ability to drive vehicles or engage in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Possible side effects

For most patients, the drug Fluconazole, the instructions and patient reviews confirm this, is well tolerated. In rare cases, the following undesirable effects may occur:

• decreased appetite and distortion of taste sensations;
• various dyspeptic disorders - nausea, vomiting, diarrhea, flatulence;
• pain impulses in the head and epigastric region;
• persistent dizziness and previously uncharacteristic fatigue;
• changes in the general blood test - leukopenia, agranulocytosis;
• various skin rashes;
• less often – angioedema, renal dysfunction;
• hypercholesterolemia.

After discontinuation of the drug, all of the above side effects are eliminated. No additional treatment is required.

What does Fluconazole help with?

The drug is indicated for the following diseases:

• cryptococcosis (as well as cryptococcal meningitis) – diseases of the central nervous system or brain caused by parasitic yeast-like microorganisms;
• candidiasis of internal organs and systems, candida sepsis;
• damage to the mucous membrane of the mouth and pharynx, esophagus and intestines;
• genital candidiasis (damage to the walls of the vagina and head of the penis);
• mycosis of the skin and nail plate;
• pityriasis versicolor;
• endemic infiltrative mycoses, coccidioidomycosis and sporotrichosis.

Fluconazole is also used as a prophylaxis:

• genital candidiasis, which worsens more than 3-4 times a year;
• fungal infections in patients suffering from cancer and AIDS;
• thrush if you have had sexual contact with a sick partner.

Effect of fluconazole

The effect of fluconazole does not depend on food intake, so the tablets can be taken before, during and after meals. The drug is well absorbed in the stomach. After an hour and a half, the maximum concentration of the drug is recorded in the blood, which means that the initial relief of itching and burning begins 2-4 hours after taking the tablet. the maximum concentration in the blood is observed on days 4-5, and when using a double dose - on the second day.

The duration of action of fluconazole is quite long; the drug tends to accumulate in tissues and continue to have an antifungal effect after discontinuation of the drug.

Thus, in the treatment of chronic thrush, which involves taking the drug for six months, after stopping the use, fluconazole acts for several more months. This property allows you to use the medication once a day, and when treating acute uncomplicated candidiasis - use it once. In addition, the drug has water-soluble properties, which explains its accumulation in all tissues of the body.

If you have kidney disease, you should be careful during therapy; due to its long action and half-life, fluconazole can damage kidney tissue.

If the remedy is ineffective and symptoms recur, it is necessary to undergo a detailed diagnosis. As a rule, genital tract secretions are inoculated on nutrient media to determine the type of candida and sensitivity to antibiotics. The vaginal microbiocenosis and detection of sexually transmitted infections (chlamydia, urea and mycoplasmosis, genital herpes, HPV) are also examined. Therapy of the sexual partner is mandatory. An important factor in the effectiveness of the fight against thrush is the complete restoration of the lactic acid flora with the help of suppositories (Acilact, Vaginorm, Laktonorm, Ecofemin). During the treatment of candidiasis, the intestinal flora is also normalized with the help of probiotics (Biogaia, Enterozermina, Linex). With intestinal dysbiosis, the chances of chronic infection increase. In addition, wearing synthetic underwear, using tampons, and self-medication in the form of douching are excluded.

Analogs

If it is not possible to buy Fluconazole, you can use medications similar in active substance, which demonstrate an antifungal effect against similar microorganisms.

Popular substitutes are the following medications:

• Flucostat;
• Mikosist;
• Diflucan;
• Nystatin;
• Diflazon;
• Mycoflucan;
• Mycomax.

There are also complete structural analogues of the active substance:

• Vero-Fluconazole;
• Disorel-Sanovel;
• Diflazon;
• Diflucan;
• Maiconil;
• Medoflucon;
• Mycomax;
• Mikosist;
• Mycoflucan;
• Nofung;
• Procanazole;
• Fangiflu;
• Flucosan;
• Flucoside;
• Flucomabol;
• Flucomicide SEDICO;
• Fluconazole Hexal;
• Fluconazole-Teva;
• Fluconorm;
• Flucoral;
• Flucorem;
• Flucostat;
• Forkan;
• Fungolon;
• Ciskan.

Before purchasing an analogue, consult your doctor.

Pregnancy and drug

What if fungal diseases are diagnosed in expectant or nursing mothers? Since the active ingredient of the drug is well absorbed into breast milk, during the treatment period nursing women should completely stop breastfeeding. The product is also not recommended for use in pregnant women, since the active component can negatively affect the development of the fetus and cause various abnormalities and defects. This information is confirmed by some studies, according to which women who took Fluconazole during pregnancy gave birth to sick and developmentally delayed children. On the other hand, the attending physician may consider it necessary to provide a course of therapy to the expectant mother, believing that the risk to the fetus is justified by the expected benefit to the health of the pregnant woman.

Be that as it may, according to numerous reviews from patients, during the period of treatment with Fluconazole, doctors recommended that they use proven contraceptives to reduce the possibility of becoming pregnant to a minimum.

Indications and contraindications

According to the RLS, the drug has a strict list of indications. These include all infectious diseases that are caused by fungi that are sensitive to the drug:

1. Diseases caused by cryptococcal infection: specific damage to the meninges (meningitis), skin, respiratory organs in patients with normal and reduced activity of the immune system (patients with HIV infection, people with organ transplants).
2. Severe generalized and disseminated candidiasis (including candidemia) affecting all organs and tissues - skin, mucous membranes, peritoneum, endocardium, visual organs, urinary and respiratory tract. Such pathological conditions can develop as a complication in cancer patients during treatment with cytostatics, immunosuppressants, as well as in patients who have been in the intensive care unit for a long time.
3. Localized forms of candidal infection - lesions of the mucous membrane of the mouth and esophagus, urinary tract infections. In these cases, capsules are prescribed when local medications - cream or ointment - are insufficiently effective.
4. Acute or chronic recurrent candidiasis of the genital organs - vaginitis or balanitis.
5. Acute or chronic dermatomycosis of the trunk, skin of the feet and groin area.
6. Pityriasis versicolor.
7. Endemic forms of mycoses are histoplasmosis, coccidioidomycosis or paracoccidioidomycosis, sporotrichosis. The drug is prescribed to patients with normal immune system activity.
8. Severe fungal diseases of the nails - onychomycosis.

The drug is also prescribed to prevent the development of fungal complications in patients with malignant neoplasms when treated with cytostatics.

Before prescribing a drug, the doctor must make sure that the patient has no contraindications to taking it. The medicine should not be prescribed:

• patients who take Astemizole, Trefenadine and other medications that increase the QT interval on the ECG;
• children under 4 years old;
• people with individual intolerance to the drug.

There are also some conditions for which the medicine is allowed to be used, but this must be done with extreme caution:

• concomitant liver or kidney failure;
• skin rashes with generalized fungal infections;
• alcohol addiction;
• simultaneous use of drugs that have hepatotoxicity;
• high risk of heart rhythm disturbances;
• violations of water-salt balance;
• pregnancy.

special instructions

“Fluconazole” for various mycoses, including nail fungus, has special instructions regarding its use in the treatment of infectious lesions of the body. You should familiarize yourself with them before you start taking the capsules or solution.

It is strictly forbidden to take Fluconazole and alcohol at the same time. Their combination can lead to liver dysfunction. Therefore, it is strongly recommended to abstain from drinking alcohol throughout the entire treatment.

It is not only Fluconazole and alcohol that should not be taken at the same time. It is prohibited to combine many medications that belong to the antifungal group with such drinks.

During the therapeutic course, clinical and laboratory monitoring of the current state of the liver and kidneys should be carried out.

Attention should also be paid to peripheral blood. Such monitoring will help to promptly identify deterioration in the functioning of internal organs and stop treatment.

Patients with AIDS may experience skin rashes due to taking the capsules. If they are detected, the drug should be discontinued.

With caution, a drug that is taken with or after meals should be combined with other drugs that can be metabolized in the liver. Pregnant women and women who are breastfeeding should not be prescribed Fluconazole treatment.

This could harm their baby's health.

You should not prescribe treatment with Fluconazole to pregnant women and women who are breastfeeding. This could harm their baby's health.

The active substance contained in the medication does not affect the functionality of the nervous system

It does not affect the speed of psychomotor reactions and a person’s ability to concentrate their attention on anything

The medicine can be purchased at a pharmacy after providing a prescription from a doctor. It is strictly forbidden to use it for self-medication, as the medication can cause harm to health.

