Diflucan

The drug Diflucan (Diflucan) contains the active ingredient fluconazole and belongs to the class of antimycotic (antifungal) agents. It is often used to treat various fungal infections such as candidiasis (including thrush), cryptococcosis, histoplasmosis, coccidioidomycosis and others.

Diflucan is available in various forms including capsules, oral solution, powder for preparation of solution for intravenous injection, and others. It is usually used according to the doctor's recommendations or instructions for use, which depend on the type of fungal infection, its localization and severity.

Diflucan is usually well tolerated, but as with any medicine, it can cause side effects including nausea, vomiting, diarrhea, headache, and others. Before starting treatment, you should consult your doctor to determine the correct dosage and duration of treatment, especially if there are any health problems or other medications being taken.

Indications Diflucan

1. Candidiasis (thrush): Diflucan is widely used to treat vaginal candidiasis vaginal candidiasis in women and urethritis in men caused by Candida albicans.
2. Oropharyngeal candidiasis: Infection with Candida fungus in the mouth and throat.
3. Esophageal candidiasis: Fungal infection of the esophagus caused by Candida.
4. Candidiasis of the skin: Fungal infection of the skin, including mycoses of the feet, scalp, and other skin lesions.
5. Cryptococcosis: A fungal infection caused by Cryptococcus neoformans that most commonly involves the lungs, skin, and nervous system.
6. Coccidioidomycosis: A fungal infection caused by the fungus Coccidioides immitis or Coccidioides posadasii that usually affects the lungs.
7. Histoplasmosis: A fungal infection caused by Histoplasma capsulatum that can affect the lungs and other organs.

Release form

1. Tablets: Diflucan comes in the form of oral (by mouth) tablets. The tablets may have different dosages depending on the patient's medical needs and the type of infection.
2. Suspension: For those who have difficulty swallowing tablets, Diflucan can be given as a suspension (liquid form) for oral administration. This is especially useful for children or patients with swallowing difficulties.
3. Intravenous solution: In some cases, when more intensive or faster treatment is needed, Diflucan may be given as an intravenous solution. This is usually done in health care facilities under the supervision of medical staff.

Pharmacodynamics

Diflucan is an antifungal medication that is used to treat various fungal infections such as candidiasis (yeast infections), cryptococcosis (infections caused by cryptococci), and other fungal diseases.

The mechanism of action of Diflucan is related to its ability to inhibit the synthesis of ergosterol, an important component of the cell membrane in fungi. Ergosterol maintains the structural integrity of the fungal cell membrane, and its inhibition leads to a disruption of membrane integrity and a fungicidal (fungus-killing) effect.

In addition, fluconazole affects the activity of cytochrome P450, an enzyme involved in the metabolism of many drugs. It inhibits the activity of cytochrome P450, which may lead to an increase in the concentration of some medicines in the blood, especially those that are also metabolized by this enzyme.

However, it should be noted that fluconazole does not affect human cytochrome P450 to a significant degree, so its potential for drug interactions is limited.

Pharmacokinetics

1. Absorption: Fluconazole is rapidly and completely absorbed from the gastrointestinal tract after oral administration. It is available as tablets, capsules and intravenous solution.
2. Metabolism: Fluconazole is metabolized in the liver with formation of inactive metabolites. It is predominantly metabolized by oxidation with the participation of cytochrome P450 enzymes.
3. Excretion: Approximately 80-90% of a fluconazole dose is excreted unchanged through the kidneys within 72 hours after dosing. Approximately 11% of the dose is excreted through the intestine.
4. Concentration: Stable concentrations of fluconazole in the blood are usually reached 1-2 hours after oral administration.
5. Pharmacodynamics: Fluconazole is an inhibitor of ergosterol synthesis in fungi cells, which disrupts their membrane integrity and leads to their death.
6. Duration of action: Once taken orally, fluconazole has a prolonged duration of action, allowing it to be used as a single or short-term regimen to treat many fungal infections.
7. Interactions with other drugs: Fluconazole may interact with other drugs, including those that are also metabolized by cytochrome P450 enzymes in the liver, which may result in changes in their blood concentrations.

Dosing and administration

The dosage and route of administration of Diflucan (fluconazole) may vary depending on the type of infection, its severity, and the individual characteristics of the patient. However, here are the general recommendations:

1. Dosage for adults:

   • For the treatment of vaginal candidiasis: usually a single dose of 150 mg.
   • For the treatment of oral, esophageal, skin, breast or urinary candidiasis: usually an initial dose of 200-400 mg followed by a maintenance dose of 100-200 mg daily.
   • For the prevention of candidiasis in patients with compromised immune systems: the usual dose is 100-400 mg per day.

