Diflucan or Fluconazole is a Imidazole class antifungal agent which acts by inhibiting the fungal Cytochrome P450 enzyme 14-alfa demethylase. By this process, there is stoppage of conversion of Lanosterol to Ergosterol. Ergosterol is a vital ingredient of the structure of the fungal cytoplasmic membrane. Therefore, the growth of fungus is reduced.

Diflucan is primarily fungistatic; this means it inhibits the growth of the organism. But in high concentrations, Diflucan shows some fungicidal (killing property) as well.
Diflucan is prescribed in the cases of fungal infection in the nails, lungs, genital parts, mouth, throat, esophagus (stomach pipe) and urinary bladder. It is also helpful for the persons having weaker immunity such as in the cases of AIDS, bone marrow transplantation and chemotherapy patients.

The following organisms are sensitive to Diflucan:

  • Candida
  • Cryptococcus neoformans
  • Coccidioides immitis
  • Blastomyesis dermatitis
  • Tricophyton
  • Microsporum
  • Histoplasma.

Bioavailability after oral ingestion is almost 100% and the rate of absorption is not essentially related to food. The half life of Diflucan strictly follows Zero-order kinetics as shown by other imidazoles. Only 10% of the total dose taken is eliminated through metabolism of the drug.

Indications of Diflucan:

  • Oral cadidasis
  • Tenia corporis, Tenia capitis, Tenia cruris and Tenia pedis.
  • Fungal infection of the nails (Tenia unguium).
  • Any case of Cryptococcal meningitis (seen in the AIDS patients) should warrant first line treatment by Diflucan.
  • In the immunocompromized persons, prophylaxis through Diflucan is essential for the Candida infection.

Contraindications of Diflucan:
The patients having any previous sensitivity to Diflucan or similar Imidazole antifungal agents like Ketoconazole: should not be prescribed this drug. If the patient is on Cisapride, Diflucan should not be given to prevent severe cardiac complications. Besides, Diflucan is contraindicated for the patients having prolonged QT interval and are on other medicines which stabilizes the heart rate like Digitalis.

Susceptible persons can get deranged liver function as Diflucan can cause hepatotoxicity. Diflucan should be judiciously prescribed for the patients having any kind of pre-existing liver disease.
Diflucan has teratogenic potentiality. Therefore, it should not be prescribed to pregnant mothers and those are planning to have a baby during the treatment period. Besides, Diflucan is secreted in the breast milk and nursing mothers should not be prescribed also.

Doses of Diflucan:
It can be prescribed in the children in the dose of 3-12 mg per Kg of body weight in divided doses. In case of adults, the dose varies from 100-400 mg in divided doses. The duration varies according to the necessity. In the fungal infection of scalp and groin, the duration is generally 2 weeks. But in case of infection in the finger nails it is 4 -6 weeks and for the toe nail infection, the duration is from 6-12 months.

Side effects of Diflucan:
Generally Diflucan is well tolerated. But in some patients, there is nausea, vomiting, rash over the exposed parts of the body, pain abdomen, loss of appetite and constipation. Liver failure, Stevens-Johnson’s Syndrome, thrombocytopenia and Torsades-de-pointes are among the rare and serious complications of long term use of Diflucan.

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