The drug can be purchased at a pharmacy with a prescription

Adverse reactions

While taking Fluconazole capsules, it is possible to develop negative side effects from various organs and systems:

1. Cardiovascular system - increase in the duration of the QT interval, disturbances in the rhythm of heart contraction in the form of fluttering or flickering.
2. Nervous system – headache, dizziness, increased fatigue, spasms may develop less frequently.
3. Blood and red bone marrow – decrease in the number of platelets (thrombocytopenia), leukocytes (leukopenia), granulocytes (agranulocytosis), neutrophils (neutropenia) in the blood.
4. Allergic reactions - skin rash, toxic epidermal necrolysis, exudative erythema multiforme, anaphylactoid reactions (urticaria, angioedema, anaphylactic shock).
5. Digestive system - decreased appetite, taste changes, abdominal pain, nausea accompanied by periodic vomiting, bloating (flatulence), impaired functional activity of the liver with the development of jaundice, increased activity of the enzymes ALT, AST, alkaline phosphatase (indicators of damage to hepatocytes, as well as disturbances in the outflow of bile).

Very rarely, after starting to take the drug, hair may fall out (alopecia), cholesterol and triglyceride levels may increase, the concentration of potassium ions in the blood may decrease, and the functional activity of the kidneys may be impaired. The appearance of signs of the development of negative pathological reactions is the basis for discontinuation of the drug.

Contraindications

In some cases, the use of the drug is undesirable due to the high risk of complications. The main contraindication is sensitivity to any components of the product. The doctor must rule out allergies and other reactions in advance. If the patient has been diagnosed with an allergy to azole antimycotics in the past, fluconazole is not prescribed.

Other possible contraindications:

• Patient age up to 4 years for capsules and tablets.
• Carrying a child and the period of breastfeeding.
• Concomitant use with other medications that prolong the QT interval.
• Use together with cisapride tablets.

Need a prescription from a doctor

Treatment is carried out with caution in the presence of the following factors: impaired renal function, the appearance of skin reactions, combination with other antimycotics, alcohol dependence, taking other hepatotoxic medications, impaired functioning of the cardiovascular system or the presence of risk factors for such a condition, childhood, impaired liver function.

Pharmacological properties

Pharmacodynamics. Fluconazole, a representative of the class of triazole antifungal agents, is a powerful selective inhibitor of sterol synthesis in fungal cells. The drug is effective against opportunistic mycoses, incl. caused by Candida spp., Cryptococcus neoformans, Microsporum spp., Trichophyton spp. Fluconazole has also been shown to be active in models of endemic mycoses, including infections caused by Blastomyces dermatitidis, Coccidioides immitis and Histoplasma capsulatum.

Pharmacokinetics. After oral administration, fluconazole is well absorbed, its bioavailability is 90%. The maximum concentration after oral administration on an empty stomach of 150 mg is 90% of the plasma content when administered intravenously at a dose of 2.5 - 3.5 mg/l. Concomitant food intake does not affect the absorption of the drug taken orally. The maximum concentration is reached 0.5-1.5 hours after administration; the half-life of fluconazole is about 30 hours. Plasma concentrations are directly proportional to dose. 90% level of equilibrium concentration is achieved by 4-5 days of treatment with the drug (when taken 1 time / day).

The introduction of a “loading” dose (on the first day), 2 times higher than the usual daily dose, allows you to achieve a level corresponding to 90% of the equilibrium concentration by the second day. The apparent volume of distribution approximates the total body water content. Plasma protein binding - 11-12%.

Fluconazole penetrates well into all biological fluids of the body. Drug concentrations in saliva and sputum are similar to those in plasma. In patients with fungal meningitis, the fluconazole content in the cerebrospinal fluid reaches 80% of its plasma level.

In the stratum corneum, epidermis, dermis and sweat fluid, high concentrations are reached that exceed serum concentrations.

It is an inhibitor of the CYP2C9 isoenzyme in the liver.

The pharmacokinetics of fluconazole depends significantly on the functional state of the kidneys, and there is an inverse relationship between the half-life and creatinine clearance (CC). Fluconazole is excreted primarily by the kidneys; approximately 80% of the administered dose is excreted unchanged in the urine. No fluconazole metabolites were detected in peripheral blood.

special instructions

Treatment with Fluconazole should be continued until stable clinical and hematological remission occurs - otherwise there is a high probability of disease relapse. If problems with the functioning of the kidneys and/or liver are detected, as well as in the event of side effects, the drug is discontinued. In addition, it is necessary to take into account the peculiarities of the interaction of the substance with certain medications:

• Fluconazole increases the PTT of coumarin anticoagulants, thereby increasing their activity;
• Carbamazepine impairs the absorption of the drug and significantly increases its content in the blood plasma;
• parallel use with Cisapride, Quinidine, Astemizole, Pimozide and Terfenadine (if the patient takes 400 mg of Fluconazole per day or more) can provoke arrhythmia, including paroxysmal ventricular tachycardia;
• combination with Fentanyl sometimes causes respiratory depression;
• Hydrochlorothiazide increases the plasma concentration of Fluconazole by 40%;
• the drug prolongs the half-life of theophylline and can cause intoxication;
• when taken simultaneously with Glipizide, Chlorpropamide and other sulfonylurea derivatives, it is necessary to monitor the concentration of glucose in the patient’s blood and adjust the dose of hypoglycemic agents if necessary;
• Fluconazole may increase negative reactions that sometimes occur while taking Zidovudine, Rifabutin, Phenytoin and Cyclosporine;
• parallel use with Midazolam increases the risk of developing psychomotor reactions;
• Prednisone accelerates the breakdown of the drug, increasing the activity of the CYP3A4 isoenzyme, which can lead to acute adrenal insufficiency in patients who have undergone liver transplantation;
• Taking antacids does not affect the absorption of Fluconazole.

Fluconazole can interact with a significant number of drugs from other clinical and pharmacological groups, so the doctor must be notified of all medications the patient is taking.

How to take Fluconazole for thrush

In order to effectively get rid of thrush (candidiasis), women and men are recommended to undergo treatment at the same time. During therapy, it is best to abstain from sexual intercourse. The treatment regimen for candidiasis of both partners is the same.

For acute forms of thrush, a single dose of Fluconazole 150 mg is recommended. After three days, therapy should be continued with 50 mg of the drug.

The chronic form of the disease is much more difficult to treat. The treatment regimen is as follows: take 150 mg of the drug twice a day for three days. Then treatment with a similar dosage is recommended on the first day of the menstrual cycle. The duration of therapy is from 1/2 to 1 year.

To treat thrush of the oral cavity, pharynx and esophagus, more gentle therapy is used. Thus, the patient is recommended to take a single daily dose of 50-100 mg for a week. For intestinal candidiasis, the regimen is slightly different: 50 mg 2 times a day. The course of treatment is also 5-7 days.

Recommendations regarding treatment according to diseases

According to the instructions, Fluconazole capsules must be taken in a certain dosage depending on the manifestation of the disease.

For example, in acute forms of generalized candidiasis, four hundred milligrams of the drug should be consumed in the first 24 hours after diagnosis, then two hundred milligrams per day. In some cases, the attending physician may increase the dosage to four hundred milligrams. The duration of the course is also determined by a specialist based on laboratory tests and clinical indicators.

For cryptococcosis, the dosage and treatment schedule are almost the same as the therapy for generalized candidiasis. The duration of taking tablets, most often, does not exceed six to eight weeks. In order to prevent the recurrence of this disease in HIV-infected people, two hundred milligrams of the drug should be consumed every day for a fairly long period of time, determined by the attending physician.

How to use this medicine if candidiasis of the oral cavity and pharynx is detected? You need to use fifty to one hundred milligrams of the drug per day for one or two weeks, and sometimes a whole month (especially when it comes to candidiasis of the skin and mucous membranes). In order to prevent relapse of the disease in those infected with HIV, it is necessary to take 150 milligrams of the drug once every seven days.

Is it possible to cure thrush in women with Fluconazole? The instructions for use of the drug recommend taking 150 milligrams of the active substance at a time.

This method of therapy also applies to the treatment of balanoposthitis. In some cases, to consolidate the result, you can take another 150 milligrams of the active substance after a period of time determined by the doctor. Also, in order to prevent relapse of the disease, the doctor may prescribe taking one capsule monthly for six months or even a year. These recommendations are written down in the instructions for use of Fluconazole 150 mg capsules. The price of the product will be presented below.

