Dosing & Uses
Dosage Forms & Strengths
injection solution
- 2mg/mL
oral suspension
- 10mg/mL
- 40mg/mL
tablet
- 50mg
- 100mg
- 150mg
- 200mg
Oropharyngeal Candidiasis
200 mg PO on Day 1, THEN 100 mg qDay
Dosing considerations
- Treatment should be continued for at least 2 weeks to decrease likelihood of relapse
Esophageal Candidiasis
200 mg PO on Day 1, THEN 100 mg qDay; doses up to 400 mg/day may be used based on patient’s response
Dosing considerations
- Treat for a minimum of 3 weeks and for at least 2 weeks following resolution of symptoms
Cryptococcal Meningitis
400 mg PO on Day 1, THEN 200 mg PO qDay
Dosage of up to 400 mg qDay may be used based on patient’s response
Suppression of relapse in patients with AIDS: 200 mg PO qDay
Dosing considerations
- Recommended duration of therapy is 10-12 weeks after cerebrospinal fluid becomes culture negative
Prophylaxis of Candidiasis with BMT
Prevention of candidiasis incidence in patients undergoing bone marrow transplant
400 mg PO qDay
Dosing considerations
- Patients who are anticipated to have severe granulocytopenia should start prophylaxis several days before anticipated onset of neutropenia and continue for 7 days after neutrophil count rises >1000 cells per mm³
Vaginal Candidiasis
Uncomplicated: 150 mg PO as a single dose
Complicated: 150 mg PO q72hr for 3 doses
Recurrent: 150 mg PO qDay for 10-14 days followed by 150 mg once weekly for 6 months
Candida UTI/Peritonitis
50-200 mg PO qDay
Dosage Modifications
Hepatic impairment: Not studied
Renal impairment
- Percent of recommended dose:
- CrCl >50 mL/min: 100% of dose
- CrCl ≤50 mL/min: 50% dose
- Regular dialysis: 100% dose after each dialysis; on nondialysis days, reduce dose according to creatinine clearance
Dosage Forms & Strengths
injection solution
- 2mg/mL
oral suspension
- 10mg/mL
- 40mg/mL
tablet
- 50mg
- 100mg
- 150mg
- 200mg
Oropharyngeal Candidiasis
6 mg/kg PO on Day 1, THEN 3 mg/kg qDay; not to exceed 600 mg/day
Dosing considerations
- Treatment should be administered for at least 2 weeks to decrease likelihood of relapse
Esophageal Candidiasis
Esophageal candidiasis: 6 mg/kg PO on Day 1, THEN 3 mg/kg qDay
Doses up to 12 mg/kg/day may be used, based on patient’s response
Dosing considerations
- Treat for a minimum of 3 weeks and for at least 2 weeks following resolution of symptoms
Systemic Candida Infections
6-12 mg/kg/day PO/IV; not to exceed 600 mg/day
Cryptococcal Meningitis
12 mg/kg PO/IV on Day 1, THEN 6 mg/kg qDay
Dose of 12 mg/kg once daily may be used, based on patient’s response
Suppression in children with AIDS: 6 mg/kg once daily
Dosing considerations
- Recommended duration of therapy is 10-12 weeks after cerebrospinal fluid becomes culture negative
Premature Neonates
26-29 weeks' gestation:: 6-12 mg/kg IV/PO
Maintenance: 3-6 mg/kg IV/PO qDay
Maintenance dose interval
- 26-29 weeks' gestation: q72hr; administer q24hr after 2 weeks of life
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (25)
- alfuzosin
alfuzosin and fluconazole both increase QTc interval. Contraindicated.
- asenapine
asenapine and fluconazole both increase QTc interval. Contraindicated.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and fluconazole both increase QTc interval. Contraindicated.
- ceritinib
ceritinib and fluconazole both increase QTc interval. Contraindicated.
- citalopram
citalopram and fluconazole both increase QTc interval. Contraindicated.
- disopyramide
disopyramide and fluconazole both increase QTc interval. Contraindicated.
- erythromycin base
fluconazole will increase the level or effect of erythromycin base by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
erythromycin base and fluconazole both increase QTc interval. Contraindicated. - erythromycin ethylsuccinate
erythromycin ethylsuccinate and fluconazole both increase QTc interval. Contraindicated.
fluconazole will increase the level or effect of erythromycin ethylsuccinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. - erythromycin lactobionate
erythromycin lactobionate and fluconazole both increase QTc interval. Contraindicated.
fluconazole will increase the level or effect of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. - erythromycin stearate
erythromycin stearate and fluconazole both increase QTc interval. Contraindicated.
fluconazole will increase the level or effect of erythromycin stearate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. - fezolinetant
fluconazole will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitors
- flibanserin
fluconazole will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of flibanserin with moderate or strong CYP3A4 inhibitors is contraindicated. Severe hypotension or syncope can occur.
- ibutilide
fluconazole and ibutilide both increase QTc interval. Contraindicated.
- indapamide
fluconazole and indapamide both increase QTc interval. Contraindicated.
- lomitapide
fluconazole increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increases lomitapide levels several folds.
- lonafarnib
fluconazole will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated.
- mavacamten
fluconazole will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction.
- pentamidine
fluconazole and pentamidine both increase QTc interval. Contraindicated.
- pimozide
fluconazole and pimozide both increase QTc interval. Contraindicated.
fluconazole increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation. - procainamide
fluconazole and procainamide both increase QTc interval. Contraindicated.
- quinidine
fluconazole will increase the level or effect of quinidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
quinidine and fluconazole both increase QTc interval. Contraindicated. - ribociclib
ribociclib increases toxicity of fluconazole by QTc interval. Contraindicated.
- solifenacin
solifenacin and fluconazole both increase QTc interval. Contraindicated.
- sunitinib
sunitinib and fluconazole both increase QTc interval. Contraindicated.
- tacrolimus
tacrolimus and fluconazole both increase QTc interval. Contraindicated.
Serious - Use Alternative (124)
- abrocitinib
fluconazole will increase the level or effect of abrocitinib by decreasing metabolism. Avoid or Use Alternate Drug. Abrocitinib is a CYP2C9 and CYP2C19 substrate. Drugs that are moderate-to-strong inhibitors of both CYP2C9 and CYP2C19 increase systemic exposure of abrocitinib and its active metabolites, which may increase adverse effects.
- adagrasib
adagrasib, fluconazole. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- amiodarone
fluconazole will increase the level or effect of amiodarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration can cause additive effects on QT prolongation.
amiodarone and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. - amisulpride
amisulpride and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- amitriptyline
amitriptyline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- amoxapine
amoxapine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- anagrelide
anagrelide and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- aripiprazole
aripiprazole and fluconazole both increase QTc interval. Contraindicated.
- arsenic trioxide
arsenic trioxide and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and fluconazole both increase QTc interval. Contraindicated.
- artemether/lumefantrine
fluconazole and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and fluconazole both increase QTc interval. Contraindicated.
- avapritinib
fluconazole will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with moderate CYP3A4 inhibitors. If unable to avoid, reduce avapritinib starting dose. See drug monograph Dosage Modifications.
