Fluconazole is a triazole antifungal medication used in the treatment of various fungal infections. It is available in both oral and parenteral formulations. Liver damage has been reported with fluconazole use, but most commonly it is benign elevated liver transaminases. Acute liver failure (ALF) in fluconazole use is rare, with cases being reported sporadically in literature and large cohorts describing incidence rates of acute liver injury ranging from 0.0 to 31.6/10,000 patients. We present a case of a 45-year-old African-American male with no history of liver disease who presented with superficial candidiasis and superimposed bacterial cellulitis. He was subsequently started on intravenous fluconazole and clindamycin. Shortly after he developed ALF and a drug-induced liver injury (DILI) was suspected. Fluconazole and itraconazole are considered safe drugs that occasionally have been associated with slight alterations of liver function tests that usually do not require interruption of treatment. The mechanism of the toxicity is not elucidated although an idiosyncratic reaction appears to be involved. We report two cases with marked liver toxicity due to fluconazole and itraconazole, respectively, in whom discontinuation of the azoles was required and that resolved rapidly after discontinuation of the drugs. We have also carried out a review of the literature searching for other reported cases of liver toxicity due to these agents.
My question is this - my doctor's nurse just told me that they didn't want to prescribe me any additional Rx for this because it can damage the liver. I've checked the whites of my eyes and there is no yellowing what-so-ever. After only 4 days it is so much better but I do not know if results are temporary. I have been taking ketoconazole for about 1.5 months (just stopped taking it) and am now taking 100mg fluconazole and 250mg lamisil pills at the same time once per day. being treated for fingernail fungus and taking fluconazole tabs and using same in ointment and skin is much worse,redder, doctor stopped use of tablets waiting for blood work for liver possible liver damage. I have had this very painful condition for7 months. I know a little bit about this testing and having an elevated reading could be liver damage. I am wondering what medications could possilbe effect this test, if any. I am also wondering if I should be very concerned with my results. i to have the same thing ive had it for years and is agervating itchy painful and scaly and i hate it my doctor has me on fluconazole 200mg i take 1 every two days and wash my hair with Nizoral you can get it at wallmart its for stuff like bin taking the pills for about a little over two months and shampoo for two weeks and my ringworm is almost gone no more flakes you get the shampoo please get up with me so i can tell you proper way to use for your condition. I would not think there is a clash with having Lyme and taking and an '-azole' medication, but your Lyme doc *and* the doc who prescribed the -azole meds should both be aware that you are on it just so everybody's on the same page. I seem to recall it should not be taken indefinitely, due to possible damage to the [liver? ], but don't stop taking it without your doc's approval -- he's got you on it for a reason, and it should be given a chance to work. Tetracycline, Isoniazid and Rifampin have prolonged half life in patients with liver cirrhosis. The use of fluconazole has been rarely associated with hepatotoxicity. Reversible idiosyncratic hepatitis, cholestasis and fatal fulminant hepatic failure have been reported, the latter occurring primarily in patients with serious underlying medical conditions and taking multiple concomitant medications. Liver function tests should be performed periodically in patients with preexisting hepatic abnormalities, particularly during prolonged therapy. Treatment should be withdrawn if persistent elevations or worsening of liver enzyme levels occur. Most of the azole antifungals have been associated with prolongation of the QT interval. There have been postmarketing rare reports of QT prolongation, and torsade de pointes usually involving patients with risk factors such as structural heart disease, electrolyte abnormalities, and concomitant medications. These drugs should be administered with caution to patients with potentially proarrhythmic conditions.
Fluconazole is a first-generation triazole antifungal medication. It differs from earlier azole antifungals (such as ketoconazole) in that its structure contains a triazole ring instead of an imidazole ring. While the imidazole antifungals are mainly used topically, fluconazole and certain other triazole antifungals are preferred when systemic treatment is required because of their improved safety and predictable absorption when administered orally. Fluconazole's spectrum of activity includes most Candida species (but not Candida krusei or Candida glabrata), Cryptococcus neoformans, some dimorphic fungi, and dermatophytes, among others. Common uses include: Fungal resistance to drugs in the azole class tends to occur gradually over the course of prolonged drug therapy, resulting in clinical failure in immunocompromised patients (e.g., patients with advanced HIV receiving treatment for thrush or esophageal Candida infection). albicans, resistance occurs by way of mutations in the ERG11 gene, which codes for 14α-demethylase. These mutations prevent the azole drug from binding, while still allowing binding of the enzyme's natural substrate, lanosterol. glabrata is increasing the rate of efflux of the azole drug from the cell, by both ATP-binding cassette and major facilitator superfamily transporters. Development of resistance to one azole in this way will confer resistance to all drugs in the class. Other gene mutations are also known to contribute to development of resistance. In New Zealand, fluconazole is available as 50 mg, 150 mg and 200 mg capsules on prescription (Diflucan®). There is also a 2 mg/ml injection for intravenous use. In New Zealand, Pharmaceutical Schedule subsidy of the capsules requires Specialist recommendation. Fluconazole binds to the fungal p450 enzymes and stops the cells making ergosterol, the main component of the cell wall. Fluconazole is well absorbed orally with or without food. It takes 22 to 30 hours for half of the medication to be cleared from the blood stream and may take several days of continuous treatment to reach a steady concentration. The drug is eliminated unchanged in the urine so doses should be reduced if there is kidney disease. For versicolor, either 50 mg daily or 150 mg once weekly is taken for two to six weeks.
People with liver problems Fluconazole can cause liver problems. If you already have liver problems, talk to yourYour doctor should monitor your kidney and liver function while you take this drug. Find patient medical information for Fluconazole Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.