According to reviews from satisfied patients, such treatment is considered not very expensive, but effective. Thanks to the capsules, they were able to get rid of burning and discomfort in the vagina and other unpleasant symptoms. Many women recommend abstaining from sex during the treatment period, which will speed up recovery. Gynecologists also necessarily warn about this.

For skin lesions with fungal infections, you should take fifty milligrams of Fluconazole every day or 150 milligrams of the drug every week. It is clear that your doctor will prescribe a more accurate schedule for you after a detailed examination. In this case, the duration of the course usually does not exceed two to four weeks. If we are talking about mycosis of the feet, then longer treatment will be required - about one and a half months.

If we are talking about pityriasis versicolor lesions, then the doctor can prescribe three hundred milligrams of the drug once every seven days, and so on for two to three weeks.

If the nails are affected by the fungus, then drug therapy covers a fairly long period of time until the affected tissue is completely renewed. For onychomycosis of the palms, the course duration covers three to six months, and for diseases of the feet, even longer - up to a year. During the treatment period, you need to take one capsule of 150 milligrams once a week.

If we are talking about severe forms of mycoses, then the duration of treatment can be two years. In this case, you will need to take the drug every day, two to four hundred milligrams.

General characteristics. Compound

Active ingredient: fluconazole – 0.050 g or 0.150 g;

excipients: lactose monohydrate (milk sugar) – 0.1804 g or 0.19265 g, pregelatinized starch – 0.0012 g or 0.00175 g, povidone (low molecular weight polyvinylpyrrolidone) – 0.0012 g or 0.00175 g, silicon colloidal dioxide (aerosil) – 0.0048 g or 0.00035 g, magnesium stearate – 0.0024 g or 0.0035 g;

gelatin capsule composition: for a dosage of 50 mg - body: gelatin - 0.038102 g, titanium dioxide E 171 - 0.000778 g, cap: gelatin - 0.022513 g, titanium dioxide E 171 - 0.000462 g, iron oxide dye yellow E 172 – 0.000145 g; for a dosage of 150 mg - body: gelatin - 0.045408 g, titanium dioxide E 171 - 0.000461 g, iron dye yellow oxide E 172 - 0.000231 g; cap: gelatin - 0.029648 g, titanium dioxide E 171 - 0.000301 g, iron dye yellow oxide E 172 - 0.000151 g.

Description. Hard gelatin capsules No. 2 are opaque white with a yellow cap (for a dosage of 50 mg) or hard gelatin capsules No. 1 are opaque yellow with a yellow cap (for a dosage of 150 mg). The contents of the capsules are white or white powder with a yellowish tint.

Video about the consequences of six months of fluconazole therapy

• Author: Alexandra
• Print

General practitioner at a city clinic. Eight years ago I graduated from Tver State Medical University with honors. Rate this article:

1. 5
2. 4
3. 3
4. 2
5. 1

(32 votes, average: 3.2 out of 5)

Share with your friends!

Relatox is a Russian drug for facial wrinkles that has the longest shelf life

Can children be given Fluconazole - everything mothers need to know

Side effects and overdose

During treatment with Fluconazole, adverse events may develop. These include:

Extremely rare complications during treatment with Fluconazole are: alopecia (hair loss), increased levels of triglycerides and cholesterol in the blood serum, necrosis of liver cells and hypokalemia. If any of these complications occur, the drug should be discontinued and other treatment options should be discussed with your doctor.

If the recommended therapeutic dose has been exceeded, overdose symptoms may develop. Most often, patients experience hallucinosis and paranoid-type changes in thinking. In this case, a person’s behavior changes dramatically under the influence of painful experiences. Such a patient urgently needs to rinse the intestines and stomach, give intestinal sorbents to drink - activated carbon, Enterosgel, etc.

Interactions with drugs

Fluconazole may react with some medications. Concomitant use with other drugs may cause the following consequences:

• Concomitant use with Cisapride is contraindicated, since there is a high risk of developing ventricular tachysystolic arrhythmia.
• Taking the antibiotic Erythromycin together with Fluconazole leads to cardiotoxicity and sudden cardiac death.
• Combination with Warfarin increases the prothrombin time of the antifungal drug.
• The likelihood of hypoglycemia increases when the active substance of the tablets and sulfonylurea derivatives interact.
• Repeated combined use with hydrochlorothiazide can increase the concentration of fluconazole in the blood.
• When interacting with Rifampicin, the doctor should consider the possibility of increasing the dose of antifungal tablets, since the half-life of the active substance decreases.
• Concomitant use of Fluconazole with Terfenadine, Astemizole, Pimozide, Quinidine is contraindicated due to the risk of tachysystolic ventricular arrhythmia.
• If the medicine is combined with Cyclosporine, it is recommended to monitor the content of the latter in the patient’s blood.
• Fluconazole, with long-term use, can provoke a decrease in the clearance rate of Theophylline, so it is necessary to monitor the appearance of possible symptoms of overdose.
• The combination of an antifungal drug and Zidovudine increases the side effects of the latter.

Release form and composition

Fluconazole is available in the following dosage forms:

• Capsules (in blisters of 1 piece, 1-7 blisters in a cardboard box; in blisters of 2-7, 10 pieces, 1-4, 7 blisters in a cardboard box; in jars of 1-4, 7, 10 pcs., 1 can in a cardboard pack; in a polymer container 1, 2, 7, 10, 14, 28, 50, 100 pcs., 1 container in a cardboard pack);
• Solution for infusion (in polyethylene or glass bottles or bottles with or without suspension, 100 ml, 1 bottle in a cardboard box; in 50 ml bottles, 1, 2, 5, 10 bottles in a cardboard box);
• Film-coated tablets (2, 10 pcs. in blister packs, 1 pack in a cardboard box).

1 capsule contains:

• Active substance: fluconazole – 50, 100, 150 mg;
• Auxiliary components: potato starch, low molecular weight polyvinylpyrrolidone, magnesium stearate or calcium stearate.

1 film-coated tablet contains the active substance: fluconazole - 50, 100, 150 mg.

The composition of 1 ml of solution for infusion includes:

• Active substance: fluconazole – 2 mg;
• Auxiliary components: sodium chloride, sodium hydroxide or hydrochloric acid, water for injection.

Analogues and substitutes

An active substance such as fluconazole is produced by many domestic and foreign pharmacological companies. There are both 100% preparations based on this component, and complex products that contain two or three active substances.

The first type of drugs includes “Diflucan”, which is a powder for injection with a dosage of fifty milligrams and a solution for infusion with a dosage of one hundred milligrams, as well as “Mimomax”, presented on the pharmacological market in the form of syrup, infusion solution and capsules. In this list it is necessary to mention such drugs as “Forkan”, “Mikoflucan”, “Mikosist”, “Flucostat”, “Maikonil” and “Fluconorm”. Almost all of these products are available in the form of tablets (or capsules) and solutions for infusion.

The second group of drugs, among which fluconazole is not the only active ingredient, includes:

• “Safocide.” This product is a set of three tablets - “Azithromycin” (at a dosage of one thousand milligrams), “Secnidazole” (one thousand milligrams) and “Fluconazole” (150 milligrams).
• “Vagisept.” Other active ingredients are metronidazole. The drug is used to treat diseases caused by Trichomonas.
• "Vagiferon". A product based on fluconazole, metronidazole and interferon. Used for antimicrobial, antiprotozoal, immunomodulatory purposes.

If a patient is found to have individual intolerance to fluconazole, then drugs with a similar spectrum of action that contain other active ingredients can be prescribed:

• “Intraconazole.” A drug based on the substance of the same name.
• “Ketozoral.” A product whose active component is imidazole.
• “Mikogel.” A drug based on another active ingredient – ​​miconazole nitrate.

These drugs should be taken only after being prescribed by the attending physician, strictly observing the dosage and dosage schedule.

Analogues of Fluconazole, list of drugs

If a decision has been made to replace Fluconazole with an analogue due to its lack of effectiveness or severe side effects, pay attention to the following drugs:

1. Diflazon;
2. Mycomax;
3. Mikosist;
4. Diflucan;
5. Flucostat.

Despite the fact that the above drugs have similar compositions, actions, indications and contraindications (sometimes), it is recommended to consult a doctor before changing medications. Instructions for use of Fluconazole, reviews and prices for analogues do not apply and should not be used as a guide to the use, prescription or independent replacement of Fluconazole with an analogue.

