Fluconazole, Oral/Injection

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KEY POINTS

• This medicine is used to treat fungal infections in various parts of the body. It may also be used to prevent fungus infections following bone marrow transplants.
• This medicine may cause severe liver problems. Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Some medicines may cause serious, even fatal, problems if taken with this medicine. Do not drink alcohol while you are taking this medicine.

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What are other names for this medicine?

Type of medicine: antifungal; anti-infective

Generic and brand names: fluconazole, injection; fluconazole, oral; Diflucan

What is this medicine used for?

This medicine is taken by mouth to treat fungal infections in various parts of the body. It may also be used to prevent fungus infections following bone marrow transplants. This medicine does not treat viral infections like the common cold.

This medicine may also be given by IV infusion (slow drip through a needle into a large vein).

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Be sure to tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Heart failure, irregular heartbeat, or other heart disease
• Liver or kidney disease
• Long QT syndrome (problems with electrical activity in the heart muscle)
• Problems with low levels of potassium, magnesium, or calcium in your blood
• Problems digesting dairy products, lactose, or sugar. Some products contain lactose (milk sugar) or sucrose (table sugar).

Some medicines may cause serious, even fatal, problems if taken with this medicine. Tell your healthcare provider about all of the medicines you take.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your healthcare provider's approval, even if you feel better.

Check with your healthcare provider before using this medicine in children.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach. Take the medicine at the same time each day to help you remember to take it. If you are taking the liquid form, shake the bottle well before pouring a dose. Use a specially marked measuring device to measure each dose. The average household teaspoon may not hold the right amount of liquid.

Injections of this medicine are usually given by your healthcare provider.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: confusion, hallucinations, unusual thoughts or behavior.

What should I watch out for?

You need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

In rare cases, this medicine has caused a severe rash that has resulted in death. Contact your healthcare provider immediately if you develop a rash while taking this medicine.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

This medicine may cause severe liver problems. Contact your healthcare provider right away if you develop severe tiredness, loss of appetite, nausea, vomiting, yellowing of your skin or eyes, dark urine, or light-colored bowel movements. These may be symptoms of liver problems.

Do not drink alcohol while you are taking this medicine. Alcohol may increase the risk of liver problems.

This medicine may make you dizzy. Do not drive or operate machinery unless you are fully alert.

If you have diabetes: This medicine may affect your blood sugar level and change the amount of diabetes medicines you may need. Talk to your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; tightness in your chest; swelling of your lips, tongue, or throat; trouble breathing).

Serious (Report these to your healthcare provider right away.): Severe nausea or vomiting; yellowing of your skin or eyes; dark urine; light-colored bowel movements; unexplained loss of appetite; severe stomach pain; skin sores or severe rash; blistered peeling or red skin; seizures; unusual bruising or bleeding; severe dizziness or fainting; severe tiredness or weakness; chest pain; irregular heartbeat; trouble urinating.