- axitinib
fluconazole increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with moderate CYP3A4 inhibitors, monitor closely and reduce dose if necessary .
- bosutinib
fluconazole increases levels of bosutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- buprenorphine
buprenorphine and fluconazole both increase QTc interval. Contraindicated.
- buprenorphine buccal
buprenorphine buccal and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and fluconazole both increase QTc interval. Contraindicated.
- buprenorphine transdermal
buprenorphine transdermal and fluconazole both increase QTc interval. Contraindicated.
- chlorpromazine
chlorpromazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- cilostazol
fluconazole increases toxicity of cilostazol by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Decrease cilostazol dose by 50%; serum levels of 3,4-dehydrocilostazol (active metabolite) increased by strong CYP2C19 inhibitors.
- clarithromycin
clarithromycin and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- clomipramine
fluconazole will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
clomipramine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. - clopidogrel
fluconazole decreases effects of clopidogrel by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Clopidogrel efficacy may be reduced by drugs that inhibit CYP2C19. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metabolized to this active metabolite in part by CYP2C19. .
- clozapine
clozapine and fluconazole both increase QTc interval. Contraindicated.
- cobimetinib
fluconazole will increase the level or effect of cobimetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concurrent short term (14 days or less) use of moderate CYP3A inhibitors is unavoidable for patients who are taking cobimetinib 60 mg, reduce the cobimetinib dose to 20 mg. After discontinuation of a moderate CYP3A inhibitor, resume cobimetinib 60 mg. Use an alternative to a moderate CYP3A inhibitor in patients who are taking a reduced dose of cobimetinib (40 or 20 mg daily).
- colchicine
fluconazole will increase the level or effect of colchicine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid use of colchicine with strong CYP3A4 inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with strong CYP3A4 inhibitors is contraindicated in patients with renal or hepatic impairment.
- desflurane
desflurane and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- desipramine
desipramine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- dihydroergotamine
fluconazole will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- dihydroergotamine intranasal
fluconazole will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- dofetilide
dofetilide and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- doxepin
doxepin and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- dronedarone
fluconazole will increase the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
dronedarone and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. - droperidol
droperidol and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- elacestrant
fluconazole will increase the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- eliglustat
fluconazole increases levels of eliglustat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Moderate CYP3A4 inhibitors are not recommended with eliglustat poor or intermediate metabolizers; reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive metabolizers .
eliglustat and fluconazole both increase QTc interval. Contraindicated. - encorafenib
fluconazole will increase the level or effect of encorafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concomitant use of a moderate CYP3A4 inhibitor is unavoidable, reduce encorafenib dose to one-half of the dose (eg, reduce from 450 mg/day to 225 mg/day). After discontinuing the inhibitor for 3-5 elimination half-lives, resume previous encorafenib dose.
encorafenib and fluconazole both increase QTc interval. Contraindicated. - entrectinib
fluconazole and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
fluconazole will increase the level or effect of entrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of moderate CYP3A4 inhibitors with entrectinib, a CYP3A4 substrate. If coadministration unavoidable, reduce dose to 200 mg/day for patients aged 12 y or older with BSA >1.50m2. Resume previous entrectinib dose after discontinuing moderate CYP3A inhibitor for 3-5 elimination half-lives. - epinephrine
epinephrine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- epinephrine racemic
epinephrine racemic and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- erdafitinib
fluconazole will increase the level or effect of erdafitinib by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with strong CYP2C9 inhibitors, monitor closely for adverse reactions and consider decreasing dose accordingly. If strong CYP2C9 inhibitor is discontinued, consider increasing erdafitinib dose in the absence of any drug-related toxicities.
- ergotamine
fluconazole will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- eribulin
eribulin and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- everolimus
fluconazole will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- fedratinib
fluconazole will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadministration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib has not been studied.
- fentanyl
fluconazole will increase the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.
- fentanyl intranasal
fluconazole will increase the level or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.
- fentanyl transdermal
fluconazole will increase the level or effect of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.
- fentanyl transmucosal
fluconazole will increase the level or effect of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.
- fexinidazole
fexinidazole and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- fluphenazine
fluphenazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- formoterol
fluconazole and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- gilteritinib
gilteritinib and fluconazole both increase QTc interval. Contraindicated.
- glasdegib
fluconazole and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- haloperidol
fluconazole and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- ibrutinib
fluconazole increases levels of ibrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of ibrutinib and strong CYP3A4 inhibitors. If a strong CYP3A4 inhibitor must be used short-term (eg, anti-infectives for =7 days), interrupt ibrutinib therapy until strong CYP3A4 inhibitor is discontinued.
- imipramine
fluconazole will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
imipramine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. - infigratinib
fluconazole will increase the level or effect of infigratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- inotuzumab
inotuzumab and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.
- isoflurane
isoflurane and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- itraconazole
fluconazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
- ivabradine
fluconazole will increase the level or effect of ivabradine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of ivabradine with moderate CYP3A4 inhibitors.
- ivosidenib
ivosidenib and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
- ketoconazole
fluconazole and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- lemborexant
fluconazole will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lemborexant with moderate or strong CYP3A inhibitors.
- levoketoconazole
fluconazole and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
- lofepramine
lofepramine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- lovastatin
fluconazole will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- lumefantrine
fluconazole and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- lurbinectedin
fluconazole will increase the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- macimorelin
macimorelin and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
- maprotiline
maprotiline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- midazolam intranasal
fluconazole will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of moderate CYP3A4 inhibitors with midazolam intranasal causes higher midazolam systemic exposure, which may prolong sedation.
- mirtazapine
mirtazapine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
fluconazole will increase the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use of moderate CYP3A4 inhibitor unavoidable, reduce mobocertinib dose by ~50% (eg, 160 to 80 mg); closely monitor QTc interval.
mobocertinib and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently. - moxifloxacin
fluconazole and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- naloxegol
fluconazole will increase the level or effect of naloxegol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministation of naloxegol with moderate CYP3A4 inhibitors is unavoidable, reduce naloxegol dose to 12.5 mg qDay
- neratinib
fluconazole will increase the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of neratinib with strong/moderate CYP3A4 inhibitors.
- nilotinib
fluconazole and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- nortriptyline
nortriptyline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- octreotide
fluconazole and octreotide both increase QTc interval. Avoid or Use Alternate Drug.
- octreotide (Antidote)
fluconazole and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.
- olaparib
fluconazole will increase the level or effect of olaparib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with moderate CYP3A inhibitors cannot be avoided, reduce olaparib dose to 200 mg (capsule) or 150 mg (tablet) PO BID. Do not substitute tablets with capsules.
- omaveloxolone
fluconazole will increase the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unavoidable, reduce omaveloxolone dose to 100 mg/day. Closely monitor for adverse effects. If adverse effects emerge, further reduce to 50 mg/day.
- ondansetron
fluconazole and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias. Combination may increase ondansetron levels.
- oxaliplatin
oxaliplatin and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- pacritinib
fluconazole will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- panobinostat
fluconazole and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.