Mechanism of pharmacotherapy

Since the drug “Fluconazole,” which helps with thrush, is a representative of a subgroup of antimycotics, the mechanism of its pharmacological action is based on the ability to block the enzymatic activity of fungal flora. Under the influence of the active substance of the drug, the permeability of the pathogen cell membranes significantly increases, and the growth and replication of the microorganisms themselves is also inhibited.

At the same time, the activity of Fluconazole as an active substance is selective. It has no effect on healthy cells of the human body. The greatest effectiveness is observed in the complex treatment of opportunistic mycoses. Thus, the use of the drug is justified not only for the purpose of treatment, but also for the prevention of fungal complications, for example, during chemotherapy, antibacterial therapy - long courses. The remedy has proven itself well in the field of transplantology and in other situations when there is a high probability of lowering the patient’s immune barriers.

The drug "Fluconozol" is successfully used, the instructions for use inform about this, and in the gynecological field - for various vaginal candidiasis, since its high concentration in the secreted secretion is achieved after 8 hours. In this case, the therapeutic level of the required concentration is maintained for at least 22-24 hours.

Metabolites of the drug are excreted by the renal structures, so it is recommended to carry out dynamic observation by a specialist and undergo laboratory tests while taking the medication.

Instructions for use, dosage

Fluconazole capsules should be taken once a day, regardless of meals.

In severe forms of generalized candidiasis and candidemia, take 400 mg of the drug on the 1st day, then reduce the dose to 200 mg and take up to 4 weeks. For children, the dosage is selected taking into account body weight - per 1 kg the daily dose ranges from 6 to 12 mg.

When treating candidiasis of the oral cavity and pharynx, the medicine is taken for 1-2 weeks, 50-100 mg per day. In case of development of the atrophic form of candidiasis, take 1 tablet per day with a dosage of 150 mg. The total duration of treatment can take from 14 to 30 days. For prophylactic purposes, to prevent candidiasis of the oral cavity and pharynx in HIV-infected and AIDS patients, 150 mg of medication is prescribed once a week. For children, when treating the local form, the dose is 3 mg per kilogram of body weight.

For cryptococcal infection of any localization, the daily dosage ranges from 200 to 400 mg. Treatment must be continued for 1.5 to 2 months.

For fungal skin infections, including mycosis of the feet, take the medicine 50 mg daily or 150 mg weekly. You need to take Fluconazole for 2 to 4 weeks; for mycosis of the feet, the course must be extended to one and a half months.

For the treatment of pityriasis versicolor, the drug is prescribed in a dosage of 300 mg; it must be taken 2 times with a break of 7 days. If necessary, the attending physician may prescribe a third dose of the medication. There is another treatment regimen - 50 mg of the drug is drunk daily for 2-4 weeks.

For fungal infections of the nail plates, Fluconazole is prescribed at a dose of 150 mg per week. You need to continue taking the capsules until a healthy one grows back in place of the affected nail.

Deep endemic mycoses require medication for 2 years. The daily dose is from 200 to 400 mg.

In case of development of vaginal candidiasis, a single dose of 150 mg of medication is sufficient. If thrush is chronic and recurrent, your doctor may prescribe taking 1 capsule of the medicine per month for preventive purposes. The duration of treatment in this case will be from 4 months to 1 year. You can take tablets and capsules regardless of the phase of the menstrual cycle.

For men, a single dose of 150 mg is enough to treat balanitis.

Price and analogues

There are several drugs with the same active ingredient

Many patients are interested in the price of the drug Fluconazole. Its cost directly depends on the pricing policy of the pharmacy and the drug manufacturer. To find out exactly how much the drug Fluconazole costs, you need to ask your pharmacist this question.

The average cost of Fluconazole in a dosage of 150 mg is 30 rubles. This is the price of a package that includes 1 capsule. The 50 mg medicine will cost the same. But this time the price is for 7 pcs.

Fluconazole has its own analogues. They can replace this drug if for a certain reason it is not suitable for the patient. Medicines similar to it are also used in the fight against fungal diseases. Therefore, they have the same medicinal properties.

Replacing a medication with its analogue must necessarily be agreed upon with the attending physician. Otherwise, this may lead to a decrease in the effectiveness of the therapeutic course and a greater spread of the infectious pathogen.

A specialist can recommend to his patient a replacement for Fluconazole only if he is not satisfied with the cost of the medication or if it begins to cause side effects in the person.

The most popular analogues of Fluconazole are the following medications:

• "Diflucan". The antimycotic drug is available in the form of capsules, powder and tablets. Its active component is characterized by rapid absorption. Moreover, it is easily eliminated from the human body naturally. There are different methods of treatment with Diflucan. It is usually recommended to take the medication at a dose of 150 mg per day. In the chronic course of the pathological process, the frequency of use of capsules or tablets is increased. Therapy is continued until the patient is no longer bothered by relapses of the fungal infection;
• "Flucostat". Another popular substitute, presented in the form of a solution and capsules. This structural analogue is characterized by good absorption and high bioavailability, which reaches 90%. The minimum dose of the drug is only 50 mg. The maximum should not exceed 400 mg.

Other analogues of Fluconazole, which are similar to it in their properties, are Voritab, Itraconazole, Oruzol and Difluzol.

Indications for use

What does it help with? Fluconazole has an active effect against fungal pathogens of various diseases. The drug is prescribed in such cases as:

1. Onychomycosis.
2. Balanitis of candidal nature.
3. Mycoses of the feet, body, skin of the groin area.
4. Pityriasis versicolor and versicolor.
5. Deep epidermal mycosis.
6. Cryptococcosis. For any location of the lesion, including the brain, lungs and skin. The drug is suitable for patients with a normal immune response, and is also effective for the treatment of patients with reduced immunity, after transplantation or with immunodeficiency syndrome.
7. Generalized candidiasis, candidoderma, disseminated candidiasis and other types of invasive infections affecting the peritoneum, endocardium, eye tissue, respiratory and genitourinary systems. A positive quality of the drug is that treatment can be carried out in patients with cancer, in intensive care, receiving a course of immunosuppressive or cytostatic therapy.
8. Candidiasis of mucous membranes of various localizations. Damage to the oral cavity and nasopharynx, esophagus, skin, lungs and bronchi, on the mucous membrane of the eyes.
9. Vaginal candidiasis in all forms of the disease, including acute, chronic and recurrent stages.

The pharmacological form, dosage and duration of the course are selected only by the doctor. In some cases, only local exposure is sufficient. For example, for oral thrush in children, only a suspension is prescribed, and for genital recurrent candidiasis, in addition to Fluconazole vaginal suppositories, systemic forms, tablets or injections are necessarily prescribed.

special instructions

Therapy must be continued according to the regimen prescribed by the doctor. The disappearance of visible signs of the disease can in no way be regarded as a cure. If you stop treatment without permission at this stage, the fungal infection may return again.

If you suspect a fungal infection, you should seek help from a dermatologist (if the skin is involved), a gynecologist (curd-like vaginal discharge) or a pediatrician (the child has white specks or plaque in the mouth).

This drug is usually recommended in a comprehensive manner, that is, in parallel, a local effect on the infection should be carried out using ointments or suppositories.

Timely diagnosis is the key to a speedy recovery! Fungus is not only unpleasant and unsightly, it is also dangerous. Do not forget to adhere to the rules of personal hygiene during treatment so as not to “reward” your household with an insidious infection.

Fluconazole in the treatment of fungus

The product is most effective against fungal microorganisms of the genus Candida, dermatophytes and cryptococcus.

Fluconazole is especially often prescribed for toenail fungus, as well as for women with thrush.

The effect is due to the action of the active component. It blocks the transformation of lanosterol in fungal cells into ergosterol (a membrane lipid). The permeability of the cell membrane increases, and the latter stops growing and developing.

The drug reaches effective concentration in the blood within 24 hours after entering the body. After this, the remedy begins to systematically and gradually affect the vital activity of the parasite.

Thus, the medicine is highly effective for serious fungal infections and in advanced cases. Acting from the inside, the product helps fight pathogenic microorganisms almost systemically.

The main thing is to follow the dosage regimen and act strictly according to medical instructions.

