DESCRIPTION
Fluconazole is an oral antifungal medication that is used to treat a wide range of fungal diseases.
Although a drug called amphotericin B is currently the FDA-approved drug to treat endophthalmitis caused by fungal infection, there are concerns about its potential to cause renal damage and the need to administer it by intravenous infusion, as reported in the Archives of the Spanish Society of Ophthalmology.
Those risks are raised when it is given in conjunction with certain other drugs that the patient may be taking. In those instances, the physician may look to off-label anti-fungal drugs, such as fluconazole.
ORIGINAL USES (ON-LABEL)
Treatment of various fungal and yeast infections.
NEWLY DISCOVERED USES (OFF-LABEL)
Endophthalmitis
POTENTIAL SIDE EFFECTS
Headache, rash, nausea, vomiting, abdominal pain, diarrhea, upset stomach, taste perversion, serious skin reactions, liver toxicity.
CAUTIONS
- Do not take this drug at the same time as cisapride.
- Notify your doctor if you have impaired liver or kidney function or if you have developed liver problems while taking other antifungals.
- This drug has caused (rarely) serious problems with liver function or skin reactions and may require monitoring during multiple dose therapy. Notify your doctor immediately if you develop abdominal pain, jaundice (yellowing of skin), dark urine, or rash.
DRUG INTERACTIONS
Rifampin, cisapride, amiodarone, selected benzodiazepines, calcium channel blockers,
citalopram, cyclosporine,
diazepam,
ergot derivatives,
fluoxetine, glimepiride, glipizide, statin drugs (such as lovastatin,
atorvastatin, etc.), methsuximide, mirtazapine, nateglinide, nefazodone, phenytoin,
pioglitazone, propranolol,
rosiglitazone,
sertraline,
sildenafil,
tadalafil,
tacrolimus,
venlafaxine, warfarin.
FOOD INTERACTIONS
May be taken with or without regard to food.
HERBAL INTERACTIONS
Unknown
PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category C. Excreted in breast milk. Consult your doctor.
SPECIAL INFORMATION
This drug is often used as single dose therapy to treat some vaginal yeast infections.
The Spanish Society reported on the case of a patient with endophthalmitis due to the fungus Candida parapsilosis.
The person was treated with amphotericin without success.
Subsequently, the person was treated simultaneously with two off-label drugs - topical fluconazole and oral itraconazole - and they appeared to be effective in controlling the infection.
Additionally, oral fluconazole may be administered as reported by Indian researchers at the Joseph Eye hospital.
They reported at a recent conference that in some cases oral fluconazole may be more effective than oral itraconazole because of its high water-soluble properties, which allow it to be absorbed into the body faster.
An earlier study reported in the Journal of Ocular Pharmacological Therapy had shown no retinal toxicity with Diflucan infusion and that it was effective in the treatment of experimental endophthalmitis due to the fungus candida.
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