Fluconazole: Brands, Price & Uses in Bangladesh

Fluconazole is a triazole antifungal used to treat and prevent a range of fungal (candidal and cryptococcal) infections. Its indications can be classified by strength of evidence as follows:

Established / FDA-approved uses

• Vaginal candidiasis (vulvovaginal candidiasis)
• Oropharyngeal and esophageal candidiasis
• Systemic Candida infections, including candidemia, disseminated candidiasis, and candida infections of the peritoneum, endocardium, and urinary tract
• Cryptococcal meningitis (including as maintenance therapy to prevent relapse in patients with AIDS)
• Prophylaxis of candidiasis in patients undergoing bone marrow transplantation who are expected to have neutropenia following cytotoxic chemotherapy or radiation therapy

Guideline-supported / commonly used indications

• Dermatophyte infections such as tinea corporis, tinea cruris, tinea pedis, and tinea versicolor (used based on clinical guidelines and long-standing clinical practice, though not all are separately listed in every regulatory label)
• Prevention of recurrent fungal infections in immunocompromised patients (e.g. HIV/AIDS, organ transplant recipients) at increased risk

Off-label uses

• Fungal urinary tract infections and prosthetic device-related candidiasis in select patients, under specialist guidance

Use of Fluconazole should always be guided by a physician's diagnosis and, where possible, fungal culture/susceptibility results.

Fluconazole may be given orally (capsule/tablet or oral suspension) or by slow intravenous infusion; the oral and intravenous doses are the same because of high oral bioavailability. Fluconazole may be taken with or without food.

Dose adjustment is required in patients with renal impairment (see Use in Special Populations).

Antimicrobial stewardship: Take Fluconazole exactly as prescribed by your physician; do not stop, extend, skip doses, or share this medicine with others without medical advice, even if symptoms improve before the course is finished.

Most patients tolerate Fluconazole well. Reported side effects include:

Common

• Headache
• Nausea, abdominal pain, diarrhea, vomiting
• Dizziness
• Rash
• Altered taste

Less common / serious (seek medical attention)

• Signs of liver injury: yellowing of skin/eyes, dark urine, unusual fatigue, loss of appetite (see Precautions and Warnings)
• Severe skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis (rare)
• Signs of an allergic reaction, including anaphylaxis and angioedema (rare)
• Palpitations or irregular heartbeat, suggestive of QT prolongation (rare)
• Low blood counts (leukopenia, thrombocytopenia) with prolonged use

Patients should seek prompt medical attention if serious symptoms occur while taking Fluconazole.