Treatment with fluconazole

So, almost all women experience episodes of vaginal dysbiosis, many of which are actually accompanied by candidiasis, which in some cases is successfully treated with fluconazole.
Thus, fluconazole is prescribed by a doctor to treat bacterial candidiasis. After the fungus dies, the vaginal mucosa is open to colonization, which can lead to a repeat episode of candidiasis or bakvaginosis.

To resolve this situation, after prescribing fluconazole, experienced doctors often recommend vaginal forms of probiotics that compensate for the flora and restore normal vaginal acidity. In this case, the risk of chronicity of the process is significantly reduced.

Release forms

Fluconazole has several forms of release (some manufacturers have everything).

• Capsules. There are No. 1, No. 5, No. 7, the standard dosage is 50 and 150 mg;
• Solution for intravenous administration. It is used in a hospital to treat generalized forms of fungal infection (thrush is rarely treated in this way);
• Syrup. Fluconazole in the form of syrup is prescribed to children, as well as to persons who have problems with swallowing. The dosage is 3 mg/kg body weight/day;
• Pills. This form of release is mainly indicated for the treatment of chronic forms of the disease. Capsules are considered the more preferable form in terms of drug bioavailability.

Schemes for the use of fluconazole in the treatment of vaginal candidiasis

Each specialist has their own. This is due not only to specific indications for a particular patient, but also to a large extent to the clinical preferences of a particular doctor, and also depends on the level of qualifications of the specialist.

Example of a fluconazole treatment regimen

Theoretically, with each episode of thrush, the doctor should do a culture of the flora, find out which antimycotic/antibiotic this flora is sensitive to, and only then prescribe this or that remedy. In practice, doctors often prescribe complex drugs or regimens that, in addition to fluconazole, also contain an antibiotic (just to be sure). This is not entirely humane to the entire body; it significantly reduces immunity, but it almost certainly treats dysbacteriosis. However, this approach increases the risk of recurrence of the condition in the future.

For chronic forms of the disease, postmenopause or immune deficiency, the following treatment regimens are practiced:

• A single dose of 150 mg capsule is the standard for the prevention of candidiasis after antibiotics are prescribed;
• Two days 150 mg;
• 150 mg capsule daily for 3 days;
• Weekly course of therapy 150 mg;
• 1 capsule every three days 2, 3 and 5 times.

For chronic candidiasis, 1 capsule is recommended weekly for a long time (for 6 months or longer).

In addition, there is the practice of 3 days after 3 days, as well as “author’s” treatment regimens. Doctors at dermatovenerological dispensaries are particularly sophisticated in this area - they combine fluconazole with a number of quite severe (for the liver and kidneys) drugs.

An example of such a “shock” therapy is the drug safocid, which includes azithromycin (an antibiotic), fluconazole (an antimycotic) and secnidazole (against chlamydia and trichomonas).

For example, with persistent thrush after 50 years in women (postmenopause), it is better not to take fluconazole every week, but to install an intrauterine device once, which corrects estrogen levels. As a result, the vagina will acidify naturally, and thrush will stop bothering you.

Illiterate, uncontrolled use of fluconazole quite often leads to the emergence of multi-resistant strains of fungus that are resistant to almost all known groups of drugs.

Fluconazole is also prescribed for men (sexual partners). The fact is that balanitis of a fungal nature (damage to the head of the penis) requires treatment, despite the fact that it is often asymptomatic. If a fungal infection again enters the vagina, the flora of which has been killed by an antibiotic, and the fungus by fluconazole, the meaning of thrush treatment is lost.

Treatment of a sexual partner

Fluconazole price

The cost of the drug differs depending on the country of manufacture, but domestic Fluconazole also has different price levels. When writing a prescription, the doctor must warn that when replacing expensive drugs with cheap ones, addiction may develop without obtaining the desired result. The table below shows prices for 1 capsule of 150 mg:

Manufacturer	Cost, rub.
Biocom, Russia	23
Vertex, Russia	32
Obolenskoye FP, Russia	37
Kanonpharma, Russia	47
Sandoz, Switzerland	173
Teva, Israel	177

Fluconazole for thrush

Suppositories are considered an effective remedy for thrush; the active substance they contain, fluconazole, fights all forms of candidiasis. The advantage of using suppositories is the direct effect of the drug on the source of infection and the absence of negative effects on the digestive organs. Fluconazole is available in capsules, suppositories and tablets.

Composition of Fluconazole

Capsules contain 50 or 150 mg of the active ingredient Fluconazole, have a gelatin shell containing white granular powder. Suppositories can be used slightly longer than tablets. They contain the same active ingredient, but the excipients may be different. Composition of Fluconazole capsules:

Substance	Quantity
Fluconazole	50 mg and 150 mg
Excipients: colloidal anhydrous silicon dioxide; lactose monohydrate; magnesium stearate; sodium lauryl sulfate; pregelatinized starch.

How the drug works

Doctors prescribe Fluconazole for candidiasis. The product is used to treat fungal infections of any etiology; it is widely used to eliminate and prevent candidiasis (thrush), the causative agents of which are yeast fungi. The main feature of the drug is its minimal effect on the body, so it can be used even by people with immunodeficiency. The drug causes virtually no side effects due to the low inhibition of cytochrome enzymes.

The active ingredients of Fluconazole suppositories quickly penetrate into body fluids and blood. The absolute concentration of the drug in the body from the moment of administration of the suppositories is achieved after 5 hours and remains there for more than a day, which helps to prolong the action of the active components of the drug and consolidate the antifungal effect. Fluconazole is eliminated by urination.

Indications for use

The drug is widely used to treat a large number of lesions caused by fungal infections. Treatment and prevention with the drug is prescribed to patients with oncology, patients in intensive care units, and persons predisposed to candidiasis due to decreased immunity and insufficient food intake. The medicine is used to treat the following diseases caused by fungus:

• cryptococcosis;
• pityriasis versicolor;
• nail and skin fungus;
• cutaneous mycosis;
• onychomycosis;
• coccidioidomycosis;
• histoplasmosis.

Fluconazole is used to treat all types of candidal diseases: candidiasis of the oral cavity, pharynx, mucous membranes of the eyes, and esophagus. The drug is used to get rid of invasive candidiasis infections: lesions of the urinary and respiratory tract, peritoneum, endocardium. The drug is widely used for the treatment and prevention of the following systemic candidiasis:

• chronically;
• vaginal;
• bronchopulmonary;
• oropharyngeal;
• candidal balanitis.

Fluconazole. Description of the medicine

The main active ingredient is fluconazole. The element has a pronounced antimycotic effect, which damages the cell membranes of the parasite. The fungus stops growing, stops spreading and gradually dies.

Other components of the medicine:

• lactose monohydrate;
• sodium dodecyl sulfate;
• polysorb;
• corn starch.

The product is produced in two forms:

• capsules of 50, 100, 150 and 200 milligrams;
• syrup (5 ml of active element per 1 ml).

In most cases, a capsule is prescribed. The drug has other forms of release: gels and ointments, injection solutions, suppositories. However, they are not prescribed for fungal infections.

In the case of Fluconazole, the instructions for use for skin and nail fungus give the most general recommendations, which may change in each specific case.

Pharmacological forms

• IV solution with an active ingredient concentration of 200 mg / 100 ml volume;
• powder for preparing suspension (Diflucan);
• Fluconazole tablets containing 50, 100 or 150 mg of the active substance (for example, Mikoflucan, it is used for long courses of treatment of chronic infection);
• gel with a concentration of 5 mg / 1 g volume (Flucorem);
• syrup used at a dosage of 3 mg/kg body weight per day (Mikomax; aimed at children and patients with swallowing problems);
• capsules with a concentration of the active component of 50 mg (Flunol), 100, 150 (Flucomicide Sediko) and 200 mg (Forkan, Ciskan), number per package: 1, 5, or 7 (recommended if you need quick and more complete, in terms of bioavailability , result).

Due to the variety of forms, the possibility of multifactorial influence on the infectious agent is possible, which leads to a good therapeutic effect.

Side effects are described in detail in the instructions. Judging by the reviews, gastrointestinal problems occur more often than others: nausea, bloating, gurgling, mild abdominal pain, diarrhea. In isolated cases - migraine, rash, hair loss.

Why do you need an Esmarch mug when treating thrush >>.

Description of the drug

To answer the main question, it is necessary to find out what antibiotics are and describe the drug Fluconazole.
Antibiotics are substances that inhibit the growth of living microorganisms or cause their death. The action of antibiotics is mainly directed towards bacteria and protozoa. And also some antibacterial agents are effective in combating fungi and other microorganisms.