- pazopanib
fluconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day
- pemigatinib
fluconazole will increase the level or effect of pemigatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors cannot be avoided, reduce selumetinib dosage (refer to selumetinib monograph for further information). After discontinuation of the strong or moderate CYP3A4 inhibitor for 3 elimination half-lives, resume selumetinib dose that was taken before initiating the inhibitor.
- perphenazine
perphenazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- pexidartinib
fluconazole will increase the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pexidartinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.
- pitolisant
fluconazole and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- prochlorperazine
prochlorperazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- promazine
promazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- promethazine
promethazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- protriptyline
protriptyline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- ranolazine
fluconazole will increase the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- Saccharomyces boulardii
fluconazole decreases effects of Saccharomyces boulardii by unspecified interaction mechanism. Avoid or Use Alternate Drug. Systemic or oral antifungals may decrease activity of probiotic.
- selumetinib
fluconazole will increase the level or effect of selumetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors cannot be avoided, reduce selumetinib dosage (refer to selumetinib monograph for further information). After discontinuation of the strong or moderate CYP3A4 inhibitor for 3 elimination half-lives, resume selumetinib dose that was taken before initiating the inhibitor.
- sevoflurane
sevoflurane and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- silodosin
fluconazole will increase the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- simvastatin
fluconazole will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- siponimod
fluconazole will increase the level or effect of siponimod by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with drugs that cause moderate CYP2C9 AND a moderate or strong CYP3A4 inhibition is not recommended. Caution if siponimod coadministered with moderate CYP2C9 inhibitors alone.
fluconazole will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor is not recommended.
siponimod and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. - sirolimus
fluconazole will increase the level or effect of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- sotalol
fluconazole and sotalol both increase QTc interval. Avoid or Use Alternate Drug. Avoid combination if possible. Potential for increased risk of QT prolongation.
- tazemetostat
fluconazole will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of tazemetostat with moderate CYP3A4 inhibitors. If coadministration is unavoidable, reduce tazemetostat current dose (see drug monograph Dosage Modifications).
- tetrabenazine
tetrabenazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- thioridazine
thioridazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- tofacitinib
fluconazole increases levels of tofacitinib by decreasing metabolism. Avoid or Use Alternate Drug. Reduce tofacitinib dose to 5 mg qDay when coadministered with 1 or more concomitant medications that result in both moderate CYP3A4 inhibition and potent CYP2C19 inhibition.
- tolvaptan
fluconazole will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- trazodone
trazodone and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- trifluoperazine
trifluoperazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- trimipramine
trimipramine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- umeclidinium bromide/vilanterol inhaled
fluconazole increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- vandetanib
fluconazole, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.
- vemurafenib
vemurafenib and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.
- venetoclax
fluconazole will increase the level or effect of venetoclax by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If a moderate CYP3A inhibitor must be used, reduce the venetoclax dose by at least 50%. Monitor more closely for signs of venetoclax toxicities.
- vilanterol/fluticasone furoate inhaled
fluconazole increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- vilazodone
fluconazole increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.
- ziprasidone
fluconazole and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (227)
- acalabrutinib
fluconazole will increase the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease acalabrutinib dose to 100 mg once daily if coadministered with a moderate CYP3A inhibitor.
- albuterol
albuterol and fluconazole both increase QTc interval. Use Caution/Monitor.
- almotriptan
fluconazole will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- alprazolam
fluconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- amitriptyline
fluconazole will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
fluconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - amlodipine
fluconazole will increase the level or effect of amlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- apomorphine
apomorphine and fluconazole both increase QTc interval. Use Caution/Monitor.
- aprepitant
fluconazole will increase the level or effect of aprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- arformoterol
arformoterol and fluconazole both increase QTc interval. Use Caution/Monitor.
- aripiprazole
fluconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- artemether/lumefantrine
fluconazole will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- atogepant
fluconazole will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- atomoxetine
atomoxetine and fluconazole both increase QTc interval. Use Caution/Monitor.
- atorvastatin
fluconazole will increase the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- avanafil
fluconazole will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inhibitors may reduce avanafil clearance increasing systemic exposure to avanafil; increased levels may result in increased associated adverse events; the maximum recommended dose of STENDRA is 50 mg, not to exceed once every 24 hours for patients taking concomitant moderate CYP3A4 inhibitors
- avatrombopag
fluconazole will increase the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. When treating ITP, coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inhibitor requires a decreased avatrombopag starting dose. Refer to drug monograph for specific recommendations.
- azithromycin
azithromycin and fluconazole both increase QTc interval. Use Caution/Monitor.
- bazedoxifene/conjugated estrogens
fluconazole will increase the level or effect of bazedoxifene/conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- bedaquiline
fluconazole and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- belzutifan
fluconazole will increase the level or effect of belzutifan by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Belzutifan is a CYP2C19 substrate. Coadministration with CYP2C19 inhibitors may increase incidence or severity of adverse effects. Monitor for anemia and hypoxia and reduce belzutifan dose as recommended.
- bexarotene
fluconazole will increase the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- bortezomib
fluconazole will increase the level or effect of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- brexpiprazole
fluconazole will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP3A4 inhibitor PLUS a strong/moderate CYP2D6 inhibitor.
- budesonide
fluconazole will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- buprenorphine subdermal implant
fluconazole will increase the level or effect of buprenorphine subdermal implant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor patients already on buprenorphine subdermal implant who require newly-initiated treatment with CYP3A4 inhibitors for signs and symptoms of overmedication. If the dose of the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, implant removal may be necessary and the patient should then be treated with a buprenorphine dosage form that permits dose adjustments. If a CYP3A4 inhibitor is discontinued in a patient who has been stabilized on buprenorphine, monitor the patient for withdrawal.
- buprenorphine, long-acting injection
fluconazole will increase the level or effect of buprenorphine, long-acting injection by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Patients who transfer to buprenorphine long-acting injection from transmucosal buprenorphine coadministered with CYP3A4 inhibitors should be monitored to ensure buprenorphine plasma levels are adequate. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose occur and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, transition the patient back to a buprenorphine formulation that permits dose adjustments.
- buspirone
fluconazole will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cabazitaxel
fluconazole will increase the level or effect of cabazitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A4 inhibitors.
- cabozantinib
fluconazole will increase the level or effect of cabozantinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cannabidiol
fluconazole will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor.
fluconazole will increase the level or effect of cannabidiol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a strong CYP2C19 inhibitor. - carbamazepine
fluconazole will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor plasma levels when used concomitantly
- carvedilol
fluconazole will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- chloroquine
chloroquine increases toxicity of fluconazole by QTc interval. Use Caution/Monitor.
- chlorpropamide
fluconazole increases levels of chlorpropamide by decreasing metabolism. Use Caution/Monitor.
- cilostazol
fluconazole will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction to 50 mg twice daily should be considered
- cinacalcet
fluconazole will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- citalopram
fluconazole will increase the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Citalopram 20 mg/day is the maximum recommended dose for patients taking CYP2C19 inhibitors because of the risk of QT prolongation. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- clobazam
fluconazole will increase the level or effect of clobazam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Dosage adjustment may be required; CYP2C19 inhibitors may result in increased exposure to N-desmethylclobazam (active metabolite).
