Fluconazole (intravenous route)


    Brand Name

    US Brand Name

    Diflucan IV

    Canadian Brand Name

    Diflucan


    Description

    Fluconazole injection is used to treat serious fungal or yeast infections, including oropharyngeal candidiasis (thrush, oral thrush), esophageal candidiasis (candida esophagitis), other candida infections (including urinary tract infections, peritonitis [inflammation of the lining of the stomach], and infections that may occur in different parts of the body), or fungal (cryptococcal) meningitis. It is also used in children on life support called extracorporeal membrane oxygenation (ECMO). This medicine works by killing the fungus or yeast, or preventing its growth.

    Fluconazole injection is also used to prevent candidiasis in patients having bone marrow transplants, who receive cancer or radiation treatment.

    This medicine is to be given only by or under the direct supervision of a doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of fluconazole injection for the treatment of oropharyngeal candidiasis in children 6 months to 13 years of age, for the treatment of esophageal candidiasis, other candida infections, or fungal (cryptococcal) meningitis in children, and for children on ECMO. Safety and efficacy have been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fluconazole injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving fluconazole injection.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Alfuzosin
    • Amiodarone
    • Aripiprazole
    • Aripiprazole Lauroxil
    • Artemether
    • Atazanavir
    • Bedaquiline
    • Bepridil
    • Buprenorphine
    • Cisapride
    • Citalopram
    • Clarithromycin
    • Clozapine
    • Crizotinib
    • Dabrafenib
    • Dasatinib
    • Deuruxolitinib
    • Dofetilide
    • Domperidone
    • Donepezil
    • Dronedarone
    • Ebastine
    • Encorafenib
    • Entrectinib
    • Erythromycin
    • Escitalopram
    • Etrasimod
    • Flibanserin
    • Glasdegib
    • Granisetron
    • Haloperidol
    • Iloperidone
    • Itraconazole
    • Ivabradine
    • Ivosidenib
    • Ketoconazole
    • Lapatinib
    • Levoketoconazole
    • Levomethadyl
    • Lomitapide

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Abrocitinib
    • Acalabrutinib
    • Acenocoumarol
    • Adagrasib
    • Ajmaline
    • Alfentanil
    • Alprazolam
    • Amisulpride
    • Amitriptyline
    • Amoxapine
    • Anagrelide
    • Anisindione
    • Apixaban
    • Apomorphine
    • Aprepitant
    • Aprindine
    • Arsenic Trioxide
    • Asenapine
    • Atorvastatin
    • Avanafil
    • Avapritinib
    • Avatrombopag
    • Azilsartan
    • Azilsartan Medoxomil
    • Azithromycin
    • Belzutifan
    • Benzhydrocodone
    • Bosutinib
    • Bretylium
    • Brexpiprazole
    • Brigatinib
    • Brotizolam
    • Budesonide
    • Buserelin
    • Buspirone
    • Capivasertib
    • Carbamazepine
    • Carvedilol
    • Celecoxib
    • Ceritinib

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Amlodipine
    • Atevirdine
    • Losartan
    • Nicardipine
    • Prednisone
    • Ramelteon
    • Rifapentine
    • Rivaroxaban
    • Tretinoin
    • Trimetrexate

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Electrolyte problems (mineral imbalance) or
    • Heart disease—Use with caution. These conditions may increase your chance of having heart rhythm problems and make the effects of this medicine worse.
    • Heart rhythm problems (eg, QT prolongation) or
    • Liver disease—Use with caution. May make these conditions worse.
    • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    A nurse or other trained health professional will give you or your child this medicine. This medicine is given through an IV catheter placed in one of your veins.

    Your doctor will give you or your child a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.


    Precautions

    It is very important that your doctor check the progress of you or your child at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

    If your or your child's symptoms do not improve, or if they become worse, check with your doctor. You may need to use this medicine for several months before your infection gets better.

    You or your child should not use erythromycin (Ery-Tab®), pimozide (Orap®), or quinidine (Cardioquin®) while receiving this medicine because of the risk of unwanted side effects.

    Using this medicine for a long time or using it too much while you are pregnant (especially during the first trimester) can harm your unborn baby. Use an effective form of birth control during treatment with this medicine and for at least 1 week after the last dose. If you think you have become pregnant while using this medicine, tell your doctor right away.

    This medicine may rarely cause serious liver problems. Check with your doctor right away if you or your child have stomach pain or tenderness, clay-colored stools, dark urine, decreased appetite, fever, headache, itching, loss of appetite, nausea and vomiting, skin rash, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin.

    This medicine may rarely cause a serious type of allergic reaction, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you or your child have a rash, itching, swelling of the face, tongue, and throat, trouble breathing, or chest pain after you receive the medicine.

    Serious skin reactions can occur in certain people during treatment with this medicine. Check with your doctor right away if you or your child start having a skin rash, itching, or any other skin changes while using this medicine.

    Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem including QT prolongation.

    This medicine may cause adrenal gland problems. Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

    This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    Rare

    • Chest tightness
    • chills
    • clay-colored stools
    • cough
    • dark urine
    • diarrhea
    • difficulty with swallowing
    • dizziness
    • fast heartbeat
    • fever
    • headache
    • hives, itching, or skin rash
    • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
    • light-colored stools
    • loss of appetite
    • nausea and vomiting
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • stomach pain, continuing
    • unpleasant breath odor
    • unusual tiredness or weakness
    • upper right abdominal or stomach pain
    • vomiting of blood
    • yellow eyes and skin

    Incidence not known

    • Black, tarry stools
    • blistering, peeling, or loosening of the skin
    • chest pain or discomfort
    • decreased urine
    • dry mouth
    • fainting
    • hoarseness
    • increased thirst
    • irregular or slow heart rate
    • joint or muscle pain
    • loss of bladder control
    • lower back or side pain
    • mood changes
    • muscle pain or cramps
    • muscle spasm or jerking of all extremities
    • numbness or tingling in the hands, feet, or lips
    • painful or difficult urination
    • pale skin
    • red skin lesions, often with a purple center
    • red, irritated eyes
    • seizures
    • sore throat
    • sores, ulcers, or white spots in the mouth or on the lips
    • sudden loss of consciousness
    • swollen glands
    • unusual bleeding or bruising

    Get emergency help immediately if any of the following symptoms of overdose occur:

    Symptoms of overdose

    • Fearfulness, suspiciousness, or other mental changes
    • seeing, hearing, or feeling things that are not there

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Acid or sour stomach
    • belching
    • change in taste or bad, unusual, or unpleasant (after) taste
    • heartburn
    • indigestion
    • stomach discomfort or upset

    Incidence not known

    • Hair loss or thinning of the hair

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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