Fluconazole belongs to the azole group of antifungal agents. The active substance of Fluconazole is fluconazole, which has a detrimental effect on many types of pathogenic fungi, especially the genus Candida.

Fluconazole is also effective against other fungal microorganisms. As a result of the fact that the drug has a detrimental effect on fungi, we can safely say that the drug Fluconazole is not an antibiotic .

The drug is released in the form of capsules for oral administration in dosages of 50 and 150 mg. Capsules in lower dosages are usually used in pediatrics. The second dosage option is mainly used to treat adults.

pharmachologic effect

The most common side effects observed during clinical trials of fluconazole were headache, skin rash, abdominal pain, nausea, and diarrhea.

Other adverse reactions from organs and systems:

• nervous system: often – headache; uncommon – paresthesia, convulsions, dizziness, seizures, tremor, drowsiness, insomnia, general weakness, severe fatigue;
• cardiovascular system: rarely - prolongation of the QT interval, pirouette-type arrhythmia;
• digestive system: often - decreased appetite, abdominal pain, nausea, vomiting, diarrhea; uncommon – flatulence, constipation, anorexia, dyspepsia, dry mouth, toothache, change in taste;
• hepatobiliary system: often - clinically significant increase in the activity of liver enzymes [ALT (alanine aminotransferase), AST (aspartate aminotransferase), alkaline phosphatase (ALP)]; uncommon – hepatitis, jaundice, cholestasis, scleral icterus, clinically significant increase in plasma concentration of total bilirubin (0.3%); rarely - liver dysfunction, toxic hepatitis (including fatal);
• hematopoietic organs: infrequently – anemia; rarely – thrombocytopenia (petechial hemorrhages, bleeding), leukopenia, agranulocytosis, neutropenia;
• skin: infrequently – hyperhidrosis, drug-induced dermatitis; very rarely - acute generalized exanthematous pustulosis;
• musculoskeletal system: infrequently – myalgia;
• organ of hearing and balance: infrequently – vertigo;
• metabolism: rarely – hypertriglyceridemia, hypokalemia, hypercholesterolemia;
• hypersensitivity reactions: often - skin rash; rarely - exudative erythema multiforme (including Stevens-Johnson syndrome), anaphylaxis; very rarely - exfoliative dermatitis, Lyell's syndrome (toxic epidermal necrolysis), anaphylactoid reactions (including facial swelling, angioedema, itching, urticaria);
• other: rarely – alopecia, renal failure.

Side effects are more common in children than in adult patients, the most common of which are anemia and irritability.

Symptoms of Fluconazole overdose: paranoid behavior, hallucinations.

Treatment of this condition is symptomatic: formed diuresis, gastric lavage. Hemodialysis, carried out for three hours, reduces the plasma concentration of the substance by approximately 1/2.

• warfarin: on average, prothrombin time increases by 12% (careful monitoring of prothrombin time in patients receiving Fluconazole in combination with coumarin anticoagulants is recommended);
• oral hypoglycemic agents, sulfonylurea derivatives (glibenclamide, chlorpropamide, glipizide, tolbutamide): in healthy people, fluconazole increases their plasma half-life; in patients with diabetes, this combination may cause hypoglycemia;
• phenytoin: the concentration of phenytoin in plasma may increase to a clinically significant level (monitoring of the concentration of phenytoin and adjustment of its dose is required to maintain the level of the drug within therapeutic values);
• rifampicin: AUC is reduced by 25% and the half-life of fluconazole from plasma is reduced by 20% (it is advisable to increase the dose of fluconazole);
• cyclosporine: the plasma concentration of cyclosporine slowly increases in patients with a kidney transplant when using fluconazole at a dose of 200 mg/day (monitoring of this indicator is necessary);
• theophylline (in high doses or when theophylline intoxication is likely to develop): fluconazole reduces the average rate of theophylline clearance from plasma (patient monitoring is required to promptly detect signs of theophylline overdose at an early stage);
• terfenadine, cisapride: there is evidence of cases of adverse effects from the cardiovascular system [tachycardia, dizziness, increased risk of arrhythmias, including paroxysms of ventricular tachycardia (torsades de pointes)];
• hydrochlorothiazide: possible increase in plasma concentration of fluconazole up to 40%;
• rifabutin: its serum level increases, as a result of which uveitis may develop (control of the combined use of these drugs is required);
• zidovudine: the conversion of zidovudine into its main metabolite decreases, which leads to an increase in its concentration; there may be an increase in unwanted side effects characteristic of zidovudine;
• midazolam: fluconazole increases its concentration, increasing the risk of developing psychomotor effects (more pronounced when using oral forms of Fluconazole);
• tacrolimus: increased risk of nephrotoxicity.

The abstract contains information that the drug acts as an antifungal agent, specifically inhibiting the synthesis of fungal sterols. Belongs to the class of triazole compounds.

There is a specific effect on fungal enzymes that depend on cytochrome P450. The active substance demonstrates activity against a variety of strains of Candida spp. (including effective against visceral candidiasis), Cryptococcus neoformans (including effective against intracranial infections), Trichophytum spp, Microsporum spp.

The drug stops the conversion of fungal cells into lanosterol into ergosterol. Under its influence, the permeability of the cell membrane increases, the process of its growth and replication is inhibited. It is highly selective for cytochrome P450 of fungi, but in the human body it almost does not inhibit these enzymes. Does not demonstrate antiandrogenic activity.

When treated with the drug, the patient may develop the following side effects:

• abdominal pain, diarrhea;
• headache;
• nausea, flatulence;
• skin rash;
• hepatotoxic effects;
• anaphylactic reactions.

How to take the medicine when such effects occur, and whether it is worth continuing treatment, should be individually consulted with a doctor.

Before starting treatment, it is important to know not only why Fluconazole in tablets and other forms helps, but also about the interaction of drugs with other drugs.

https://www.youtube.com/watch?v=upload

When taking Warfarin simultaneously, the prothrombin time of fluconazole becomes longer.

With simultaneous administration of hypoglycemic oral agents belonging to the group of sulfonylurea derivatives, the half-life of Fluconazole increases. As a result, there is a possibility of hypoglycemia.

With simultaneous administration of Phenytoin, a clinically significant increase in the concentration of phenytoin is observed.

With simultaneous repeated use of hydrochlorothiazide, an increase in the concentration of fluconazole in the blood is observed. There is no need to change the dosage.

With simultaneous treatment with Rifampicin, AUC decreases by 25%. The half-life is also reduced by 20%. In some cases, the doctor decides to increase its dose.

When treating with Fluconazole, monitoring the concentration of cyclosporine in the blood is recommended.

If the patient is simultaneously receiving high doses of Theophylline, it is important to consider the possibility of Theophylline overdose.

It is contraindicated to take a dose of more than 400 mg per day in combination with Terfenadine.

When taking Cisapride simultaneously, negative side effects from blood vessels and the heart may occur, in particular, paroxysms of ventricular tachycardia.

If Fluconazole and Zidovudine are combined, the patient should be monitored by a doctor, as the side effects of Zidovudine may increase.

If treatment with Astemizole, Cisapride, Tacrolimus, Rifabutin or any other drug that is metabolized by the cytochrome P450 system is simultaneously prescribed, the concentration of these drugs in the blood may increase.

The absorption of Fluconazole is not affected by simultaneous administration of Cimetidine or antacids.

• dizziness;
• increased dry mouth;
• pain in the abdomen;
• nausea or vomiting (mainly occurs with a significant overdose of the drug);
• local allergic reactions (increased skin itching, urticaria);
• frequent or recurrent headache;
• flatulence.

https://www.youtube.com/watch?v=ytaboutru

If any of the above side effects develop, it is recommended to temporarily stop further use of the drug, and also be sure to consult with your doctor!

During pregnancy

There have been no controlled studies regarding the use of Fluconazole tablets in pregnant women.
There is a description of several cases where, when high doses of the drug were used by the mother in the first trimester of pregnancy, developmental disorders were detected in the fetus. The following negative consequences were identified: failures in the formation of the skull in the facial part, curvature of the hip bones, congenital heart defects, brachycephaly, cleft palate, arthrogryposis. There are no data on abnormalities in child development when using low doses of Fluconazole. The drug is not prescribed during pregnancy, except in cases where the fungal infection is life-threatening, difficult to tolerate, and also if the benefit of the drug for the mother outweighs the risk to the fetus. The use of the drug during lactation is contraindicated, since its concentration in breast milk is similar to the content of the active substance in blood plasma. Under such conditions, the child may experience unwanted side effects.