- clopidogrel
fluconazole increases effects of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Clopidogrel efficacy may be reduced by drugs that inhibit CYP3A4. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metabolized to this active metabolite in part by CYP3A4. .
- clozapine
fluconazole will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- conivaptan
fluconazole will increase the level or effect of conivaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- conjugated estrogens
fluconazole will increase the level or effect of conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- conjugated estrogens, vaginal
fluconazole will increase the level or effect of conjugated estrogens, vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cortisone
fluconazole will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- crizotinib
crizotinib and fluconazole both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
fluconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - cyclosporine
fluconazole will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- daridorexant
fluconazole will increase the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Daridorexant dose should not exceed 25 mg per night when coadministered with moderate CYP3A4 inhibitors.
- darifenacin
fluconazole will increase the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- darunavir
fluconazole will increase the level or effect of darunavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dasatinib
fluconazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely. - deflazacort
fluconazole will increase the level or effect of deflazacort by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease deflazacort dose to one-third of the recommended dose if coadministered with moderate or strong CYP3A4 inhibitors.
fluconazole and deflazacort both decrease serum potassium. Use Caution/Monitor. - degarelix
degarelix and fluconazole both increase QTc interval. Use Caution/Monitor.
- deutetrabenazine
deutetrabenazine and fluconazole both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dexamethasone
fluconazole will increase the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- diazepam
fluconazole will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- diazepam intranasal
fluconazole will increase the level or effect of diazepam intranasal by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Strong or moderate CYP2C19 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam.
fluconazole will increase the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam. - dichlorphenamide
dichlorphenamide and fluconazole both decrease serum potassium. Use Caution/Monitor.
- diclofenac
fluconazole will increase the level or effect of diclofenac by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Do not exceed diclofenac dose of 50 mg BID
- dienogest/estradiol valerate
fluconazole will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache.
- diltiazem
fluconazole will increase the level or effect of diltiazem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dolasetron
dolasetron and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- donepezil
donepezil and fluconazole both increase QTc interval. Use Caution/Monitor.
- doxorubicin
fluconazole will increase the level or effect of doxorubicin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- doxorubicin liposomal
fluconazole will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dronabinol
fluconazole will increase the level or effect of dronabinol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Dronabinol is a CYP2C9 substrate.
- efavirenz
efavirenz and fluconazole both increase QTc interval. Use Caution/Monitor.
- eletriptan
fluconazole will increase the level or effect of eletriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- eluxadoline
fluconazole increases levels of eluxadoline by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP2C9/10 inhibitors.
fluconazole increases levels of eluxadoline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP2C19 inhibitors. - erlotinib
fluconazole will increase the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- escitalopram
fluconazole will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
escitalopram increases toxicity of fluconazole by QTc interval. Use Caution/Monitor. - esomeprazole
fluconazole will increase the level or effect of esomeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- estradiol
fluconazole will increase the level or effect of estradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- estrogens conjugated synthetic
fluconazole will increase the level or effect of estrogens conjugated synthetic by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- estrogens esterified
fluconazole will increase the level or effect of estrogens esterified by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- estropipate
fluconazole will increase the level or effect of estropipate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ethinylestradiol
fluconazole will increase the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ethotoin
fluconazole will increase the level or effect of ethotoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- etonogestrel
fluconazole will increase the level or effect of etonogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- etoposide
fluconazole will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- etravirine
fluconazole will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
fluconazole will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
fluconazole will increase the level or effect of etravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - ezogabine
ezogabine, fluconazole. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.
- felodipine
fluconazole will increase the level or effect of felodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fesoterodine
fluconazole will increase the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- finerenone
fluconazole will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed.
- fingolimod
fingolimod and fluconazole both increase QTc interval. Use Caution/Monitor.
- flecainide
flecainide and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- flibanserin
fluconazole will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Coadministration of flibanserin with strong CYP2C19 inhibitors may increase flibanserin exposure and increase the risk of hypotension, syncope, and CNS depression.
- fludrocortisone
fluconazole will increase the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fluoxetine
fluconazole and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.
- fluvoxamine
fluvoxamine and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- fosamprenavir
fluconazole will increase the level or effect of fosamprenavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fosaprepitant
fluconazole will increase the level or effect of fosaprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- foscarnet
fluconazole and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.
- fosphenytoin
fluconazole will increase the level or effect of fosphenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- fostemsavir
fluconazole and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gadobenate
gadobenate and fluconazole both increase QTc interval. Use Caution/Monitor.
- gemifloxacin
gemifloxacin and fluconazole both increase QTc interval. Use Caution/Monitor.
- gemtuzumab
fluconazole and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- glimepiride
fluconazole increases levels of glimepiride by decreasing metabolism. Use Caution/Monitor.
- glipizide
fluconazole increases levels of glipizide by decreasing metabolism. Use Caution/Monitor.
- glyburide
fluconazole increases levels of glyburide by decreasing metabolism. Use Caution/Monitor.
fluconazole increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism. - goserelin
goserelin increases toxicity of fluconazole by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- granisetron
granisetron and fluconazole both increase QTc interval. Use Caution/Monitor.
- guanfacine
fluconazole will increase the level or effect of guanfacine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Strong or moderate CYP3A4 inhibitors significantly increase guanfacine plasma concentrations. FDA-approved labeling for extended-release (ER) guanfacine recommends that, if coadministered, the guanfacine dosage should be decreased to half of the recommended dose. Specific recommendations for immediate-release (IR) guanfacine are not available.
- histrelin
histrelin increases toxicity of fluconazole by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- hydrocortisone
fluconazole will increase the level or effect of hydrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- hydroxyprogesterone caproate (DSC)
fluconazole will increase the level or effect of hydroxyprogesterone caproate (DSC) by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and fluconazole both increase QTc interval. Use Caution/Monitor.
- ifosfamide
fluconazole will decrease the level or effect of ifosfamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use of a CYP3A4 inhibitor may decrease metabolism of ifosfamide, potentially reducing ifosfamide therapeutic effects.
- iloperidone
fluconazole will increase the level or effect of iloperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fluconazole and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely. - imipramine
fluconazole will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- indacaterol, inhaled
indacaterol, inhaled, fluconazole. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
- indinavir
fluconazole will increase the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- irinotecan
fluconazole will increase the level or effect of irinotecan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- irinotecan liposomal
fluconazole will increase the level or effect of irinotecan liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- isavuconazonium sulfate
fluconazole will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ivacaftor
fluconazole will increase the level or effect of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce ivacaftor dose if coadministered with moderate CYP3A4 inhibitors. See specific ivacaftor-containing product for precise dosage modification.
- ivosidenib
fluconazole will increase the level or effect of ivosidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with moderate CYP3A4 inhibitors may increase ivosidenib plasma concentrations, thus increasing the risk of QTc prolongation. Monitor for increased risk of QTc interval prolongation.