Other: headache, hair loss, stomach pain, mild nausea, diarrhea, fever, dizziness, change in sense of taste, unusual taste in your mouth.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alcohol
• Alfentanil (Alfenta)
• Alpha blockers such as alfuzosin (Uroxatral), silodosin (Rapaflo), and tamsulosin (Flomax)
• Antianxiety medicines such as alprazolam (Xanax), diazepam (Valium), midazolam (Versed), and triazolam (Halcion)
• Antiarrhythmic medicines (to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), ivabradine (Corlanor), and quinidine
• Antibiotics such as azithromycin (Zithromax, Zmax), bedaquiline (Sirturo), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), gemifloxacin (Factive), isoniazid, levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin, pentamidine (NebuPent, Pentam), rifabutin (Mycobutin), rifampin (Rifadin), and telithromycin (Ketek)
• Antidepressants such as amitriptyline, citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), imipramine (Tofranil), mirtazapine (Remeron), nefazodone, nortriptyline (Pamelor), and trazodone
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), brexpiprazole (Rexulti), chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), iloperidone (Fanapt), lurasidone (Latuda), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), risperidone (Risperdal), thioridazine, thiothixene (Navane), and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), clobazam (Onfi), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Apomorphine (Apokyn)
• Bosentan (Tracleer)
• Buspirone
• Calcium channel blockers such as amlodipine (Norvasc), amlodipine/atorvastatin (Caduet), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), nimodipine (Nymalize), nisoldipine (Sular), and verapamil (Calan, Covera, Verelan)
• Cancer medicines such as arsenic trioxide (Trisenox), axitinib (Inlyta), bosutinib (Bosulif), busulfan (Busulfex, Myleran), cabozantinib (Cometriq), cobimetinib (Cotellic), crizotinib (Xalkori), cyclophosphamide (Cytoxan), degarelix (Firmagon), docetaxel (Docefrez, Taxotere), everolimus (Afinitor, Zortress), ibrutinib (Imbruvica), ifosfamide (Ifex), imatinib (Gleevec), irinotecan (Camptosar), lapatinib (Tykerb), nilotinib (Tasigna), olaparib (Lynparza), pazopanib (Votrient), regorafenib (Stivarga), ruxolitinib (Jakafi), sonidegib (Odomzo), sorafenib (Nexavar), sunitinib (Sutent), toremifene (Fareston), trabectedin (Yondelis), tretinoin (Atralin, Renova, Retin-A), vandetanib (Caprelsa), vemurafenib (Zelboraf), vinblastine, vincristine (Marqibo), and vinorelbine (Navelbine)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), and simvastatin (Zocor)
• Cinacalcet (Sensipar)
• Colchicine (Colcrys)
• Corticosteroids such as budesonide (Entocort, Rhinocort, Uceris), dexamethasone, fluticasone (Flonase, Flovent, Veramyst), methylprednisolone (Medrol, Solu-Medrol), and prednisone (Prednisone Intensol)
• Diabetes medicines such as chlorpropamide, glipizide (Glucotrol), glyburide (Glynase), and tolbutamide
• Digoxin (Lanoxin)
• Doxepin (Silenor)
• Eletriptan (Relpax) (Do not take antifungal medicines within 72 hours of taking this medicine.)
• Eliglustat (Cerdelga)
• Eplerenone (Inspra)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Ergot medicines such as bromocriptine (Cycloset, Parlodel), dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar), and methylergonovine
• Fingolimod (Gilenya)
• Flibanserin (Addyi)
• HIV medicines such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), etravirine (Intelence), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), maraviroc (Selzentry), nelfinavir (Viracept), nevirapine (Viramune), rilpivirine (Edurant), ritonavir (Norvir), saquinavir (Invirase), tipranavir (Aptivus), and zidovudine (Retrovir)
• Hormonal birth control implants, IUDs, patches, pills, shots, and vaginal rings (Talk to your healthcare provider if you need birth control.)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Lomitapide (Juxtapid)
• Losartan (Cozaar)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• Medicines to block or prevent stomach acid such as dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (AcipHex)
• Medicines to treat breathing or lung problems such as arformoterol (Brovana), formoterol (Perforomist), salmeterol (Serevent), and theophylline
• Medicines to treat low sodium levels such as conivaptan (Vaprisol) and tolvaptan (Samsca)
• Medicines to treat or prevent blood clots such as apixaban (Eliquis), cilostazol (Pletal), clopidogrel (Plavix), rivaroxaban (Xarelto), and warfarin (Coumadin)
• Mifepristone (Korlym, Mifeprex)
• Naloxegol (Movantik)
• Nausea medicines such as aprepitant (Emend), dolasetron (Anzemet), granisetron (Sancuso), and ondansetron (Zofran)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), flurbiprofen, ibuprofen (Advil, Motrin), meloxicam (Mobic), naproxen (Aleve, Anaprox, Naprelan), and piroxicam (Feldene)
• Ospemifene (Osphena)
• Other antifungal medicines such as amphotericin b (Abelcet, AmBisome, Amphotec), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Pain medicines such as codeine (Tylenol #3), fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), methadone (Dolophine, Methadose), oxycodone (OxyContin, Roxicodone), tapentadol (Nucynta), and tramadol (ConZip, Ultram)
• Ranolazine (Ranexa)
• Sleeping pills such as ramelteon (Rozerem) and zolpidem (Ambien, Edluar, Intermezzo)
• St. John's wort
• Stimulants such as armodafinil (Nuvigil) and modafinil (Provigil)
• Tofacitinib (Xeljanz)
• Tolterodine (Detrol)

Ask your healthcare provider or pharmacist if you need to avoid products that contain grapefruit, Seville oranges, and tangelos while you are taking this medicine. These fruits and juices can affect the way this medicine works and may increase your risk of serious side effects.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

Shake the liquid suspension well before using. Discard any unused liquid medicine after 2 weeks.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.