Popular analogues in composition in tablets and other forms

Structural analogues of Fluconazole, which are produced in the form of tablets, are popular in the treatment of various etiologies of candidiasis.

Diflucan

Diflucan is a generic version of Fluconazole and is manufactured in several dosage forms - a dry mixture for the preparation of a suspension, a solution for injections and capsules.

The medication is prescribed for the following pathologies:

• pulmonary cryptococcosis;
• meningitis;
• sepsis;
• candidiasis of various origins;
• fungal pathologies in cancer patients;
• mycosis of skin and nails.

It is prohibited to use the medication for:

• allergies to the medicinal composition;
• liver and kidney failure;
• patient age up to 6 months;
• pregnancy and lactation.

Diflucan is administered into a vein using a dropper at 200-400 mg per day for all types of candidiasis and cryptococcosis. On average, treatment lasts 6-8 weeks. For therapy in childhood, the dosage is halved. For genital and vaginal candidiasis – 1 capsule once. For candidiasis of the mouth and ENT organs - 1 capsule for 7 days.

For the treatment of mycosis - 150 mg once a day for 7-14 days or 520 mg per day for 14-28 days.

Among the adverse reactions, patients note headache and dizziness, body fatigue and sleep disturbances, dyspeptic disorders, systemic pathologies (blood pressure fluctuations) and cardiac diseases (arrhythmia) and dermatological allergies.

Mikosist

Mikosist is prepared in a solution for injections and in capsules with the main component fluconazole. The drug is an antifungal agent that is prescribed for the treatment of the following pathologies:

• candidiasis of different localization sites;
• candidemia;
• fungal infections in the endocardium, peritoneum, lungs, and skin;
• cryptococcosis;
• meningitis of cryptococcal etiology;
• mycoses on the skin.

The medication is also prescribed for immunodeficiency of various origins (AIDS, HIV, oncology, organ transplantation), as well as for long-term therapy with antibacterial medications.

Mikosist is not used in therapy for:

• lactose intolerance and deficiency;
• treatment with medications terfenadine and astemizole;
• hypersensitivity to components in the drug;
• pregnancy and pregnancy.

With restrictions, the drug is prescribed for:

• kidney and liver dysfunction;
• systemic infections;

Also used with caution in children over 5 years of age. The medication is prescribed according to the progression of the pathology, taken orally or parenterally

The medication is prescribed in accordance with the progression of the pathology, taken orally or parenterally.

Therapy for generalized candidiasis - the first day of therapy (dosage 400 mg), the second and subsequent days of the drug course - 200 mg. Severe development of pathology allows dosage to be doubled. Atrophic candidiasis is treated for 2 weeks with a daily dosage of 50 mg, and candidiasis on the mucous membranes - 50-100 mg for 14-30 days. As part of preventive measures, patients with immunodeficiency are prescribed 50-100 mg once a day.

Side effects:

• dyspeptic reactions - nausea, diarrhea, vomiting, epigastric and abdominal pain;
• skin allergies - swelling and redness of the skin, itching of the skin and rash;
• Johnson-Stevenson syndrome, Quincke's edema and urticaria;
• epidermal necrolysis.

Futsis

Fucis is a complete analogue of Fluconazole and is produced in tablets and solution for infusion. This antifungal medication is prescribed for the following pathologies:

• candidiasis of various localizations;
• disseminated candidiasis;
• balanitis and vaginal candidiasis;
• dermatomycosis;
• pityriasis versicolor;
• fungus on nail plates.

Also, the drug Fucis is used as a preventive measure for the development of fungal pathologies in immunodeficiency in humans, as well as in cancer patients after chemotherapy and radiation therapy, during long-term treatment with antibacterial drugs and cytostatics.

A Fluconazole substitute is not prescribed in the following cases:

• allergic reactions to the composition of the drug;
• pregnancy and breastfeeding period;
• in pediatrics;
• joint therapy with cisapride, terfenadine.

The duration of the therapeutic course, dosage and form of the medication are prescribed by the doctor in accordance with the pathology and the stage of its progression. The tablets must be taken regardless of the eating procedure. It is recommended to dissolve the tablet in a small amount of water (50 ml) for better absorption.

Negative reactions:

• hepatitis and food jaundice;
• dyspepsia;
• dizziness and headache;
• changes in the hemostatic system;
• tremors of limbs and convulsions;
• cardiac pathologies – tachycardia and arrhythmia.

Prevention of fungal infections

A drug such as Fluconazole can be prescribed not only for the treatment of mixed infections, but also as a prophylactic against candidiasis, which often occurs while taking antibiotics. Let's figure out why this technique is effective.

The fact is that human microflora is divided into beneficial, normal and opportunistic. The latter species, with a small amount of normal microflora, begins to actively multiply and predominate, causing various diseases.

Antibiotics have a detrimental effect not only on pathogenic, but also on beneficial microflora. At the same time, antibiotics do not affect opportunistic fungi of the genus Candida, which begin to actively multiply in the absence of beneficial microflora. A large number of such fungi leads to a disease called candidiasis.

Therefore, to avoid the development of such diseases, it is prescribed to take Fluconazole together with antibiotics. As a result, antibiotics will help eliminate the underlying disease, and antifungals will prevent Candida fungi from multiplying and causing systemic or generalized candidiasis.

Fluconazole has a systemic effect, because it is taken in the form of tablets. Having good absorption, the antifungal agent is distributed throughout the organs, providing prevention of candidiasis during antibiotic therapy in almost the entire body.

In no case should you prescribe such a treatment on your own , because Fluconazole has a toxic effect on the liver and, when taken simultaneously with certain antibiotics, can lead to negative consequences.

On average, the doctor prescribes taking Fluconazole during antibiotics, on days 2-5 of treatment with drugs that have an antibacterial effect. It makes no sense to start prevention right away, because the beneficial microflora that prevents the proliferation of candidiasis does not die immediately.

If the patient has diseases that are accompanied by reduced immunity, then Fluconazole may be prescribed from the first day of antibiotic treatment.

The dosage and duration of use for preventive purposes depends on the type of disease, the degree of risk of developing fungal diseases and many other factors and is determined individually by the doctor. It can vary from 50 to 400 mg per day.

Examples of fluconazole drugs on the Russian pharmaceutical market

The comparison is made based on the most common dosage of fluconazoles – 150 mg No. 1 (one capsule).

Diflucan is the original drug. If the doctor prescribes it, and the amount is not critical for you, buy it with confidence. Cost from 500 rub. Traditionally, it is believed that a generic should be at least 2 times more accessible than the original. Prices are indicative only to visualize the relationships between different manufacturers.

• Mikosist. Gedeon Richter (Hungary) is a well-known European brand, high quality - from 300 rubles;
• Flucostat Pharmstandard OJSC domestic brand, price from 190 rubles;
• Diflazon KRKA (Slovenia) is a well-known generic company operating primarily in the CIS market. The quality is not bad, the price starts from 250 rubles;
• Mycomax Zentiva (Czech Republic). The quality is good, price from 230 rubles;
• Mycoflucan Reddy's Laboratories Ltd. (India). To the credit of this company, I would like to say that it is one of the few Indian companies that produces high-quality generics. You can safely take mycoflucan, price from 190 rubles;
• Fluconazole VERTEX (Russia) price for 150 mg No. 2 (2 capsules) is up to 50 rubles. Of course, for this money you get the appropriate quality of the product. It cannot be said that absolutely all prescriptions of this kind are ineffective, however, it is not worth replacing Diflucan with fluconazole from VERTEX - resistance to the active substance may develop, and the effect will not be achieved.

• Fluconazole-Stada (STADA AG concern). An international concern that includes 4 separate companies. Positioned as a domestic manufacturer (European standards). The quality is acceptable, price from 80 rubles;
• Flucostat Pharmstandard-Leksredstva (Russia). Domestic quality, price from 200 rubles.

Thus, an acceptable price for 1 capsule of 150 mg of fluconazole is in the range from 100 to 300 rubles. An adequate purchase would be products from Zentiva, KRKA, Dr. Reddy´sLaboratoriesLtd. If funds are tight, one of the best offers is Fluconazole-Stada.