- ixabepilone
fluconazole will increase the level or effect of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lacosamide
fluconazole increases levels of lacosamide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Consider decreasing lacosamide dose when coadministered with strong CYP2C9 inhibitors.
- lapatinib
fluconazole will increase the level or effect of lapatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fluconazole and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely. - lefamulin
fluconazole will increase the level or effect of lefamulin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for adverse effects if lefamulin is coadministered with moderate CYP3A inhibitors.
- lenvatinib
fluconazole and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.
- lesinurad
fluconazole will increase the level or effect of lesinurad by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.
- leuprolide
leuprolide increases toxicity of fluconazole by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- levamlodipine
fluconazole will increase the level or effect of levamlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with moderate and strong CYP3A inhibitors results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is coadministered with CYP3A inhibitors to determine the need for dose adjustment.
- levofloxacin
fluconazole and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- lithium
lithium and fluconazole both increase QTc interval. Use Caution/Monitor.
- lopinavir
fluconazole will increase the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- loratadine
fluconazole will increase the level or effect of loratadine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- losartan
fluconazole will increase the level or effect of losartan by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. May inhibit the conversion of losartan to its active metabolite E-3174. Importance of interaction not established; monitor individual therapeutic response to determine losartan dosage.
- lumateperone
fluconazole will increase the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce lumateperone dose to 21 mg/day if coadministered with moderate CYP3A4 inhibitors.
- lumefantrine
fluconazole will increase the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lurasidone
fluconazole increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Manufacturer recommends decreasing starting dose of lurasidone to 20 mg/day and maximum daily dose of lurasidone 80 mg when coadministered with moderate CYP3A4 inhibitors. Concurrent use may increase risk of lurasidone-related adverse reactions.
- maraviroc
fluconazole will increase the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- mavacamten
fluconazole will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose.
- mefloquine
fluconazole will increase the level or effect of mefloquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- mestranol
fluconazole will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- methadone
fluconazole will increase the level or effect of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fluconazole and methadone both increase QTc interval. Modify Therapy/Monitor Closely. - methylprednisolone
fluconazole will increase the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- midazolam
fluconazole will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- mifepristone
fluconazole will increase the level or effect of mifepristone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
mifepristone, fluconazole. Either increases toxicity of the other by QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available. - mipomersen
mipomersen, fluconazole. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
- naldemedine
fluconazole increases levels of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with strong or moderate CYP3A4 inhibitors.
- nateglinide
fluconazole will increase the level or effect of nateglinide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- nelfinavir
fluconazole will increase the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nevirapine
fluconazole increases levels of nevirapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
- nicardipine
fluconazole will increase the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nilotinib
fluconazole will increase the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nisoldipine
fluconazole will increase the level or effect of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ofloxacin
fluconazole and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- olanzapine
olanzapine and fluconazole both increase QTc interval. Use Caution/Monitor.
- oliceridine
fluconazole will increase the level or effect of oliceridine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.
- olodaterol inhaled
fluconazole and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias
- omeprazole
fluconazole will increase the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- osilodrostat
osilodrostat and fluconazole both increase QTc interval. Use Caution/Monitor.
- osimertinib
osimertinib and fluconazole both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.
- ospemifene
fluconazole increases levels of ospemifene by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely.
fluconazole increases levels of ospemifene by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. - oxaliplatin
oxaliplatin will increase the level or effect of fluconazole by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- ozanimod
ozanimod and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- palbociclib
fluconazole will increase the level or effect of palbociclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- paliperidone
fluconazole and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- parecoxib
fluconazole will increase the level or effect of parecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- paroxetine
fluconazole and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.
- pasireotide
fluconazole and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- pazopanib
fluconazole and pazopanib both increase QTc interval. Use Caution/Monitor.
- phenytoin
fluconazole will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- posaconazole
fluconazole and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- prednisone
fluconazole will increase the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- primaquine
primaquine and fluconazole both increase QTc interval. Use Caution/Monitor.
- quetiapine
fluconazole will increase the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
quetiapine, fluconazole. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT. - quinine
fluconazole and quinine both increase QTc interval. Use Caution/Monitor.
- ranolazine
fluconazole and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.
- repaglinide
fluconazole will increase the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rifampin
rifampin decreases levels of fluconazole by increasing metabolism. Use Caution/Monitor.
- rilpivirine
fluconazole increases levels of rilpivirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No rilpivirine dose adjustment is required. Clinically monitor for breakthrough fungal infections when azole antifungals are co-administered with rilpivirine.
rilpivirine increases toxicity of fluconazole by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes. - rimegepant
fluconazole will increase the level or effect of rimegepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid repeating rimegepant dose within 48 hr if coadministered with a moderate CYP3A4 inhibitor.
- risperidone
fluconazole and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- ritonavir
fluconazole will increase the level or effect of ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rivaroxaban
fluconazole increases levels of rivaroxaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Patients with renal impairment receiving rivaroxaban with moderate CYP3A4 inhibitors may have significant increases in exposure compared with patients with normal renal function and no inhibitor use; increased may increase bleeding risk.
- romidepsin
fluconazole will increase the level or effect of romidepsin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fluconazole and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely. - ruxolitinib
fluconazole will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ruxolitinib topical
fluconazole will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- saquinavir
fluconazole will increase the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- selpercatinib
selpercatinib increases toxicity of fluconazole by QTc interval. Use Caution/Monitor.
- sertraline
sertraline and fluconazole both increase QTc interval. Use Caution/Monitor.
- sildenafil
fluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
fluconazole and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- solifenacin
fluconazole will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- sonidegib
fluconazole will increase the level or effect of sonidegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid coadministration of sonidegib with moderate CYP3A4 inhibitors. If a moderate CYP3A inhibitor must be used, administer the moderate CYP3A inhibitor for <14 days and monitor closely for adverse reactions, particularly musculoskeletal adverse reactions.
- sorafenib
sorafenib and fluconazole both increase QTc interval. Use Caution/Monitor.
- sparsentan
fluconazole will increase the level or effect of sparsentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dosage adjustment needed. Monitor blood pressure, serum potassium, edema, and kidney function regularly if sparsentan is coadministered with moderate CYP3A4 inhibitors.
- sufentanil SL
fluconazole will increase the level or effect of sufentanil SL by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of sufentanil SL with any CYP3A4 inhibitor may increase sufentanil plasma concentration, and, thereby increase or prolonged adverse effects, including potentially fatal respiratory depression.
- sulfamethoxazole
sulfamethoxazole and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- sunitinib
fluconazole will increase the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- suvorexant
fluconazole will increase the level or effect of suvorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease suvorexant starting dose to 5 mg HS if coadministered with moderate CYP3A4 inhibitors
- tacrolimus
fluconazole will increase the level or effect of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tadalafil
fluconazole will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tamoxifen
fluconazole, tamoxifen. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. CYP2C9/10 inhibition decreases tamoxifen metabolism to active metabolites.
- tamsulosin
fluconazole increases levels of tamsulosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- telavancin
fluconazole and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.
