Fluconazole
Brand Names: Diflucan
Methodology & AI Transparency ⓘ
Fluconazole Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Indications and usage: Fluconazole Tablets are indicated for the treatment of: Vaginal candidiasis (vaginal yeast infections due to Candida ).
- 2 Real-world patient consensus: 89% patient "Worth It" rating across 14 anonymous logs for Fluconazole (RxNorm 197698).
- 3 Typical cash cost range: Public pharmacy ledger: $7.29 low cash benchmark vs. $34.50 chain retail average ($0.2921/unit CMS NADAC).
- 4 Top reported side effects / signs: Primary clinical safety signals tracked in FAERS for Fluconazole include diarrhea (9.5%), nausea (7.8%), headache (5.2%).
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Fluconazole Mechanism, CYP450 Pathways & DailyMed Monograph
Indications and usage: Fluconazole Tablets are indicated for the treatment of: Vaginal candidiasis (vaginal yeast infections due to Candida ). Oropharyngeal and esophageal candidiasis. In open noncomparative studies of relatively small numbers of patients, Fluconazole Tablets were also effective for the treatment of Candida urinary tract infections, peritonitis, and systemic Candida infections including candidemia, disseminated candidiasis, and pneumonia. Cryptococcal meningitis. Before prescribing Fluconazole Tablets for AIDS patients with cryptococcal meningitis, please see CLINICAL STUDIES section.
CLINICAL PHARMACOLOGY Pharmacokinetics and Metabolism The pharmacokinetic properties (PK) of fluconazole are similar following administration by the intravenous or oral routes. In normal volunteers, the bioavailability of orally administered fluconazole is over 90% compared with intravenous administration. Bioequivalence was established between the 100 mg tablet and both suspension strengths when administered as a single 200 mg dose.
Following administration (150 mg/1 Tablet), Fluconazole achieves ~90% systemic bioavailability (Fluconazole) bioavailability and peak plasma concentration (tmax) reached 1–4 hours post-dose for fluconazole onset, governed by a Approximately 9–19 hours terminal plasma half-life for Fluconazole terminal half-life through hepatic oxidation via cyp3a4/cyp2c9/cyp2c19 followed by renal and biliary excretion of fluconazole metabolites.
Before initiating Fluconazole at 150 mg/1 Tablet, clinical safety checklists rule out contraindications fluconazole is contraindicated in patients who have shown hypersensitivity to fluconazole or to any of its excipients.; there is no information regarding cross-hypersensitivity between fluconazole and other azole antifungal agents.; caution should be used in prescribing fluconazole to patients with hypersensitivity to other azoles.. Logged tolerability patterns center on diarrhea (9.5% of reports), nausea (7.8% of reports), headache (5.2% of reports).
Strong CYP3A4 blockade slows first-pass metabolism of Fluconazole, elevating systemic AUC exposure.
Potent CYP3A4 modulators alter hepatic clearance of Fluconazole, shifting steady-state plasma concentrations.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- CONTRAINDICATIONS Fluconazole is contraindicated in patients who have shown hypersensitivity to fluconazole or to any of its excipients.
- There is no information regarding cross-hypersensitivity between fluconazole and other azole antifungal agents.
- Caution should be used in prescribing fluconazole to patients with hypersensitivity to other azoles.
Logged Side-Effect Incidence (14 Reports)
Fluconazole Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Fluconazole)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| New Insights on Phase 3 study evaluating the safety and real-world benefits of oteseconazole in: What a 219-Participant Study Found In participants with recurrent vulvovaginal candidiasis, oteseconazole was safe and efficacious in the treatment and prevention of recurrent acute vulvovaginal candidiasis episodes and was noninferior to vulvovaginal... American journal of obstetrics and gynecology • 2022-12-15 • Phase III Randomized Trial | N = 219 | 88/100 | PMID 35863457 ↗ |
| New Insights on Oteseconazole versus fluconazole for the treatment of severe vulvovaginal: What a 322-Participant Study Found No subjects discontinued study treatment or withdrew study due to side effects. Antimicrobial agents and chemotherapy • 2024-01-10 • Phase III Randomized Trial | N = 322 | 87/100 | PMID 38095426 ↗ |
Fluconazole Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $0.2921/unit (~$8.76/30u) | Wholesale baseline |
| Mark Cuban Cost Plus Drugs (Mail-Order Generic) | Public Wholesale Price List (NADAC + 15% + pharmacy fee) | $7.29 / mo | Formulary listing ↗ |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $34.50 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 14 Anonymous DotMD Community Micro-Logs | $8.38 / mo | View logs ↓ |
Fluconazole Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Fluconazole RxNorm Concept ID | 197698 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.2921 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $34.50 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $7.29 / mo (Cost Plus Drugs) | Mark Cuban Cost Plus Public API |
| Real-World Patient Consensus | 89.00% Worth It (14 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Fluconazole Patient Community, Cohort Filters & Dosage Logs
Evidence synthesis for Fluconazole: FDA labeling (2026-02-10, NDC 51407-424), CYP/interaction screening, and public pharmacy acquisition costs.
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Filter Fluconazole community threads and patient logs by age, biological sex, dosage, and treatment duration.