Fluconazole has fairly broad indications for use, but it is mainly prescribed for vaginal candidiasis. Most patients experience episodes of candidiasis more than once a year. For this reason, it is worth purchasing fluconazole No. 5 or No. 7, since a single dose for chronic candidiasis does not give much effect, and doctors, when recommending the drug for several doses, do not always mention the availability of this form of release.

For better effect after treatment of vaginal candidiasis, it is advisable to use vaginal forms of probiotics, since killed fungus does not mean immediate colonization of the vagina by normal flora, which creates a risk of relapse of the pathological process.

Fakes

When buying a drug from a well-known manufacturer of fluconazole at a pharmacy, pay attention to the original packaging, instructions, blister and the capsule itself. Drugs in this group are often counterfeited, and the turnover of counterfeit pharmaceuticals in the CIS countries is quite large.

Low effectiveness of treatment is often associated with counterfeits.

Of course, the most popular, expensive, branded drugs are counterfeited.

Pharmaceutical pirates do not often pay attention to generics of the middle and lower price niche, which is another argument for purchasing them

Other

We influence mushrooms in their habitat

For local treatment, if the symptoms are definitely thrush, in my opinion, it should be a single drug: Pimafucin, Livarol, Zalain, Clotrimazole, Ginezol 7, Ginofort.

For women, most often these are suppositories or vaginal capsules/tablets, for men - cream.

The duration of treatment is different for each drug.

The average duration of use of the cream for a man is 7-10 days.

As for combined remedies (Terzhinan, Polygynax, Klion D, etc.), using them for thrush is like cutting your finger and at the same time smearing it with iodine. With the antifungal component we will destroy the fungus, and with the other, beneficial microbes, while reducing local immunity, which in itself is the cause of thrush.

They are usually prescribed for combined fungal and bacterial infections.

You may ask: how can you recognize it?

Firstly, a bacterial infection is manifested by “colored” discharge (yellowish-greenish).

Secondly, the unpleasant smell.

Thirdly, it can cause abdominal pain, fever, and deterioration in general health.

And then, most likely, you need Macmiror, Flagyl or a broad-spectrum antibiotic inside. Plus a combined local remedy such as Terzhinan or Polygynax.

Restoring microflora

And then after the antimycotic you need to restore the vaginal flora. Acilact, Laktozhinal, Ecofemin will help with this, i.e. preparations containing lactobacilli.

Food for thought. In the instructions for such drugs, candidiasis is listed as a contraindication, but doctors prescribe them in the complex treatment of thrush. How to understand this?

I haven't found any clear explanations for this. Moreover, opinions are divided as to which environment Candida mushrooms reproduce best in: some say that it is acidic (which I do not agree with), others say that it is alkaline. If we assume that they like an acidic environment, then how can we explain their existence in the large intestine, where the environment is slightly alkaline?

And yet: why are these drugs contraindicated for candidiasis?

I believe that firstly, because of the excipients. For example, in the drug Acylact it is written that bacteria are cultivated with the addition of sucrose-milk medium, and mushrooms, as you now know, love sweets.

Secondly, against the background of candidiasis, the affected cells of the vaginal epithelium contain little glycogen, so lactobacilli will not have enough nutrient substrate, and candidiasis will only get worse.

But after the end of antifungal therapy, with negative smears for the fungus, these drugs will come in very handy.

What do you think about this?

We take proper care

And ideally, especially with recurrent thrush, it is good to use a special intimate care product that will maintain an optimal environment in the vagina (for example, Lactacid).

Side effects

This medication is almost always well tolerated, and no side effects are observed. But sometimes a negative effect may occur due to intolerance to the components of this remedy.

It can manifest itself in the form of sudden attacks of headache, the appearance of skin rashes, and dyspeptic disorders.

Also, adverse reactions can occur in various organs of the human body.

• From the nervous system, the patient may experience periodic headaches, drowsiness or insomnia, and seizures.
• In the cardiovascular system , a malfunction may occur in the form of the appearance of ari class=”aligncenter” width=”450″ height=”429″[/img]
• From the digestive system, there may be a decrease in appetite, dryness of the oral mucosa, paroxysmal pain in the lower abdomen, nausea, which sometimes turns into vomiting.
• Anemia and thrombocytopenia may rarely develop in the hematopoietic organs
• With long-term treatment, there is a high probability of allergies , which manifests itself as skin itching, facial swelling, hypersalivation, and sore throat.
• Very rarely, the use of this medication can cause kidney failure and the development of alopecia.
• It should be borne in mind that side effects appear much more often in children than in adults, and their most important feature is the development of anemia.

Features of the drug action mechanism

How can Fluconazole help a man with thrush?

The drug is a new generation synthetic medicine. The product is well absorbed into the blood and is well absorbed. Its antifungal effect has been proven. To stop thrush, the substance destroys the cell walls of candida, then suppresses the synthesis of components that fungal agents need to maintain the mechanisms of their vital functions.

"Fluconazole" acts in the following areas:

• destroys excessive amounts of fungal flora on the affected mucous membranes;
• prevents the recurrence of the disease after treatment.

In addition, for candidiasis, the drug is prescribed not only to men, it is also prescribed to women (if there are necessary indications, it is taken during breastfeeding and pregnancy).

Many people are wondering whether a man can take Fluconazole if he has thrush or not?

Indications

This dosage form can be used in the treatment of any fungal pathologies, and can be used as an additional or primary remedy.

Fluconazole is used in the treatment of the following diseases:

1. Pathological processes that are caused by a fungus such as candida. As well as other types of invasive candidiasis.

2. Candidiasis, which develops damage to the mucous membranes of the mouth, esophagus, and nasopharynx.
3. Atrophic oral candidiasis, which occurs due to the use of dentures.
4. Urogenital candidiasis (vaginal).
5. Meningitis, the etiology of which is cryptococcal infection.
6. Dermatomycosis, which affects the feet, groin, and the whole body.
7. Endemic mycoses.
8. Onychomycosis and pityriasis versicolor.
9. After radiation therapy (for prophylactic purposes).

Fluconazole use regimen

Most often, when the diagnosis of thrush is confirmed, the doctor prescribes Fluconazole, since this is the most effective remedy for combating the disease.
Sometimes treatment can be complex, and then vaginal sprays or suppositories are prescribed simultaneously with Fluconazole. At the first infection with genital candidiasis, Fluconazole tablets are prescribed for thrush. This is the most common form of medication.

• For the primary form of the disease, a single dose of the drug is prescribed at a dosage of 150 mg. To consolidate the effect, a repeat appointment is sometimes prescribed after a week or two. With a long and recurring course of the disease, the dosage may be different: use 150 mg every three days for two weeks, then once a month, one dose for six months.
• For candidiasis of the skin, body and groin area, take 150 mg once a week for 2-4 weeks.
• For candidiasis after antibiotic therapy, take 150 mg once.
• For children over one year old with candidiasis of the mucous membranes, Fluconazole is administered every day at the rate of 1-3 mg per kilogram of body weight and 3-12 mg per kg for systemic candidiasis, depending on the severity of the disease.
• If taking tablets or capsules is not possible, the drug is administered intravenously as a solution. The rate of administration should not exceed 20 mg per minute or 200 mg per hour. Doses for intravenous administration are the same as for capsules and tablets.

Use of Fluconazole for pregnant women and men

Fluconazole is contraindicated for pregnant women, although during pregnancy this disease very often manifests itself, so it is necessary to carefully weigh all possible dangers to the development of the fetus. An experienced gynecologist is able to select the correct use of drugs that cannot harm the fetus and cure the mother.

Fluconazole is indicated for men when there are obvious symptoms or persistent manifestations of the disease in the partner. Thrush is not a sexually transmitted disease, but sexual intercourse with a person with thrush can cause the disease in a healthy partner.

Various creams are usually used to treat thrush in men.

Long-term treatment with Fluconazole requires strengthening the immune system with the help of multivitamins and immune medications.

Overdose

If the drug is used for a long period of time, as well as in doses not allowed by the instructions, symptoms of overdose may develop. They manifest themselves in the form of intoxication of the body.

The patient experiences nausea, progressing to vomiting, loose stools, increased sweating, pallor or bluish skin. In severe cases, spatial orientation is disrupted, speech confusion, hallucinations, convulsions, and loss of consciousness appear.

If the overdose is accompanied by severe consequences, then the patient undergoes further treatment in a hospital, where he is prescribed hemodialysis, which helps to lower the concentration of Fluconazole in the bloodstream. Therefore, Fluconazole must be taken strictly as prescribed by the doctor.