- temsirolimus
fluconazole will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- terbinafine
fluconazole will increase the level or effect of terbinafine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- tezacaftor
fluconazole will increase the level or effect of tezacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust tezacaftor dosage regimen if coadministered with a moderate CYP3A inhibitor.
- theophylline
fluconazole will increase the level or effect of theophylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tinidazole
fluconazole will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tipranavir
fluconazole will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tofacitinib
fluconazole increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No specific dose adjustment recommended when tofacitinib coadministered with moderate CYP3A4 inhibitors; decrease tofacitinib dose if coadministered with both moderate CYP3A4 and potent CYP2C19 inhibitors.
fluconazole increases levels of tofacitinib by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. No specific dose adjustment recommended when tofacitinib coadministered with potent CYP2C19 inhibitors; decrease tofacitinib dose if coadministered with both moderate CYP3A4 and potent CYP2C19 inhibitors . - tolazamide
fluconazole increases levels of tolazamide by decreasing metabolism. Use Caution/Monitor.
- tolbutamide
fluconazole increases levels of tolbutamide by decreasing metabolism. Use Caution/Monitor.
- tolterodine
fluconazole will increase the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- trabectedin
fluconazole will increase the level or effect of trabectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- trazodone
fluconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- triamcinolone acetonide injectable suspension
fluconazole will increase the level or effect of triamcinolone acetonide injectable suspension by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- triazolam
fluconazole will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- trimethoprim
fluconazole and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.
- triptorelin
triptorelin increases toxicity of fluconazole by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- tropisetron
fluconazole and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.
- valbenazine
valbenazine and fluconazole both increase QTc interval. Use Caution/Monitor.
- vardenafil
fluconazole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors
- venlafaxine
fluconazole and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.
- verapamil
fluconazole will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- voclosporin
fluconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, fluconazole. Either increases effects of the other by QTc interval. Use Caution/Monitor.
voclosporin, fluconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - voriconazole
fluconazole and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- vorinostat
vorinostat and fluconazole both increase QTc interval. Use Caution/Monitor.
- warfarin
fluconazole will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. If coadministered, consider decreasing warfarin dose by 10-20%.
- zanubrutinib
fluconazole will increase the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce zanubrutinib (a CYP3A4 substrate) to 80 mg PO BID to when coadministered with a moderate CYP3A4 inhibitor. Interrupt dose as recommended for adverse reactions. After discontinuing the CYP3A4 inhibitor, resume previous dose of zanubrutinib.
Minor (86)
- alfentanil
fluconazole will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- alfuzosin
fluconazole will increase the level or effect of alfuzosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- alosetron
fluconazole will increase the level or effect of alosetron by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
fluconazole will increase the level or effect of alosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - ambrisentan
fluconazole will increase the level or effect of ambrisentan by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.
- amikacin
fluconazole decreases levels of amikacin by unknown mechanism. Minor/Significance Unknown.
- amobarbital
amobarbital decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- armodafinil
fluconazole will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- atazanavir
fluconazole will increase the level or effect of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- bosentan
fluconazole will increase the level or effect of bosentan by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
fluconazole will increase the level or effect of bosentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - butabarbital
butabarbital decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- butalbital
butalbital decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- caffeine
fluconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.
- celecoxib
fluconazole will increase the level or effect of celecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- cevimeline
fluconazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- chlordiazepoxide
fluconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.
- cimetidine
fluconazole will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.
- clarithromycin
fluconazole will increase the level or effect of clarithromycin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- dapsone
fluconazole will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- diazepam
fluconazole will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.
- disopyramide
fluconazole will increase the level or effect of disopyramide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- docetaxel
fluconazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- donepezil
fluconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- dutasteride
fluconazole will increase the level or effect of dutasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- efavirenz
fluconazole will increase the level or effect of efavirenz by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- eplerenone
fluconazole will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- estradiol vaginal
fluconazole will increase the level or effect of estradiol vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- eucalyptus
fluconazole will increase the level or effect of eucalyptus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- finasteride
fluconazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- flucytosine
flucytosine increases effects of fluconazole by pharmacodynamic synergism. Minor/Significance Unknown.
- flurbiprofen
fluconazole will increase the level or effect of flurbiprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- fluvastatin
fluconazole will increase the level or effect of fluvastatin by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- galantamine
fluconazole will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- gentamicin
fluconazole decreases levels of gentamicin by unknown mechanism. Minor/Significance Unknown.
- ibuprofen
fluconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- ibuprofen IV
fluconazole will increase the level or effect of ibuprofen IV by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- imatinib
fluconazole will increase the level or effect of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- isradipine
fluconazole will increase the level or effect of isradipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- itraconazole
fluconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ketoconazole
fluconazole will increase the level or effect of ketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- kolanut
fluconazole increases levels of kolanut by decreasing metabolism. Minor/Significance Unknown.
- lansoprazole
fluconazole will increase the level or effect of lansoprazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.
fluconazole will increase the level or effect of lansoprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - levoketoconazole
fluconazole will increase the level or effect of levoketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- losartan
fluconazole decreases effects of losartan by decreasing metabolism. Minor/Significance Unknown. May inhibit the conversion of losartan to its active metabolite E-3174. Importance of interaction not established; monitor individual therapeutic response to determine losartan dosage.
- meloxicam
fluconazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- mestranol
fluconazole decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.
- montelukast
fluconazole will increase the level or effect of montelukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- neomycin PO
fluconazole decreases levels of neomycin PO by unknown mechanism. Minor/Significance Unknown.
- nifedipine
fluconazole will increase the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Consider initiating nifedipine at the lowest dose available if given concomitantly with this medication
- nimodipine
fluconazole will increase the level or effect of nimodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nitrendipine
fluconazole will increase the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- oxybutynin
fluconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- paclitaxel
fluconazole will increase the level or effect of paclitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- paclitaxel protein bound
fluconazole will increase the level or effect of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- pantoprazole
fluconazole will increase the level or effect of pantoprazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.
- parecoxib
fluconazole will increase the level or effect of parecoxib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- paromomycin
fluconazole decreases levels of paromomycin by unknown mechanism. Minor/Significance Unknown.
- pentobarbital
pentobarbital decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- phenobarbital
phenobarbital decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- pimozide
fluconazole will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- pioglitazone
fluconazole will increase the level or effect of pioglitazone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- piroxicam
fluconazole will increase the level or effect of piroxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- primidone
primidone decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- propafenone
fluconazole will increase the level or effect of propafenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- quinine
fluconazole will increase the level or effect of quinine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- rabeprazole
fluconazole will increase the level or effect of rabeprazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.
fluconazole will increase the level or effect of rabeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - ramelteon
fluconazole will increase the level or effect of ramelteon by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
fluconazole will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - rifabutin
rifabutin decreases levels of fluconazole by increasing metabolism. Minor/Significance Unknown.
- rifampin
fluconazole decreases levels of rifampin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Only applies to oral preparations of both agents.
- saxagliptin
fluconazole will increase the level or effect of saxagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- secobarbital
secobarbital decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- streptomycin
fluconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.