2. Dosage for children:

   • For children with fungal infections, dosage is usually calculated based on weight and severity of infection, and can range from 3 mg/kg to 12 mg/kg.

3. Duration of treatment:

   • The duration of the course usually depends on the type of infection and the severity of the disease. It usually lasts from a few days to a few weeks.

4. Method of Application:

   • Diflucan tablets are usually taken orally, with a little water, regardless of meals.
   • For children or patients who cannot swallow tablets, there are other forms of release such as suspension.

Use Diflucan during pregnancy

The use of Diflucan during pregnancy requires special attention.

There is some concern about the potential effects of diflucan on fetal development, especially when used in the first trimester of pregnancy, based on research findings. Some studies have associated the use of diflucan during pregnancy with an increased risk of birth defects in the child, including various malformations.

Because of this, many doctors prefer to avoid prescribing Diflucan to pregnant women, especially in the first trimester when the fetus' organs and systems are forming. Instead, alternative treatments or antifungal medications that are safe for pregnancy are usually recommended.

However, if diflucan treatment is needed during pregnancy, the doctor may decide to prescribe it after weighing the potential risks to the mother and baby.

Contraindications

1. Hypersensitivity or allergic reaction to fluconazole or other components of the drug.
2. Period of pregnancy, if the benefit of use does not exceed the potential risks to the fetus. In this case, the use of "Diflucan" requires special caution and medical supervision.
3. Period of breastfeeding, as fluconazole may be excreted into breast milk.
4. Individual characteristics of the patient, such as the presence of serious liver or kidney dysfunction. In this case, dosage adjustment or complete absence of "Diflucan" use may be required.
5. Aging. In elderly patients, the use of "Diflucan" may require special attention and regular doctor's supervision due to possible age-related changes in body functions.
6. The use of "Diflucan" in children requires special attention and supervision by a doctor, since the dosage and regimen may differ from adult patients.
7. Interaction with other medicinal products. Patients taking certain drugs, such as triazolam, terfenadine, cyclosporine, etc., may be contraindicated to use Diflucan due to possible interaction.

Side effects Diflucan

1. Gastrointestinal disorders: For example, nausea, vomiting, diarrhea, dyspepsia (digestive disorders), abdominal pain.
2. Liver disorders: Increased levels of liver enzymes in the blood (ALT, AST), which may indicate liver damage.
3. Hematopoietic disorders: Reduced whiteblood cell, platelet, or red blood cell counts may occur.
4. Nervous system: Headache, dizziness, drowsiness, taste changes.
5. Skin reactions: Rash, itching, skin redness, angioedema (edema of the skin and mucous membranes).
6. Allergic reactions: Including allergic dermatitis, angioedema, anapylactic shock (in rare cases).
7. Other Reactions: Cardiac arrhythmias, generalized weakness, anorexia may occur.
8. Increasedrisk of hepatitis B: Some patients, especially those with impaired liver function, may experience increased levels of hepatitis B virus after taking Diflucan.

Overdose

1. Worseningof undesirable effects: Overdose may lead to an increase in side effects associated with the use of Diflucan, such as nausea, vomiting, diarrhea, dizziness, drowsiness, and there may be an increase in the activity of liver enzymes.
2. Serious complications: In case of serious overdose, more serious complications may develop, such as liver dysfunction, increased risk of GI bleeding and even the development of hepatic failure.
3. Medical intervention: If an overdose of Diflucan is suspected, medical attention should be sought immediately. Treatment of overdose may include measures to eliminate the drug from the body, maintenance of vital functions, and symptomatic therapy.
4. Avoiding overdose: To prevent overdose, the doctor's recommendations regarding the dosage and regimen of Diflucan should be strictly followed. You should not exceed the recommended dose without consulting your doctor.
5. Prevention of overdose: It is also important to warn the patient about possible consequences of overdose and regularly assess the patient's condition during treatment.

Interactions with other drugs

1. Cyclosporine: Diflucan may increase the concentration of cyclosporine in the blood, which may increase its toxic effects on the kidneys and other organs.
2. Hypoglycemic drugs (e.g. Sulfonylurea, insulin): Diflucan may enhance the hypoglycemic effects of these drugs, which may lead to an increase in blood glucose levels. Blood glucose levels should be carefully monitored in patients taking Diflucan together with hypoglycemic drugs.
3. Warfarin: Diflucan may increase the concentration of warfarin in the blood, which may increase its anticoagulant effect and increase the risk of bleeding.
4. Cycloserine: Diflucan may increase the concentration of cycloserine in the blood, which may lead to an increase in its toxic effects on the nervous system.
5. Terfenadine and astemizole: Combination of diflucan with these drugs may lead to increased QT-interval on ECG and risk of cardiac arrhythmias.