- sufentanil
fluconazole will increase the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- sulfamethoxazole
fluconazole will increase the level or effect of sulfamethoxazole by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- tamoxifen
fluconazole, tamoxifen. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. CYP3A4 inhibition decreases metabolism of tamoxifen to N-desmethyl tamoxifen (active metabolite with similar biologic activity).
- tobramycin
fluconazole decreases levels of tobramycin by unknown mechanism. Minor/Significance Unknown.
- tolbutamide
fluconazole will increase the level or effect of tolbutamide by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- vinblastine
fluconazole will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- vincristine
fluconazole will increase the level or effect of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- vincristine liposomal
fluconazole will increase the level or effect of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- vinorelbine
fluconazole will increase the level or effect of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- voriconazole
fluconazole will increase the level or effect of voriconazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.
fluconazole will increase the level or effect of voriconazole by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown. - zaleplon
fluconazole will increase the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- zidovudine
fluconazole increases levels of zidovudine by decreasing metabolism. Minor/Significance Unknown.
- ziprasidone
fluconazole will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- zolpidem
fluconazole will increase the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- zonisamide
fluconazole will increase the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
Adverse Effects
>10%
Headache (2-13%)
1-10%
Nausea (2-7%)
Abdominal pain (2-6%)
Diarrhea (2-3%)
Rash (2%)
Vomiting (2-5%)
Frequency Not Defined
QT prolongation
Torsades de pointes
Alopecia
Anaphylactic reactions
Angioedema
Cholestasis
Dizziness
Dyspnea
Hepatic failure
Hepatitis
Hypertriglyceridemia
Hypokalemia
Increased alkaline phosphatase
Increased ALT/AST
Jaundice
Leukopenia
Pallor
Seizures
Stevens-Johnson syndrome
Taste perversion
Thrombocytopenia
Toxic epidermal necrolysis
Warnings
Contraindications
Hypersensitivity
Pregnancy
Concurrent QT-prolonging drugs that are metabolized via the enzyme CYP3A4 (cisapride, erythromycin, pimozide, and quinidine)
Cautions
Hypersensitivity to other azoles
Use caution in proarrhythmic conditions and renal impairment
Use extreme caution or avoid in congenital long-QT patients and patients with conditions that increase QT-prolongation risk
Fluconazole inhibits CYP2C9, CYP2C19, and CYP3A4 isoenzymes; coadministration with drugs that are substrates if these isoenzymes may be contraindicated or warrant dosage modifications
Capsules contain lactose and should not be given to patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption
Powder for oral suspension contains sucrose and should not be used in patients with hereditary fructose, glucose/galactose malabsorption or sucrase-isomaltase deficiency
Syrup contains glycerol; may cause headache, stomach upset, and diarrhea
Hepatotoxicity reported with use; use with caution in patients with hepatic impairment
Rare exfoliative skin disorders reported; monitor closely if rash develops and discontinue if it progresses
When driving vehicles or operating machines, it should be taken into account that dizziness or seizures may occasionally occur
Candida krusei is inherently resistant
Convenience and efficacy of single dose oral tablet of fluconazole regimen for the treatment of vaginal yeast infections should be weighed against acceptability of higher incidence of drug related adverse events with fluconazole (26%) versus intravaginal agents (16%)
If drug is used during pregnancy or if patient becomes pregnant while taking the drug, patient should be informed of potential hazard to fetus; effective contraceptive measures should be considered in women of child-bearing potential who are being treated with 400 to 800 mg/day and should continue throughout the treatment period and for approximately 1 week (5 to 6 half-lives) after the final dose
Pregnancy & Lactation
Pregnancy
Single maternal PO dose of 150 mg for vaginal candidiasis
- Results of a Danish study concludes there is a possible increased risk of miscarriage; women who are pregnant or actively trying to get pregnant should ask their physician about alternative treatments
- Spontaneous abortion between 7 and 22 weeks' gestation occurred significantly more often in women exposed to oral fluconazole than unexposed pregnancies (4.43% vs. 4.25%; hazard ratio, 1.48); fluconazole was also compared with intravaginal azole antifungals to account for confounding by candidiasis, again, the oral drug was associated with significantly increased risk for spontaneous abortion - JAMA. 2016;315(1):58-67
- CDC guidelines recommend only using topical antifungal products to treat pregnant women with vulvovaginal yeast infections, including for longer periods than usual if these infections persist or recur
All other indications
- Use in pregnancy should be avoided except in patients with severe or potentially life-threatening fungal infections in whom fluconazole may be used if the anticipated benefit outweighs the possible risk to the fetus
- A few published case reports describe a rare pattern of distinct congenital anomalies in infants exposed in-utero to high dose maternal fluconazole (400-800 mg/day) during most or all of the first trimester
- Effective contraceptive measures should be considered in women of child-bearing potential who are being treated with 400-800 mg/day and should continue throughout the treatment period and for approximately 1 week (5 to 6 half-lives) after the final dose
- Reported anomalies are similar to those seen in animal studies and consist of brachycephaly, abnormal facies, abnormal calvarial development, cleft palate, femoral bowing, thin ribs and long bones, arthrogryposis, and congenital heart disease
Lactation
Secreted in human milk at concentrations similar to maternal plasma concentrations; use caution (AAP Committee states "compatible with nursing")
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Highly selective inhibitor of fungal cytochrome P-450-dependent enzyme lanosterol 14-alpha-demethylase
Subsequent loss of normal sterols correlates with accumulation of 14 alpha-methyl sterols in fungi and may be responsible for the fungistatic activity of fluconazole
Absorption
Bioavailability: >90% (oral)
Peak plasma time: 1-2 hr (PO)
Distribution
Vd: 0.6 L/kg; widely distributed throughout body, with good penetration into CSF, eye, peritoneal fluid, sputum, urine and skin
CSF to blood level ratio: 50-90% (normal meninges); >70-80% (inflamed meninges)
Relative diffusion blood into CSF: Adequate with or without inflammation (exceeds MICs)
Protein bound: 11-12%
Metabolism
Liver, partially
Enzymes inhibited: Hepatic CYP2C9 (potent); CYP3A4 (moderate)
Elimination
Half-life: 30 hr (range: 20-50 hrs); 46 hr (elderly)
Excretion: Urine 80% (unchanged drug), 11% (metabolites)
Administration
IV Incompatibilities
Additive: TMP-SMX
Y-site: Amphotericin B, amphotericin B cholesteryl sulfate, ampicillin, calcium gluconate, cefotaxime, ceftazidime(?), ceftriaxone, cefuroxime, chloramphenicol, clindamycin, co-trimoxazole, diazepam, digoxin, erythromycin lactobionate, furosemide, haloperidol, hydroxyzine, imipenem/cilastatin, pentamidine, piperacillin, ticarcillin, TMP-SMX
IV Compatibilities
Solution: D5W, LR
Additive: Acyclovir, amikacin, amphotericin B, cefazolin, ceftazidime, ciprofloxacin, clindamycin, gentamicin, heparin, meropenem, metronidazole, morphine, piperacillin, potassium chloride, ranitidine with ondansetron, theophylline
Y-site: Acyclovir, aldesleukin, allopurinol, amifostine, amikacin, aminophylline, amiodarone, ampicillin-sulbactam, aztreonam, benztropine, bivalirudin, cefazolin, cefepime, cefotetan, cefoxitin, cefpirome, chlorpromazine, cimetidine, cisatracurium, dexamethasone sodium phosphate, dexmedetomidine, diltiazem, diphenhydramine, dobutamine, docetaxel, dopamine, doxorubicin liposomal, droperidol, etoposide PO4, famotidine, fenoldopam, filgrastim, fludarabine, foscarnet, ganciclovir, gatifloxacin, gemcitabine, gentamicin, granisetron, heparin, hetastarch, hydrocortisone, immune globulin, leucovorin, linezolid, lorazepam, melphalan, meperidine, meropenem, metoclopramide, metronidazole, midazolam, morphine, nafcillin, nitroglycerin, ondansetron, oxacillin, paclitaxel, pancuronium, penicillin G, phenytoin, piperacillin-tazobactam, prochlorperazine, promethazine, propofol, quinupristin-dalfopristin, ranitidine, remifentanil, sargramostim, tacrolimus, teniposide, theophylline, thiotepa, ticarcillin-clavulanate, tobramycin, vancomycin, vecuronium, vinorelbine, zidovudine
IV Preparation
Standard diluent: 200 mg/100 mL NS (premixed); 200 mg/200 mL NS (premixed)
Do not use if cloudy or precipitated
IV Administration
IV infusion over approximately 1-2 hr
Maximum infusion rate: 200 mg/hr
To prevent air embolism, do not connect in series with other infusions
Storage
Tablets: Store below 86° F (30°C)
Dry powder: Store below 86° F (30°C); reconstituted suspension should be stored between 41-86° F (5-30°C), and unused portion should be discarded after 2 weeks; protect from freezing
Injection (glass bottles): Store between 41-86° F (5-30°C); protect from freezing
Injection (Viaflex Plus plastic containers): Store between 41-77° F (5-25°C); protect from freezing
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
fluconazole oral - | 150 mg tablet | ![]() | |
fluconazole oral - | 150 mg tablet | ![]() | |
fluconazole oral - | 150 mg tablet | ![]() | |
fluconazole oral - | 100 mg tablet | ![]() | |
fluconazole oral - | 150 mg tablet | ![]() | |
fluconazole oral - | 100 mg tablet | ![]() | |
fluconazole oral - | 200 mg tablet | ![]() | |
fluconazole oral - | 50 mg tablet | ![]() | |
fluconazole oral - | 10 mg/mL suspension | ![]() | |
fluconazole oral - | 200 mg tablet | ![]() | |
fluconazole oral - | 100 mg tablet | ![]() | |
fluconazole oral - | 50 mg tablet | ![]() | |
fluconazole oral - | 200 mg tablet | ![]() | |
fluconazole oral - | 100 mg tablet | ![]() | |
fluconazole oral - | 200 mg tablet | ![]() | |
fluconazole oral - | 200 mg tablet | ![]() | |
fluconazole oral - | 50 mg tablet | ![]() | |
fluconazole oral - | 50 mg tablet | ![]() | |
fluconazole oral - | 200 mg tablet | ![]() | |
fluconazole oral - | 150 mg tablet | ![]() | |
fluconazole oral - | 150 mg tablet | ![]() | |
fluconazole oral - | 100 mg tablet | ![]() | |
fluconazole oral - | 50 mg tablet | ![]() | |
fluconazole oral - | 100 mg tablet | ![]() | |
fluconazole oral - | 40 mg/mL suspension | ![]() | |
fluconazole oral - | 10 mg/mL suspension | ![]() | |
fluconazole oral - | 40 mg/mL suspension | ![]() | |
fluconazole oral - | 10 mg/mL suspension | ![]() | |
fluconazole oral - | 200 mg tablet | ![]() | |
fluconazole oral - | 40 mg/mL suspension | ![]() | |
fluconazole oral - | 150 mg tablet | ![]() | |
fluconazole oral - | 100 mg tablet | ![]() | |
fluconazole oral - | 150 mg tablet | ![]() | |
fluconazole oral - | 50 mg tablet | ![]() | |
Diflucan oral - | 150 mg tablet | ![]() | |
Diflucan oral - | 200 mg tablet | ![]() | |
Diflucan oral - | 40 mg/mL suspension | ![]() | |
Diflucan oral - | 100 mg tablet | ![]() | |
Diflucan oral - | 10 mg/mL suspension | ![]() | |
Diflucan oral - | 50 mg tablet | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
fluconazole oral
FLUCONAZOLE 150 MG - ORAL
(floo-KON-a-zole)
COMMON BRAND NAME(S): Diflucan
USES: Fluconazole is used to treat vaginal yeast infections. It works by stopping the growth of common types of vaginal yeast (fungus). This medication belongs to a class of drugs called azole antifungals.
HOW TO USE: Read the Patient Information Leaflet before you start taking fluconazole and each time you get a refill. If you have any questions, ask your doctor or pharmacist.In Canada, some brands of this medication are available without a prescription. Before taking over-the-counter fluconazole, read the product instructions and talk to your doctor if this is your first vaginal yeast infection, if this is your second infection within 2 months, or if you are considering treatment for a girl under 12 years old.Take this medication by mouth usually as a single dose, with or without food at any time of the day, or as directed by your doctor.The effect of this medication continues for several days. If your condition does not improve after a few days or if it worsens, or if you think you may have a serious medical problem, get medical help right away.
SIDE EFFECTS: Nausea, diarrhea, stomach pain, headache, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.If your doctor has directed you to use this product, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this product do not have serious side effects.Get medical help right away if you have any very serious side effects, including: fast/irregular heartbeat, severe dizziness, fainting.This drug may rarely cause serious liver disease. Get medical help right away if you develop any signs of liver disease, including: nausea/vomiting that doesn't stop, severe stomach/abdominal pain, yellowing eyes/skin, dark urine, unusual tiredness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking fluconazole, tell your doctor or pharmacist if you are allergic to it; or to other azole antifungal drugs (such as ketoconazole, itraconazole); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease.Fluconazole may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using fluconazole, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using fluconazole safely.Although uncommon, this drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby if taken during the first 3 months of pregnancy. Discuss the risks and benefits with your doctor, and ask if you should use a medication applied in or around the vagina instead.Fluconazole passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Products that may interact with this drug include: clopidogrel.Many drugs besides fluconazole may affect the heart rhythm (QT prolongation), including pimozide, quinidine, macrolide antibiotics (such as erythromycin), among others.Fluconazole can slow down the removal of other medications from your body, which can affect how they work. Examples of affected drugs include abrocitinib, asunaprevir, flibanserin, lemborexant, lomitapide, macitentan, mavacamten, among others.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: hallucinations, mental/mood changes.
NOTES: Not applicable.
MISSED DOSE: Not applicable.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised January 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.